Patient Reported Improvement After Patch Testing and Allergen Avoidance Counseling: A Retrospective Analysis.

INTRODUCTION

Our objectives were to assess patient-reported improvement after patch testing at the 2-3-month follow-up visit in patients referred for patch testing with relevant positive patch test reactions at the University of California, San Francisco.

METHODS

Cross-sectional analyses of patients patch tested between 2013 and 2016 who returned for a follow-up visit approximately 2-3 months after patch testing. We examined positive patch test results considered of definite, probable or possible relevance to the patient's eczematous eruptions. Patients reported improvement after patch testing as a percentage: 0-100%. Patients were categorized into four groups: (1) those that reported no improvement or worsened, (2) those that reported > 0% and ≤ 60% improvement, (3) those that reported > 60% but < 100% improvement and (4) those that reported 100% improvement. Secondary measures included the association of allergens, gender, age and location of the rash.

RESULTS

The majority (81%) of patients seen at follow-up reported improvement after patch testing. Women reported more improvement than men with statistical significance. Notably, there does not appear to be a statistically significant relationship in patient-reported improvement and age, atopy, strength of a the patient's positive reactions, number of positive reactions and follow-up time or with potential systemic contact allergens (i.e., balsam of Peru, nickel, chrome and cobalt).

CONCLUSION

We find the large percentage of patients that self-report global benefit from patch testing encouraging, as we believe this to be a powerful measure of disease and symptom activity, as well as quality of life. The gender differences we found contradict the previous literature.