The Relevance of 7-Day Patch Test Reading

Higgins, E. M.; Collins, Paul M.

doi:10.1097/der.0b013e31829cb0d1

Cited by 38 publications

(29 citation statements)

References 12 publications

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“…In patch tests with a broad panel of allergens, up to 15 % of positive reactions are not detected if there is no subsequent reading after day 3 (15 % ; 13.5 % ; 12.8 % ; 3 % .…”

Section: Duration Of Exposurementioning

confidence: 99%

S3 guidelines: Epicutaneous patch testing with contact allergens and drugs – Short version, Part 1

Mahler

Nast

Bauer

et al. 2019

J Deutsche Derma Gesell

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Summary Epicutaneous patch testing is the diagnostic standard for the detection of allergic contact dermatitis. The present guidelines are aimed at residents and board‐certified physicians in the fields of dermatology and allergology as well as other medical specialties involved in establishing the indication for patch testing and its execution in patients with contact dermatitis and other forms of delayed‐type hypersensitivity. The target audience also includes other health care providers and insurance funds. Based on a systematic literature search and a formal consensus process (S3), the guidelines were developed by dermatologists in collaboration with pediatricians, occupational medicine physicians, nursing staff as well as patient representatives. The systematic methodological approach and appraisal of evidence upon which the recommendations are based are outlined in a separate method report that also contains evidence tables. The guidelines address general aspects of patch testing as well as medicolegal issues. The recommendations given relate to topics such as the indication for patch testing, informed patient consent, as well as the choice of test substances, test chambers and test site, duration of exposure, reading times and interpretation of test reactions. Furthermore, recommendations are provided with respect to endogenous and exogenous factors, specific patient groups (children, pregnant women, immunosuppressed individuals) as well as possible risks and adverse events associated with patch testing using contact allergens. Note: This publication is part 1 of the short version of the S3 guidelines for “Epicutaneous patch testing using contact allergens and drugs” (registry no. 013 – 018; date: March 20, 2019; valid until December 31, 2021). Part 2 of the short version will be published in the next issue. The long version of these guidelines can be accessed at http://www.awmf.org. The method report is available as online publication (https://www.awmf.org/leitlinien/detail/ll/013-018.html) and contains the evidence tables in its appendix.

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“…In patch tests with a broad panel of allergens, up to 15 % of positive reactions are not detected if there is no subsequent reading after day 3 (15 % ; 13.5 % ; 12.8 % ; 3 % .…”

Section: Duration Of Exposurementioning

confidence: 99%

S3 guidelines: Epicutaneous patch testing with contact allergens and drugs – Short version, Part 1

Mahler

Nast

Bauer

et al. 2019

J Deutsche Derma Gesell

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“…Most centres perform patch test readings on D2 to D4. A late patch test reading on D7 in addition to the D3 or D4 reading can identify new positive patch test reactions, ranging from 3% up to 34% in previous studies, which were found to be negative, doubtful or irritant on preceding readings . Multiple studies have reported the importance of an additional late patch test reading, especially for suspected contact allergies to metals, topicals, and corticosteroids.…”

Section: Introductionmentioning

confidence: 99%

New positive patch test reactions on day 7—The additional value of the day 7 patch test reading

et al. 2019

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Background Not performing a day (D) 7 patch test reading might result in positive patch test reactions being missed. Objectives To investigate the added value of the D7 patch test reading for individual allergens, and to identify patient characteristics and allergen groups associated with new positive D7 reactions. Methods Data from patients patch tested between 2008 and 2018 with the extended European baseline series were analysed. Patch test readings were performed on D3 and D7. Positive reactions were categorized into positive on D3 or new positive on D7. Results A total of 3292 patients were consecutively patch tested with at least 43 allergens of the TRUE Test panels 1 and 2 supplemented with investigator‐loaded allergens. In total, 447 (13.6%) patients showed new positive D7 reactions. In univariable regression analysis, age between 18 and 30 years showed a negative association with new positive D7 reactions. Significantly more D7 positive reactions were seen for topicals (odds ratio [OR] 2.60, 95% confidence interval [CI]: 1.92‐3.51) and corticosteroids (OR 1.87, 95%CI: 1.09‐3.21). No associations were found between sex, atopic dermatitis and occupational dermatitis and a new positive D7 reaction. Conclusion A D7 reading to identify new positive patch test reactions is of added value, especially for topicals and corticosteroids.

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“…Studies have shown that reactions to metals can become positive up to 168 hours after initial patch placement. 18,20,21 In their study, Jonker and Bruynzeel 20 compared patch test readings at 48 and 72 hours with readings at 144 and 168 hours. They found that 8.2% of patients displayed late positive reactions at 144 or 168 hours to certain allergens including nickel sulfate.…”

Section: Discussionmentioning

confidence: 97%

“…20 Therefore, while it is possible that the patch testing schedule used in this study may not have allowed us to detect nickel allergy in those with delayed positive reactions to nickel, the patch testing schedule likely detected most nickel sensitive individuals, given that most positive reactions occur in the first 72 hours. 18,19 The inconsistencies between results of patch testing and testing with the metal disc can be partially explained by the differences in nickel bioavailability. There is a greater bioavailability of nickel in the 2.5% nickel sulfate in petrolatum used for patch testing compared with that of the metal disc.…”

Section: Discussionmentioning

confidence: 99%

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Patch Testing for Metal Allergy With Manufacturer-Supplied Materials Before Nuss Bar Insertion

et al. 2015

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The Relevance of 7-Day Patch Test Reading

Abstract: These results confirm findings in the literature and support the argument for performing a day 7 reading (168 hours) to identify relevant late positive reactions.

Cited by 38 publications

References 12 publications

S3 guidelines: Epicutaneous patch testing with contact allergens and drugs – Short version, Part 1

S3 guidelines: Epicutaneous patch testing with contact allergens and drugs – Short version, Part 1

New positive patch test reactions on day 7—The additional value of the day 7 patch test reading

Patch Testing for Metal Allergy With Manufacturer-Supplied Materials Before Nuss Bar Insertion

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