Evidence for the effectiveness of patch testing and the need for an expanded series that provides experience and evidence-based suggestions for an extended patch testing series are examined in this review. Many of those testing with shorter allergen series are interested in expanding the spectrum of patch testing. The American Contact Dermatitis Society (ACDS) Core Allergen Series Group has arranged a group of suggested allergen groups that can be logically scaled up or down depending on the needs of the patch tester and the community being tested. This is not an “ACDS 80 Standard.” We suggest a core group of allergens similar to the TRUE Test (SmartPractice, Phoenix, Ariz) with subsequent trays providing a greater breadth of coverage in a logical fashion, with more likely allergens being higher in the tray. For more extensive testing, specialty trays (ie, cosmetics, metals, plant, etc) are recommended.
Get full access to this article
View all access options for this article.
References
1.
DickelH, AltmeyerP, BraschJ. “New” techniques for more sensitive patch testing?. J Dtsch Dermatol Ges, 2011; 9 (11): 889–896.
2.
NethercottJR.Practical problems in the use of patch testing in the evaluation of patients with contact dermatitis. Curr Probl Dermatol, 1990; 2: 97–123.
3.
KadykDL, McCarterK, AchenF, et al..Quality of life in patients with allergic contact dermatitis. J Am Acad Dermatol, 2003; 49: 1037–1048.
4.
DiepgenTL, CoenraadsPJ. Sensitivity, specificity and positive predictive value of patch testing: the more you test, the more you get?. Contact Dermatitis, 2000; 42: 315–317.
5.
UterW, SchnuchA, GefellerO. Guidelines for the descriptive presentation and statistical analysis of contact allergydata. Contact Dermatitis, 2004; 51: 47–56.
6.
NethercottJR, HolnessDL. Validity of patch test screening trays in the evaluation of patients with allergic contact dermatitis. J Am Acad Dermatol, 1989; 21: 568.
7.
BourkeJF, BattaK, PraisL, et al..The reproducibility of patch tests. Br J Dermatol, 1999; 140: 102–105.
8.
GollhausenR, PrzybillaB, RingJ. Reproducibility of patch tests. J Am Acad Dermatol, 1989; 21: 1196–1202.
9.
LindelöfB.A left versus right side comparative study of Finn Chamber patch tests in 220 consecutive patients. Contact Dermatitis, 1990; 22: 288–289.
10.
BraschJ, HenselerT, AbererW, et al..Reproducibility of patch tests: a multicenter study of synchronous left- versus rightsided patch tests by the German Contact Dermatitis Research Group. J Am Acad Dermatol, 1994; 31: 584–591.
11.
LarkinA, RietschelRL. The utility of patch tests using larger screening series of allergens. Am J Contact Dermat, 1998; 9 (3): 142–145.
12.
PatelD, BelsitoDV. The detection of clinically relevant contact allergens with a standard screening tray of 28 allergens. Contact Dermatitis, 2012; 66: 154–158.
13.
WetterDA, YianniasJA, PrakashAV, et al..Results of patch testing to personal care product allergens in a standard series and a supplemental cosmetic series: an analysis of 945 patients from the Mayo Clinic Contact Dermatitis Group, 2000–2007. J Am Acad Dermatol, 2010; 63: 789–798.
14.
CohenDE, RaoS, BrancaccioRR. Use of the North American Contact Dermatitis Group Standard 65-Allergen Series alone in the evaluation of allergic contact dermatitis: a series of 794 patients. Dermatitis, 2008; 19: 137–141.
15.
WarshawEM, BelsitoDV, TaylorJS, et al.. North American Contact Dermatitis Group Patch Test Results: 2009-2010. Submitted 9/21/12 Dermatitis DER-11-110.
16.
MatthieuL, DockxP. Discrepancy in patch test results with wool wax alcohols and Amerchol L-101. Contact Dermatitis, 1997; 36: 150–151.
17.
BelsitoDV.Thimerosal: contact (non)allergen of the year. Am J Contact Dermat, 2002; 13: 1–2.
18.
MalinauskieneL, BruzeM, RybergK, et al.. Contact allergy from disperse dyes in textiles-a review. Contact Dermatitis 2012. [Epub ahead of print].
19.
BrincaA, CabralR, GonçaloM. Contact allergy to local anaesthetics-value of patch testing with a caine mix in the baseline series. Contact Dermatitis 2012. [Epub ahead of print].
20.
SpringS, PrattM, ChaplinA. Contact dermatitis to topical medicaments: a retrospective chart review from the Ottawa hospital patch test clinic. Dermatitis, 2012; 23 (5): 210–213.
21.
DavisMD, WangMZ, YianniasJA, et al..Patch testing with a large series of metal allergens: findings from more than 1,000 patients in one decade at Mayo Clinic. Dermatitis, 2011; 22 (5): 256–271.
22.
SchaffranRM, StorrsFJ, SchalockP. Prevalence of gold sensitivity in asymptomatic individuals with gold dental restorations. Am J Contact Dermatitis, 1999; 10: 201–206.
23.
NedorostS, WagmanA. Positive patch-test reactions to gold: patients’ perception of relevance and the role of titanium dioxide in cosmetics. Dermatitis, 2005; 16 (2): 67–70; quiz 55-6.
