A dermatologist’s approach to patch testing: indications, pitfalls and benefits

Authors

  • Gabrielle Veillet-Lemay, MD
  • Melanie Pratt, MD

DOI:

https://doi.org/10.58931/cait.2022.2128

Abstract

Allergic contact dermatitis (ACD) is a T-cell mediated delayed type IV hypersensitivity reaction that occurs after topical or systemic exposure to an allergen. Patch testing is the gold standard in diagnosing ACD. Acquiring a detailed history from the patient including their medical history, occupational history, hobbies, topical and oral exposures, and site(s) of involvement while having knowledge of the common allergens allows the clinician to create a targeted and personalized approach thus increasing the diagnostic yield of patch testing for each patient.

Author Biographies

Gabrielle Veillet-Lemay, MD

Dr. Gabrielle Veillet-Lemay is currently completing her residency in dermatology at the University of Ottawa. She earned her medical degree from the University of Ottawa in 2018. Dr. Veillet-Lemay enjoys all aspects of dermatology but has a particular clinical interest in allergic contact dermatitis, atopic dermatitis, and pediatric dermatology.

Melanie Pratt, MD

Dr. Melanie Pratt is Professor of Dermatology at the University of Ottawa. She has a special interest in contact dermatitis and occupational dermatitis. She has run a contact dermatitis clinic at the Ottawa Hospital for the last 35 years, where she has assessed more than 500 cases of contact dermatitis annually. Dr. Pratt is a member of the North American Contact Dermatitis Group, the ICDRG [International Contact Dermatitis Research Group], and a past President of the American Contact Dermatitis Society, as well as the Canadian Contact Dermatitis Group. Her areas of clinical research are in contact dermatitis. She has special interest in textile allergy and occupational contact dermatology cases. Dr. Pratt has mentored dozens of medical students and dermatology residents in the field of general dermatology as well as contact dermatitis. She lectures in this field routinely at a local, provincial, national and international level. Dr Pratt received the Canadian Dermatology Association’s Lifetime Achievement Award in 2021.

References

De Groot, Anton C. Patch testing: test concentrations and vehicles for 4900 chemicals. Acdegroot Publishing (2018).

Silverberg, Jonathan I., et al. “Age-related differences in patch testing results among children: Analysis of North American Contact Dermatitis Group Data, 2001-2018.” Journal of the American Academy of Dermatology (2021).

DeKoven, Joel G., et al. “North American Contact Dermatitis Group Patch Test Results: 2017–2018.” Dermatitis 32.2 (2021): 111-123.

Rietschel, Robert L., et al. “Common contact allergens associated with eyelid dermatitis: data from the North American Contact Dermatitis Group 2003-2004 study period.” Dermatitis 18.2 (2007): 78-81.

Grey, Katherine R., and Erin M. Warshaw. “Allergic contact dermatitis to ophthalmic medications: relevant allergens and alternative testing methods.” Dermatitis 27.6 (2016): 333-347.

Zug, Kathryn A., et al. “Patch-testing North American lip dermatitis patients: data from the North American Contact Dermatitis Group, 2001 to 2004.” Dermatitis 19.4 (2008): 202-208.

Silverberg, Jonathan I., et al. “Hand dermatitis in adults referred for patch testing: Analysis of North American Contact Dermatitis Group Data, 2000 to 2016.” Journal of the American Academy of Dermatology 84.4 (2021): 989-999.

Atwater, Amber Reck, et al. “Shoe Allergens: A Retrospective Analysis of Cross-sectional Data From the North American Contact Dermatitis Group, 2005-2018.” Dermatitis: Contact, Atopic, Occupational, Drug 33.1 (2022): 62-69.

Matthys, Erin, Amir Zahir, and Alison Ehrlich. “Shoe allergic contact dermatitis.” Dermatitis 25.4 (2014): 163-171.

Woodruff, Carina M., et al. “Allergic contact dermatitis of the vulva.” Dermatitis 29.5 (2018): 233-243.

DeKoven, Joel G., et al. “Occupational contact dermatitis: Retrospective analysis of North American Contact Dermatitis Group Data, 2001 to 2016.” Journal of the American Academy of Dermatology (2021).

Neale, Holly, et al. “Pediatric allergic contact dermatitis. Part I: Clinical features and common contact allergens in children.” Journal of the American Academy of Dermatology 84.2 (2021): 235-244.

Hartsough, Emily M., and Sara A. Hylwa. “Wearable Woes: Allergens in Diabetic Devices.” Dermatitis 32.1 (2021): 19-31.

Warshaw, Erin M., et al. “Scalp involvement in patients referred for patch testing: Retrospective cross-sectional analysis of North American Contact Dermatitis Group data, 1996 to 2016.” Journal of the American Academy of Dermatology 84.4 (2021): 977-988.

DeLeo, Vincent A., et al. “Photopatch test results of the North American contact dermatitis group, 1999‐2009.” Photodermatology, Photoimmunology & Photomedicine (2021).

Bolognia, J., J. V. Schaffer, and L. Cerroni. “Dermatology. 4th.” Edition. USA: Mosby (2018): 245

Fowler Jr, Joseph F., et al. “Effects of immunomodulatory agents on patch testing: expert opinion 2012.” Dermatitis 23.6 (2012): 301-303.

Mufti, Asfandyar, et al. “Patch Testing During Immunosuppressive Therapy: A Systematic Review.” Dermatitis 32.6 (2021): 365-374.

Johansen, Jeanne D., et al. “European Society of Contact Dermatitis guideline for diagnostic patch testing–recommendations on best practice.” Contact dermatitis 73.4 (2015): 195-221.

Kimyon, Rebecca S., et al. “Patch Testing: The Patient Experience.” Dermatitis 32.5 (2021): 333-338.

Ramirez, Faustine, Mary-Margaret Chren, and Nina Botto. “A review of the impact of patch testing on quality of life in allergic contact dermatitis.” Journal of the American Academy of Dermatology 76.5 (2017): 1000-1004.

Silverberg, Jonathan I., et al. “Prevalence and Trend of Allergen Sensitization in Adults and Children with Atopic Dermatitis Referred for Patch Testing, North American Contact Dermatitis Group Data, 2001-2016.” The Journal of Allergy and Clinical Immunology: In Practice 9.7 (2021): 2853-2866.

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Published

2022-04-01

How to Cite

1.
Veillet-Lemay G, Pratt M. A dermatologist’s approach to patch testing: indications, pitfalls and benefits. Can Allergy Immunol Today [Internet]. 2022 Apr. 1 [cited 2024 Dec. 4];2(1):26–34. Available from: https://canadianallergyandimmunologytoday.com/article/view/2-1-veillet-lemay_et_al

Issue

Volume 2, Issue 1, April 2022

Section

Articles