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Positive Patch Test Reactions (positive + patch_test_reaction)

Distribution by Scientific Domains

Medical Sciences	94%

Selected Abstracts

p -Phenylenediamine sensitization is more prevalent in central and southern European patch test centres than in Scandinavian: results from a multicentre study

CONTACT DERMATITIS, Issue 6 2009
Jacob Pontoppidan Thyssen
Background:, Positive patch test reactions to p -phenylenediamine (PPD) are common. PPD is used in oxidative hair dyes and is also present in dark henna temporary ,tattoos'. Cross-sensitization to other contact allergens may occur. Because subjects sensitized to PPD are at risk of clinically severe reactions upon hair dyeing, there is a need for ,current' prevalence data on PPD sensitization. Objectives:, To compare PPD patch test results from dermatitis patients tested between 2003 and 2007 in 10 European patch test centres and to analyse the causes and determine relevance of positive PPD patch test reactions. Materials:, Patch testing was performed using PPD (1% free base in petrolatum from Trolab (Almirall Hermal GmbH, Reinbeck, Germany) or Chemotechnique (Malmö, Sweden), equivalent to 0.090 mg/cm2 in the TRUE® test from MEKOS Laboratories AS). Statistical analysis was performed using the chi-squared test. Results:, The weighted average prevalence was 4.6% among 21 515 patients. PPD sensitization occurred more often in centres located in Central and Southern Europe than in Scandinavian centres (odds ratio = 2.40; 95% confidence interval = 2.07,2.78). The overall proportion of positive patch test reactions to PPD that were registered as being of either current or ,past' relevance was high (weighted average 53.6% and 20.3%, respectively). Consumer hair dyeing was the most prominent cause of PPD sensitization (weighted average 41.8%). Furthermore, occupational hair dye exposure (10.6%) and cross-sensitization to textile dyes (12.6%) were frequently reported. Conclusions:, PPD sensitization caused by exposure to hair dyes is frequent and remains a present problem for patients visiting contact dermatitis clinics, especially in patch test centres located in Central and Southern Europe. [source]

Allergic contact dermatitis to mango flesh

INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 3 2004
Sari Weinstein MD
A 22-year-old white female student presented to the Emergency Department with a 2-day history of patchy pruritic erythema of the face, neck, and arms with periorbital edema. The eruption began as an isolated patch of nasal erythema, with subsequent extension to involve the entire face. Within 2 days, fine pinpoint papules were noted on the face, anterior chest, neck, and upper extremities. Periorbital edema was present without intraoral abnormalities or laryngeal changes. An erythematous, mildly lichenified plaque was noted on the ventral left wrist. The past medical history was significant for two similar, milder episodes of allergic reactions of uncertain etiology occurring within the previous 2 months. The previous eruptions resolved after treatment with oral loratodine and topical fluocinonide cream 0.05%. The patient denied any history of contact urticaria or new household or personal hygiene contactants, although she did report frequent ingestion of peeled mangoes. Her brother had a history of eczematous dermatitis. In the Emergency Department, the patient was administered intravenous diphenhydramine and a single 50 mg dose of oral prednisone. She continued treatment with a 5-day course of prednisone, 50 mg daily, with loratodine, 20 mg daily, and diphenhydramine as needed; however, no symptomatic improvement was seen over 4 days. She was then advised to restart fluocinonide cream twice daily. Patch testing was performed to the North American Contact Dermatitis Group Standard Series utilizing methods of the International Contact Dermatitis research group with Finn chambers. Mango skin and mango flesh harvested 5 mm below the skin surface were also placed in duplicate and tested under Finn chambers. Positive (1+) reactions were noted to nickel and p -tertbutylphenol formaldehyde resin, and bullous reactions were found to mango skin and surface flesh in duplicate (Fig. 1). Complete avoidance of mango led to resolution of the initial eruption. The clinical relevance of nickel and p -tertbutylphenol formaldehyde resin was thought to be associated with the wrist lesion immediately below a glued portion of a wristwatch strap and metal clasp. Figure 1. Positive patch test reactions, in duplicate, to mango skin (left column) and mango flesh 5 mm below the skin (right column) [source]

