H Dickel1, V Mahler2,3. 1. Klinik für Dermatologie, Venerologie und Allergologie, St. Josef-Hospital, Universitätsklinikum der Ruhr-Universität Bochum (UK RUB), Gudrunstr. 56, 44791, Bochum, Deutschland. heinrich.dickel@rub.de. 2. Paul-Ehrlich-Institut, Langen, Deutschland. 3. Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Deutschland.
Abstract
BACKGROUND: In the case of a contact allergy, there is only allergen avoidance instead of causal therapy. If the allergen is not identified, dermatitis persists, which is a major burden for patients. Patch testing is the diagnostic standard for detecting contact sensitization. Based on a systematic literature search, the German patch test guideline was updated and methodologically upgraded. OBJECTIVES: The most important practical aspects of patch testing with contact allergens and drugs are presented. MATERIALS AND METHODS: Current consensus guidelines for performing patch tests as well as the results of a supplementary selective literature search are summarized. RESULTS: According to the patch test guideline (AWMF registry no. 013-018, 2019), the baseline series, special series and, if necessary, test preparations prepared from the patient's own contact substances should be tested routinely. A new evidence-based recommendation is a late reading after 7-10 days, as otherwise numerous patch test reactions will be missed. Antihistamines may weaken the cellular reactions of the patch test and should be discontinued with a latency of 5 half-lives. Finally, if a false-negative patch test result is suspected, it is recommended to perform a strip patch test according to the validated protocol. CONCLUSIONS: All patients with a suspected contact allergy should receive a guideline-based patch test at an early stage. Targeted patch testing identifies clinically relevant allergens and provides suggestions for further systematic investigations.
BACKGROUND: In the case of a contact allergy, there is only allergen avoidance instead of causal therapy. If the allergen is not identified, dermatitis persists, which is a major burden for patients. Patch testing is the diagnostic standard for detecting contact sensitization. Based on a systematic literature search, the German patch test guideline was updated and methodologically upgraded. OBJECTIVES: The most important practical aspects of patch testing with contact allergens and drugs are presented. MATERIALS AND METHODS: Current consensus guidelines for performing patch tests as well as the results of a supplementary selective literature search are summarized. RESULTS: According to the patch test guideline (AWMF registry no. 013-018, 2019), the baseline series, special series and, if necessary, test preparations prepared from the patient's own contact substances should be tested routinely. A new evidence-based recommendation is a late reading after 7-10 days, as otherwise numerous patch test reactions will be missed. Antihistamines may weaken the cellular reactions of the patch test and should be discontinued with a latency of 5 half-lives. Finally, if a false-negative patch test result is suspected, it is recommended to perform a strip patch test according to the validated protocol. CONCLUSIONS: All patients with a suspected contact allergy should receive a guideline-based patch test at an early stage. Targeted patch testing identifies clinically relevant allergens and provides suggestions for further systematic investigations.
Entities:
Keywords:
(Semi-)open patch test; Patch test; Photopatch test; Repeated open application test; Strip patch test
Authors: Axel Schnuch; Werner Aberer; Monika Agathos; Detlef Becker; Jochen Brasch; Peter Elsner; Peter J Frosch; Thomas Fuchs; Johannes Geier; Uwe Hillen; Harald Löffler; Vera Mahler; Gerhard Richter; Christiane Szliska Journal: J Dtsch Dermatol Ges Date: 2008-09 Impact factor: 5.584
Authors: Jeanne D Johansen; Kristiina Aalto-Korte; Tove Agner; Klaus E Andersen; Andreas Bircher; Magnus Bruze; Alicia Cannavó; Ana Giménez-Arnau; Margarida Gonçalo; An Goossens; Swen M John; Carola Lidén; Magnus Lindberg; Vera Mahler; Mihály Matura; Thomas Rustemeyer; Jørgen Serup; Radoslaw Spiewak; Jacob P Thyssen; Martine Vigan; Ian R White; Mark Wilkinson; Wolfgang Uter Journal: Contact Dermatitis Date: 2015-07-14 Impact factor: 6.600
Authors: Vera Mahler; Heinrich Dickel; Thomas Ludwig Diepgen; Uwe Hillen; Johannes Geier; Roland Kaufmann; Burkhard Kreft; Axel Schnuch; Christiane Szliska; Albrecht Bender Journal: J Dtsch Dermatol Ges Date: 2016-10-28 Impact factor: 5.584
Authors: P Thomas; J Geier; H Dickel; T Diepgen; U Hillen; B Kreft; A Schnuch; C Szliska; V Mahler Journal: Orthopade Date: 2015-11 Impact factor: 1.087