The Final Patch Test Read: Day 5 or Day >7?

Published on Jan 1, 2020in Dermatitis4.845
· DOI :10.1097/DER.0000000000000562
Hafsa M. Cantwell3
Estimated H-index: 3
(Mayo Clinic),
Lisa A. Drage20
Estimated H-index: 20
(Mayo Clinic)
+ 4 AuthorsMark D. P. Davis21
Estimated H-index: 21
Sources
Abstract
BACKGROUND: A major question in patch testing is when to perform the final reading. Our current standard practice is to place patches on day 1, remove them on day 3, and perform readings on days 3 and 5. For certain allergens, another reading is performed sometime from days 7 to 14. OBJECTIVES: The aim of the study was to identify allergens with positive reactions on day 5 that were negative on day 7 or later and allergens with negative reactions on day 5 that were subsequently positive on day 7 or later. METHODS: We reviewed records of patients who underwent patch testing from January 2007 to December 2016 at Mayo Clinic with readings on day 5 and day 7 or later. CONCLUSIONS: In total, 131 allergens had positive reactions on day 5 that were negative on day 7 or later, and 58 allergens had negative reactions on day 5 that were positive on day 7 or later. Twenty-five allergens had significantly higher reaction rates on day 5 than day 7 or later. Our standard practice is to perform readings on days 3 and 5 and on days 3, 5, and 7 or later for series containing metals. Readings on days 3, 5, and 7 or later should also be considered for acrylates.
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References14
Newest
#1Kevin K. VeverkaH-Index: 6
#2Matthew R. Hall (Mayo Clinic)H-Index: 6
Last. Mark D. P. DavisH-Index: 21
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BackgroundPatch testing to a standard (baseline) series of allergens is the screening tool used to identify culprit allergens in patients with contact dermatitis. The allergens and concentrations used in a standard series are constantly evolving to be most relevant to the patients being patch tested
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#1Hafsa M. Chaudhry (Mayo Clinic)H-Index: 6
#2Lisa A. Drage (Mayo Clinic)H-Index: 20
Last. Mark D.P. Davis (Mayo Clinic)H-Index: 52
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Patch-test readings after day 5 have previously been used to identify delayed reactions to metals and topical antibiotics.The aims of this study were to identify allergens for which late readings (beyond day 5) would be most valuable and to compare our results with our previous study on delayed patch-test readings.This was a retrospective study of 298 patients who underwent metal and corticosteroid series patch testing from January 1, 2007, through December 31, 2013. Patch-test readings were con...
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#1Jeanne D. Johansen (UCPH: University of Copenhagen)H-Index: 87
#2Kristiina Aalto-Korte (Finnish Institute of Occupational Health)H-Index: 27
Last. An Goossens (Katholieke Universiteit Leuven)H-Index: 52
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The present guideline summarizes all aspects of patch testing for the diagnosis of contact allergy in patients suspected of suffering, or having been suffering, from allergic contact dermatitis or other delayed-type hypersensitivity skin and mucosal conditions. Sections with brief descriptions and discussions of different pertinent topics are followed by a highlighted short practical recommendation. Topics comprise, after an introduction with important definitions, materials, technique, modifica...
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#1Camilla Ahlgren (Malmö University)H-Index: 7
#2Marléne Isaksson (Lund University)H-Index: 23
Last. Magnus Bruze (Lund University)H-Index: 70
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Objectives Establishing the clinical relevance of contact allergy to dental materials in patients with oral lichen lesions (OLL) may be difficult, and tests are often read only on day 3 or day 4; also, concentration of the tested allergens may vary. Several studies on dermatitis patients have shown that additional positive patch test reactions can be found after day 4. Therefore, the aim of the present study was to analyse the frequency of late positive reactions to potential allergens in patien...
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BACKGROUND: Patch test readings are usually performed on day 2 (48 hours) and day 4 (96 hours). However, reports in the literature identify delayed allergy to metals, corticosteroids, antibiotics, some preservatives, acrylic and methacrylic monomers and p-phenylenediamine. OBJECTIVES: The aim of our study was to identify the benefit of performing a day 7 (168 hours) reading to identify relevant late positive reactions. PATIENTS/METHODS/MATERIALS: Two hundred three consecutive patients were patch...
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#1Anthony F. FranswayH-Index: 25
#2Kathryn A. ZugH-Index: 31
Last. Matthew J. ZirwasH-Index: 26
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BACKGROUND: The North American Contact Dermatitis Group (NACDG) tests patients with suspected allergic contact dermatitis to a broad series of screening allergens and publishes periodic reports. OBJECTIVE: The aims of this study were to report the NACDG patch-testing results from January 1, 2007, to December 31, 2008, and to compare results to pooled test data from the previous 2 and 10 years to analyze trends in allergen sensitivity. METHODS AND MATERIALS: Standardized patch testing with 65 all...