Clinically Relevant Patch Test Reactions in Children,A United States Based Study

PEDIATRIC DERMATOLOGY, Issue 5 2008
Sharon E. Jacob M.D.
The aim of this study was to confirm the prevalence of clinically relevant allergic contact dermatitis in children at two referral centers and determine the most common contact allergens. We performed a retrospective case series analysis of 65 symptomatic children (35 girls and 30 boys) aged 1,18 years old who were patch tested over a 5-year period for recalcitrant dermatitis. Positive patch test reactions were noted in 54 of the 65 children (prevalence rate of 83%) to 80 different allergens. Fifty children (77%) had positive reactions which were determined to be of "definite" or "probable" current clinical relevance. We conclude that the diagnosis of allergic contact dermatitis to specific relevant allergens is common in children referred for patch testing and that contact allergy should be considered in all children with recalcitrant dermatitis. With this article, we review the literature and present a US based study regarding the clinical relevance of positive patch test reactions in children. [source]

A Korean experience with chronic actinic dermatitis during an 18-year period: meteorological and photoimmunological aspects

PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE, Issue 6 2009
Kyu-Won Choi
Background and purpose: The authors noted that chronic actinic dermatitis (CAD) increased in connection with increased sun exposure and believed that there may be a correlation between the two. The purpose of this study was to determine the relationship between increased sun exposure and CAD. We also applied a clinical severity scoring system to determine the correlation with various laboratory parameters. Materials and methods: We investigated trends in sun exposure in Pusan during an 18-year period. We conducted photopatch/patch testing in 51 CAD patients. We also determined the total IgE, percentage of eosinophils, and chemokine receptor profiles in the peripheral blood and analyzed correlations between laboratory data and the clinical severity of CAD. Results: A close correlation was demonstrated between the number of CAD patients and increased sun exposure. Positive patch test reactions and positive photopatch reactions were observed in 35 and 41 of the 51 tested patients, respectively. The total IgE levels were higher in the severe group than in the others. CCR4 expression increased in parallel with clinical severity. Conclusion: Korean patients may have increased susceptibility to CAD with increased sun exposure. We believe that the majority of the CAD patients tested had photoallergy and contact allergy. The clinical severity seemed to correlate well with the total IgE level and CCR4 expression. [source]

P02 Analysis of coupled patch test reactions to nickel, cobalt and chromate

CONTACT DERMATITIS, Issue 3 2004
Janice Hegewald
Concomitant sensitizations to Nickel, Cobalt and Chromate are often observed among patch test patients. However, the reasons for being sensitized to two or more of these substances are not completely understood. Examination of IVDK (http://www.ivdk.org) patch test results with multivariate procedures has been conducted to further elucidate the mechanisms involved with these sensitizations and potential exposure factors that may have led to the concomitant sensitizations. Gender, age, occupational dermatitis, and construction work were considered and examined with multivariate logistic regression models with the dependent response variable being concurrent reactions to a metal pair versus no reactions. In addition to the aforementioned anamnestic data, examination of a poly-sensitizations variable (reactions to 1, 2, or 3 standard series allergens other than Nickel, Cobalt or Chromate) provided information regarding general susceptibility to positive patch test reactions. Combined reactions to Cobalt and Chromate were strongly linked to construction work (OR = 11.23 (7.46, 16.90)) and occupational dermatitis. Female patch test patients had a higher odds of a positive patch test reaction to both Nickel and Cobalt (OR = 4.73 (3.81, 5.87)). Sensitization to other, unrelated standard series substances was associated with concurrent reactions to all of the metal pairs. The association between construction work and Cobalt-Chromate reactions corresponds with the hypothesis that cement exposures lead to cobalt-chromate sensitizations. Individual susceptibility to delayed-type sensitizations, as represented by the poly-sensitization variable, also appears to be associated with coupled sensitizations to metals and warrants further examination. [source]

Oral lichenoid reactions associated with amalgam: improvement after amalgam removal

