Daan Dittmar1, Robert F Ofenloch2, Marie L A Schuttelaar1. 1. Department of Dermatology, University Medical Centre Groningen, University of Groningen, 9700 RB, Groningen, The Netherlands. 2. Department of Clinical Social Medicine, Occupational and Environmental Dermatology, University Hospital Heidelberg, 69115, Heidelberg, Germany.
Abstract
BACKGROUND: Studies have shown that not all positive patch test reactions are reproducible upon retesting, that is, persistent. Non-persistent reactions might represent initial false-positive reactions, meaning that patients might unnecessarily avoid allergens. OBJECTIVES: To investigate the occurrence of both persistent and non-persistent patch test reactions, to explore possible explanations, and to investigate whether allergen-specific differences exist. METHODS: A retrospective analysis was performed on patients who were patch tested at least twice between 1 January 1995 and 31 October 2016, with at least one positive patch test reaction to an allergen that had been retested. Both univariable and multivariable analyses were performed to investigate the influence of several factors on persistence. RESULTS: Of 274 retested positive reactions in 119 patients, 183 (66.8%) reactions remained positive. The strongest predictor for non-persistence in both univariable and multivariable analyses was strength of the first patch test, with weak positive reactions being significantly less persistent. Regarding allergen groups, metals and fragrances were less persistent than other allergens. CONCLUSION: Weak positive reactions have a low persistence rate, and the dermatologist should be conservative in advising the patient on avoidance of these allergens, especially if clinical relevance is uncertain.
BACKGROUND: Studies have shown that not all positive patch test reactions are reproducible upon retesting, that is, persistent. Non-persistent reactions might represent initial false-positive reactions, meaning that patients might unnecessarily avoid allergens. OBJECTIVES: To investigate the occurrence of both persistent and non-persistent patch test reactions, to explore possible explanations, and to investigate whether allergen-specific differences exist. METHODS: A retrospective analysis was performed on patients who were patch tested at least twice between 1 January 1995 and 31 October 2016, with at least one positive patch test reaction to an allergen that had been retested. Both univariable and multivariable analyses were performed to investigate the influence of several factors on persistence. RESULTS: Of 274 retested positive reactions in 119 patients, 183 (66.8%) reactions remained positive. The strongest predictor for non-persistence in both univariable and multivariable analyses was strength of the first patch test, with weak positive reactions being significantly less persistent. Regarding allergen groups, metals and fragrances were less persistent than other allergens. CONCLUSION: Weak positive reactions have a low persistence rate, and the dermatologist should be conservative in advising the patient on avoidance of these allergens, especially if clinical relevance is uncertain.
Authors: Jart A F Oosterhaven; Angelique N Voorberg; Geertruida L E Romeijn; Marjolein S de Bruin-Weller; Marie L A Schuttelaar Journal: J Dermatol Date: 2019-06-12 Impact factor: 4.005
Authors: Cynthia C A van Amerongen; Robert Ofenloch; Daan Dittmar; Marie L A Schuttelaar Journal: Contact Dermatitis Date: 2019-06-11 Impact factor: 6.600
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