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#1Jakob Torp Madsen (University of Southern Denmark)H-Index: 11
#2Klaus Ejner Andersen (University of Southern Denmark)H-Index: 77
Two readings of patch test reactions are recommended. To evaluate the outcome of a second patch test reading of TRUE TestÂź allergens on D6/7 in relation to negative or doubtful reactions on D3/4. This was a retrospective investigation of patch test data from January 1992 to October 2011 from consecutive eczema patients tested with the TRUE TestÂź panels. In the period of nearly 20 years, a total of 9997 patients were tested. The total number of positive reactions to the 29 allergens was 6509; 4.4...
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#1Uwe Hillen (University of Duisburg-Essen)H-Index: 40
#2Heinrich Dickel (RUB: Ruhr University Bochum)H-Index: 21
Last. Johannes Geier (GAU: University of Göttingen)H-Index: 55
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Background. p-Phenylenediamine (PPD) 1% in petrolatum has been shown in a prospective study to elicit late reactions in 1.5% of routine patch tests, which may be indicative of patch test sensitization. Objectives. To assess the frequency of late reactions to reduced PPD patch test concentrations. Methods. In 1838 patients, PPD was tested at three concentrations (0.5% pet., group I; 0.4% pet., group II; and 0.35% pet., group III). Patch tests were read on D1 (D2) to D3 (D4); additional late readi...
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#1Mark D.P. Davis (Mayo Clinic)H-Index: 52
#2Ketaki BhateH-Index: 3
Last. Amy L. Weaver (Mayo Clinic)H-Index: 110
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Background Some patients may have delayed allergic patch test reactions that are not identified with a typical 5-day reading protocol. Objective To identify allergens with delayed-positive reactions and to determine whether a late reading (day 7-9) can be substituted for the day-5 reading. Methods We retrospectively reviewed medical records of patients who underwent patch testing for suspected allergic contact dermatitis from October 1997 through December 2006 and returned for delayed readings b...
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#1Kristiina Aalto-Korte (Finnish Institute of Occupational Health)H-Index: 27
#2Kristiina Alanko (Finnish Institute of Occupational Health)H-Index: 25
Last. Riitta Jolanki (Finnish Institute of Occupational Health)H-Index: 33
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Late patch test reactions on day (D) 10-14, which on subsequent retesting appear in the normal time schedule on D2-D4, indicate active sensitization due to the patch test. The objective of this study was to report our series of late patch test reactions.We analysed the clinical records of all the patients who had reported late reactions for the date of the late reaction, the results of the first patch tests and retesting. Between January 2002 and February 2006, we had a total of 16 patients with...
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Cited By3
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#1Susann Forkel (GAU: University of Göttingen)H-Index: 6
#2Steffen Schubert (GAU: University of Göttingen)H-Index: 12
Last. Timo Buhl (GAU: University of Göttingen)H-Index: 17
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BACKGROUND Patch test (PT) readings are recommended after 48 h and 72 h (D3). An additional day 7 (D7) reading has been suggested by some, although data on efficient patient selection are scarce. We investigated positive D7 reactions regarding (i) allergens in the baseline series and additional PT series of the German Contact Dermatitis Research Group (DKG) and (ii) characteristics of the patients tested. METHODS Retrospective, multicentre analysis of 190 allergens derived from 17 DKG test serie...
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#1Yasemin Topal YĂŒksel (UCPH: University of Copenhagen)H-Index: 2
#2Farnam Barati Sedeh (UCPH: University of Copenhagen)H-Index: 1
Last. Eecdrg
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Background: It is recommended that patch-test readings include a day (D)7 reading. Substitution of the D7 reading with a photo may be a valid option. Objectives: To compare the sensitivity of digital photos at D7 to clinical readings, to assess the number of positive reactions appearing at D7 only (late reactions), and after D7 only (delayed reactions). Methods: Patients patch tested in six European clinics were instructed to forward photos of the patch test reactions to the respective clinics a...
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#1Holly Neale (UMass: University of Massachusetts Amherst)H-Index: 2
#2Anna Cristina Garza-Mayers (Harvard University)H-Index: 9
Last. JiaDe Yu (Harvard University)H-Index: 12
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Patch testing is the gold standard for diagnosing allergic contact dermatitis. Causative allergens differ between children and adults, necessitating the development of pediatric-specific patch test series. The Pediatric Baseline Series was developed in 2018 through expert-consensus and includes relevant pediatric allergens of which dermatologists can use in practice. Obstacles in patch testing, such as the need for multiple office visits, length of patch application, and avoidance of sweat and w...
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#1Todor A. PopovH-Index: 46
#2Gianni Passalacqua (UniGe: University of Genoa)H-Index: 37
Last. Ignacio J. AnsoteguiH-Index: 31
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Medical devices provide people with some health benefits in terms of diagnosis, prevention, treatment, and monitoring of disease processes. Different medical specialties use varieties of medical devices more or less specific for them. Allergology is an interdisciplinary field of medical science and teaches that allergic reactions are of systemic nature but can express themselves at the level of different organs across the life cycle of an individual. Subsequently, medical devices used in allergo...
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