Geier J, Gefeller O, Wiechmann K, Fuchs T
Department of Dermatology, University of Göttingen, Germany.
Contact Dermatitis. 1999 Mar;40(3):119-26. doi: 10.1111/j.1600-0536.1999.tb06008.x.
In this retrospective study, patch test reactions in 3 groups of patients were analysed, in order to obtain information on the best day for the 2nd patch-test reading after day 2 (D2), on the usefulness of additional readings after D3, and on the dependence of patch-test reactions at D4, D5, or D6 on allergen and/or patient characteristics. In the years 1990 to 1995, patch tests were routinely read at D3 and D4 in 1096 patients, at D3 and D5 in 1243 patients, and at D3 and D6 in 1136 patients. In all of the 3 groups, significantly more positive reactions diminished than appeared de novo from D3 to the later reading. Virtually identical results were observed in subgroups of patients formed by sex, age or atopy. However, men might possibly react more slowly than women on patch testing, showing more increasing than diminishing reactions in the D3/D4- and the D3/D5-comparison. Reactions to individual allergens showed wide differences in this connection. Neomycin sulfate, cobalt salts, and p-phenylenediamine can be characterized as slow allergens, with more reactions increasing than diminishing from D3 to the later readings. With fragrance mix and balsam of Peru, the opposite pattern occurred. In all subgroups of patients, and with most allergens, the gain in positive reactions was biggest when an additional reading was performed at D5. We conclude that for a single 2nd patch test reading after D2, D3 is the best day, and especially better than D4. If a 3rd reading is performed, it should be done at D5 to get the maximum information out of patch testing. However, this extends the test procedure to at least 1 day of the weekend.
在这项回顾性研究中，分析了3组患者的斑贴试验反应，以获取关于第2天（D2）后第二次斑贴试验读数的最佳日期、D3后额外读数的有用性，以及D4、D5或D6时斑贴试验反应对变应原和/或患者特征的依赖性的信息。在1990年至1995年期间，对1096例患者在D3和D4常规进行斑贴试验读数，对1243例患者在D3和D5进行读数，对1136例患者在D3和D6进行读数。在所有这3组中，从D3到后续读数，明显更多的阳性反应减弱，而非新出现。在按性别、年龄或特应性形成的患者亚组中观察到几乎相同的结果。然而，在斑贴试验中，男性的反应可能比女性更慢，在D3/D4和D3/D5比较中，显示出增加的反应比减弱的反应更多。在此方面，对个别变应原的反应显示出很大差异。硫酸新霉素、钴盐和对苯二胺可被表征为缓慢变应原，从D3到后续读数，增加的反应比减弱的反应更多。对于香料混合物和秘鲁香脂，情况则相反。在所有患者亚组中，对于大多数变应原，当在D5进行额外读数时，阳性反应的增加最大。我们得出结论，对于D2后的单次第二次斑贴试验读数，D3是最佳日期，尤其比D4更好。如果进行第三次读数，应在D5进行，以便从斑贴试验中获取最大信息。然而，这将测试程序至少延长到周末的一天。