BRITISH JOURNAL OF DERMATOLOGY, Issue 1 2003
A. Dunsche
Summary Background The pathogenetic relationship between oral lichenoid reactions (OLR) and dental amalgam fillings is still a matter of controversy. Objectives To determine the diagnostic value of patch tests with amalgam and inorganic mercury (INM) and the effect of amalgam removal in OLR associated with amalgam fillings. Methods In 134 consecutive patients 467 OLR were classified according to clinical criteria. One hundred and fifty-nine biopsies from OLR lesions were histologically diagnosed according to the World Health Organization criteria for oral lichen planus (OLP) and compared with 47 OLP lesions from edentulous patients without amalgam exposure. One hundred and nineteen patients were patch tested with an amalgam series. In 105 patients (357 of 467 lesions) the amalgam fillings were removed regardless of the patch test results and OLR were re-examined within a follow-up period of about 3 years. Twenty-nine patients refused amalgam removal and were taken as a control group. Results Eleven patients with OLR (8·2%) had skin lesions of lichen planus (LP). Histologically, the lesions in the OLR group could not be distinguished from those seen in the OLP group. Thirty-three patients (27·7%) showed a positive patch test to INM or amalgam. Amalgam removal led to benefit in 102 of 105 patients (97·1%), of whom 31 (29·5%) were cured completely. Of 357 lesions, 213 (59·7%) cleared after removal of amalgam, whereas 65 (18·2%) did not improve. In the control group without amalgam removal (n = 29) only two patients (6·9%) showed an improvement (P < 0·05). Amalgam removal had the strongest impact on lesions of the tongue compared with lesions at other sites (P < 0·05), but had very little impact on intraoral lesions in patients with cutaneous LP compared with patients without cutaneous lesions (P < 0·05). Patients with a positive patch test reaction to amalgam showed complete healing more frequently than the amalgam-negative group (P < 0·05). After an initial cure following amalgam removal, 13 lesions (3·6%) in eight patients (7·6%) recurred after a mean of 14·6 months. Conclusions Of all patients with OLR associated with dental amalgam fillings, 97·1% benefited from amalgam removal regardless of patch test results with amalgam or INM. We suggest that the removal of amalgam fillings can be recommended in all patients with symptomatic OLR associated with amalgam fillings if no cutaneous LP is present. [source]

Formaldehyde-releasers: Relationship to formaldehyde contact allergy, Part 2: Metalworking fluids and remainder

CONTACT DERMATITIS, Issue 3 2010
Anton De Groot
We have reviewed formaldehyde-releasers used in metalworking fluids (MWFs) in this and a previous part of a two-part article. These biocides do not appear to be frequent or important sensitizers. Even in highly selected patient groups of metalworkers, mean prevalence rates of sensitivity are low: 0.2% for Tris(hydroxymethyl)nitromethane, 1.6% for tris(N -hydroxyethyl)hexahydrotriazine, 1.9% for Bioban® P-1487 and Bioban® CS-1246, and 2.8% for Bioban® CS-1135. In the case of the Biobans, many reactions may have been irritant. Only N,N,-methylenebis(5-methyloxazolidine) has a fairly high mean score of 4.0% in metalworkers. With the exception of Bioban® P-1487, there is a clear relationship between positive patch test reactions to the releasers and formaldehyde sensitivity: 40,70% of reactions to releasers occur in patients sensitive to formaldehyde and may therefore be caused by formaldehyde allergy. There is a lack of reliable data on the clinical relevance of contact allergy to the formaldehyde releasers in MWF. In most studies, no data on relevance were provided and in those that did, relevance was often found for a (very small) minority of the reactions only. Also discussed here are the formaldehyde-releasers MDM hydantoin, methenamine, N -methylolchloracetamide, paraformaldehyde, and Preventol® D2. [source]

Formaldehyde-releasers in cosmetics: relationship to formaldehyde contact allergy

