International survey on skin patch test procedures, attitudes and interpretation

Abstract

BackgroundSkin patch test is the gold standard method in diagnosing contact allergy. Although used for more than 100 years, the patch test procedure is performed with variability around the world. A number of factors can influence the test results, namely the quality of reagents used, the timing of the application, the patch test series (allergens/haptens) that have been used for testing, the appropriate interpretation of the skin reactions or the evaluation of the patient’s benefit.MethodsWe performed an Internet –based survey with 38 questions covering the educational background of respondents, patch test methods and interpretation. The questionnaire was distributed among all representatives of national member societies of the World Allergy Organization (WAO), and the WAO Junior Members Group.ResultsOne hundred sixty-nine completed surveys were received from 47 countries. The majority of participants had more than 5 years of clinical practice (61 %) and routinely carried out patch tests (70 %). Both allergists and dermatologists were responsible for carrying out the patch tests. We could observe the use of many different guidelines regardless the geographical distribution. The use of home-made preparations was indicated by 47 % of participants and 73 % of the respondents performed 2 or 3 readings. Most of the responders indicated having patients with adverse reactions, including erythroderma (12 %); however, only 30 % of members completed a consent form before conducting the patch test.DiscussionThe heterogeneity of patch test practices may be influenced by the level of awareness of clinical guidelines, different training backgrounds, accessibility to various types of devices, the patch test series (allergens/haptens) used for testing, type of clinical practice (public or private practice, clinical or research-based institution), infrastructure availability, financial/commercial implications and regulations among others.ConclusionThere is a lack of a worldwide homogeneity of patch test procedures, and this raises concerns about the need for standardization and harmonization of this important diagnostic procedure.

Prevalence of Atopic Dermatitis Criteria among Textile Workers with Occupational Allergic Contact Dermatitis and Effects of Having Atopic Dermatitis on Contact Antigenic Diversity

“…The results are read at day 2 and day 4 and interpreted according to the guidelines of the International Contact Dermatitis Research Group as (-), (+), (++), or (+++). [10] Confirmation of an OACD diagnosis is based on the following criteria: (i) clinical confirmation of OCD, (ii) exposure to suspected occupational allergen(s), (iii) confirmation of a positive response to at least 1 of the relevant occupational patch test allergens, and (iv) confirmation of exposure as a cause or as an important aggravating factor in the development of the lesion. The population of the present study comprised participants who had had at least a (++) response to at least 1 of the allergens, since a (+) response can be interpreted as suspicious positivity.…”

Uji Fisikokimia dan Uji Iritasi Sabun Antiseptik Kulit Daun Aloe vera (L.) Burm. f

“…Uji iritasi sabun kulit daun lidah buaya mengikuti prosedur skin patch test (PT). PT adalah prosedur uji in vivo yang penting untuk mengkonfirmasi kondisi alergi (Wilkinson et al 1997;Tanno et al 2016). Pengujian dilakukan langsung ke kulit tubuh manusia dikarenakan diharapkan sediaan sabun ini dapat langsung diaplikasikan kepada manusia jika sudah terbukti tidak memiliki efek iritasi pada kulit manusia.…”

World Allergy Organization Journal: the Editors Look Back at 2016

“…A similarly important tool is clinical diagnostics, with the skin prick test being an important global diagnostic instrument. In an international survey on skin patch testing a lack of homogeneity was found in an international collaborative, notably with a strong contribution by the Junior Members Group of the World Allergy Organization (WAO) [6]. Allergy is the only discipline with an intrinsically high risk of diagnostic testing as well as of therapeutic intervention by allergen immunotherapy in hypersensitive patients.…”