Dermatitis®

Allergic contact dermatitis is a significant cause of both occupational and non-occupational skin disease. Patch testing is an important diagnostic tool for the determination of responsible allergens.

This study reports the results of patch testing by the North American Contact Dermatitis Group from January 1, 2003, to December 31, 2004.

At 13 centers in North America, patients were tested with the same screening series of 65 allergens, with a standardized patch-testing technique. Data were recorded on standardized forms and manually verified and entered. Descriptive frequencies were calculated, and trends were analyzed with chi-square statistics.

A total of 5,148 patients were tested. Of these, 3,432 (66.7%) had at least one positive reaction, 2,284 (44.4%) were ultimately determined to have primary allergic contact dermatitis, and 676 (13.1%) had occupation-related skin disease. There were 9,762 positive allergic reactions. Compared to the previous reporting period (2001-2002), allergies to nickel, budesonide, mercaptobenzothiazole, and paraben mix were at least 1.12 times more common (all p values < .03). Compared with the previous 8 years (1994-2002), only the prevalence rates of allergies to nickel and budesonide were statistically significantly higher (p values < .003).

Allergic contact dermatitis from nickel and budesonide may be increasing in North America. These results again underscore the value of patch-testing with many allergens.

The “gold standard” for diagnosing allergic contact dermatitis is patch testing. Previous studies have not adequately addressed the validity and usefulness of the North American Contact Dermatitis Group (NACDG) Standard 65-allergen series alone as a screening tool in the evaluation of contact dermatitis.

The purpose of this study is to examine the usefulness of the NACDG series of 65 allergens as an exclusive screening method in the diagnosis of contact allergy.

A retrospective chart review of 794 patients referred for patch testing with the NACDG Screening Series with or without additional allergens was performed to determine the number of positive patch-test results. The study groups were analyzed to identify whether the positive reactions were to allergens in the NACDG Standard Series or to allergens in the supplementary group.

Of the 794 patients patch-tested between July 1, 2004, and July 1, 2006, 590 (74.31%) had a positive reaction to either an NACDG patch-tested allergen or a supplemental allergen; 386 (65.42%) patients testing positive for an allergen were positive to an NACDG allergen only, and 534 (90.51%) of the total positive reactors were positive for at least one NACDG test allergen.

As a screening tool, the NACDG Standard Series is substantially more efficacious than are more limited standard series when used exclusively in the evaluation of patients with allergic contact dermatitis. More extensive testing, including testing with suspected supplementary allergens determined by thorough history and physical examination, can improve upon the NACDG series as a means to investigate the full causes of contact dermatitis in any individual patient.

Contact dermatitis is a universal condition. Patch testing is an effective diagnostic tool for clinically suspected allergic contact dermatitis. Previous studies have shown that the prevalence of specific allergens varies by geographic area.

To determine the relative frequency of positive reactions to different sensitizers in Thai patients with clinically suspected contact dermatitis.

The results of patch tests performed from January 1, 2004, to December 31, 2006, at the Siriraj Hospital Contact Dermatitis Clinic were analyzed. A total of 323 consecutive patients (83% women and 17% men, with mean age of 39 years) were patch-tested with the total number of allergens used from both European standard patch test series and International patch test series was 26.

The most frequent allergen was potassium dichromate (27%), followed by nickel sulfate (26.6%), fragrance mix (20.7%), and cobalt chloride (16.4%).

We compared the results with published findings in Asian-Pacific populations to identify geographic cultural differences in the prevalence of the allergens. The findings of the present study are able to identify the set of prominent local allergens for better revision of the standard patch test to local needs.

Although contact allergy to some metals is common, patch testing for allergy to platinum is rarely performed.

To determine the prevalence of positive patch-test reactions to platinum in an unselected consecutive group of patients presenting for diagnostic patch testing.

Unselected patients who presented with a possible diagnosis of contact dermatitis were tested with a series of allergens, including ammonium tetrachloroplatinate 0.25% aqueous.

Of 446 patients tested, only 2 females showed positive reactions to platinum; one had no other positive reactions, and the other had reactions to other metals.

Positive patch-test reactions to platinum are rare. However, platinum jewelry may occasionally provoke allergic contact dermatitis.