CONTACT DERMATITIS, Issue 1 2010
Part 1.
In this part of a series of review articles on formaldehyde-releasers and their relationship to formaldehyde contact allergy, formaldehyde-releasers in cosmetics are discussed. In this first part of the article, key data are presented including frequency of sensitization and of their use in cosmetics. In Europe, low frequencies of sensitization have been observed to all releasers: 2-bromo-2-nitropropane-1,3-diol 0.4,1.2%, diazolidinyl urea 0.5,1.4%, imidazolidinyl urea 0.3,1.4%, quaternium-15 0.6,1.9% (for DMDM hydantoin no recent data are available). All releasers score (far) higher prevalences in the USA; the possible explanations for this are discussed. The relevance of positive patch test reactions has been insufficiently investigated. In the USA, approximately 20% of cosmetics and personal care products (stay-on products: 17%, rinse-off products 27%) contain a formaldehyde-releaser. The use of quaternium-15 is decreasing. For Europe, there are no comparable recent data available. In the second part of the article, the patch test relationship of the releasers in cosmetics to formaldehyde contact allergy will be reviewed and it will be assessed whether products preserved with formaldehyde-releasers may contain enough free formaldehyde to pose a threat to individuals who have contact allergy to formaldehyde. [source]

Formaldehyde-releasers: relationship to formaldehyde contact allergy.

CONTACT DERMATITIS, Issue 2 2009
Contact allergy to formaldehyde, inventory of formaldehyde-releasers
This is one of series of review articles on formaldehyde and formaldehyde-releasers (others: formaldehyde in cosmetics, in clothes and in metalworking fluids and miscellaneous). Thirty-five chemicals were identified as being formaldehyde-releasers. Although a further seven are listed in the literature as formaldehyde-releasers, data are inadequate to consider them as such beyond doubt. Several (nomenclature) mistakes and outdated information are discussed. Formaldehyde and formaldehyde allergy are reviewed: applications, exposure scenarios, legislation, patch testing problems, frequency of sensitization, relevance of positive patch test reactions, clinical pattern of allergic contact dermatitis from formaldehyde, prognosis, threshold for elicitation of allergic contact dermatitis, analytical tests to determine formaldehyde in products and frequency of exposure to formaldehyde and releasers. The frequency of contact allergy to formaldehyde is consistently higher in the USA (8,9%) than in Europe (2,3%). Patch testing with formaldehyde is problematic; the currently used 1% solution may result in both false-positive and false-negative (up to 40%) reactions. Determining the relevance of patch test reactions is often challenging. What concentration of formaldehyde is safe for sensitive patients remains unknown. Levels of 200,300 p.p.m. free formaldehyde in cosmetic products have been shown to induce dermatitis from short-term use on normal skin. [source]

p -Phenylenediamine sensitization is more prevalent in central and southern European patch test centres than in Scandinavian: results from a multicentre study

Cross-reactivity between nickel and palladium demonstrated by systemic administration of nickel

CONTACT DERMATITIS, Issue 1 2005
M. Hindsén
Concomitant patch test reactions to nickel and palladium have frequently been reported in patients undergoing investigation because of suspected allergic contact dermatitis. Theoretically, these reactions can be explained by multiple, concomitant, simultaneous sensitization as well as cross-sensitization. We studied whether concomitant reactions to nickel and palladium could represent cross-sensitization in females hypersensitive to combinations of nickel, palladium and cobalt. Females were patch tested with serial dilutions of nickel sulfate, cobalt chloride and palladium chloride on the upper back. 1 month later, when the patch test reactions were gone, the patients were randomized into 2 groups that were challenged orally with either nickel or placebo. 1 day later, the areas of previous positive patch test reactions were read in a blind way looking for flare-up reactions. Nickel provocation but not placebo yielded flare-up reactions on sites previously tested with nickel (P = 0.012) and palladium (P = 0.006), but were also observed on sites previously tested with cobalt, even though this was not statistically significant. Flare-up reactions of previous patch test reactions to nickel and palladium after oral challenge with nickel speak in favour of a cross-reactivity mechanism. [source]

FS02.8 Patch testing with gold trichloride can give false test results

CONTACT DERMATITIS, Issue 3 2004
Birgitta Gruvberger
Background:, Hydrochloric acid is formed in water solutions of gold trichloride. Hydrochloric acid in contact with aluminium generates hydrogen gas which can reduce and transform trivalent gold to elemental gold. Objective:, To investigate whether patch testing with aqueous gold trichloride can cause false positive (irritant) reactions in patients without contact allergy to gold and false negative reactions in patients with gold allergy. Methods:, 13 patients with and 13 patients without positive patch test reactions to gold sodium thiosulfate were tested with gold trichloride in 2 different vehicles, water and alkaline buffer, using 2 different test techniques, the Finn Chamber technique with aluminium chambers and van der Bend technique with polypropene chambers. Results:, Irritant patch test reactions were obtained with aqueous gold trichloride tested in van der Bend chambers in 10 patients without gold allergy. In gold-allergic patients no positive test reactions were obtained from aqueous gold trichloride in Finn chambers while 2 positive test reactions were obtained from gold trichloride in alkaline buffer tested in van der Bend chambers. Conclusion:, If gold trichloride is patch tested in wrong vehicle and with wrong test technique irritant test reactions may occur which can be misinterpreted as positive allergic reactions in patients without gold allergy as well as negative reactions in patients with gold allergy. [source]

P02 Analysis of coupled patch test reactions to nickel, cobalt and chromate

Does contact dermatitis to fragrances influence the quality of life?

FLAVOUR AND FRAGRANCE JOURNAL, Issue 4 2009
A descriptive study measuring, comparing the quality of life, skin involvement in patients with contact dermatitis to fragrances
Abstract The study of the impact of diseases on individuals' quality of life is an important and useful tool for clinicians, particularly for an efficient follow-up and for the good management of patients suffering from chronic diseases. Contact dermatitis is a common condition in dermatological patients. However, despite efficient screening, the understanding and acceptance of contact allergy remain difficult and avoidance of these allergens is not always possible. The aim of this study was to determine whether contact dermatitis to fragrances affects quality of life and to define whether there is a relationship between the severity of skin involvement and quality of life. To measure the quality of life, we chose the VQ-Dermato (VQ-d) questionnaire, the only valid and reliable questionnaire in French, to which we added 10 non-validated specific questions regarding fragrances. We included patients with pertinent positive patch test reactions to fragrances attending the contact clinic between 1 January 1998 and 30 September 2004. During this time, 2814 patients were patch tested and 310 had positive reactions to the fragrance mix 8% (FM) of the standard series. We recruited non-atopic individuals, exclusively allergic to fragrance mix, with patch test reactions scored ++ and +++; the only additional positive reactions accepted were to balsam of Peru and the patient's own perfumes; 52 patients met these criteria, but only 33 participated. To evaluate the severity of skin involvement, we used the severity scoring of atopic dermatitis (SCORAD index). The quality of life of individuals allergic to fragrances was mostly moderately affected. Patients were more affected psychologically during the first year after the diagnosis of fragrance allergy. Skin reaction during the acute stage of contact allergy to fragrances can be severe. No correlation between VQ-d and SCORAD could be established. It was concluded that there was no severe impact on quality of life because of fragrance contact allergy, but that psychological issues and depression may play an important role in determining the way skin disease affects people. Patch testing improves the quality of life. Lack of correlation between VQ-d and SCORAD demonstrates that an objective measure such as SCORAD may not fully capture the impact of the disease. These results cannot be generalized because of the low response rate and limited sample size. Copyright © 2009 John Wiley & Sons, Ltd. [source]

Burning mouth syndrome: the role of contact hypersensitivity

ORAL DISEASES, Issue 4 2009
R Marino
Background:, Burning mouth syndrome is a burning sensation or stinging disorder affecting the oral mucosa in the absence of any clinical signs or mucosal lesions. Some studies have suggested that burning mouth syndrome could be caused by the metals used in dental prostheses, as well as by acrylate monomers, additives and flavouring agents, although others have not found any aetiologic role for hypersensitivity to dental materials. Objective:, To evaluate the extent and severity of adverse reactions to dental materials in a group of patients with burning mouth syndrome, and investigate the possible role of contact allergy in its pathogenesis. Materials and methods:, We prospectively studied 124 consecutive patients with burning mouth syndrome (108 males; mean age 57 years, range 41,83), all of whom underwent allergen patch testing between 2004 and 2007. Results:, Sixteen patients (13%) showed positive patch test reactions and were classified as having burning mouth syndrome type 3 or secondary burning mouth syndrome (Lamey's and Scala's classifications). Conclusion:, Although we did not find any significant association between the patients and positive patch test reactions, it would be advisable to include hypersensitivity to dental components when evaluating patients experiencing intermittent oral burning without any clinical signs. [source]