Department of Occupational and Environmental Dermatology, Lund University, Ska˙ne University Hospital, Malmö, Sweden.
Division of Dermatology, University of Louisville School of Medicine, KY.
Dermatitis. 2018 Sep/Oct;29(5):258-263. doi: 10.1097/DER.0000000000000395.
Dose/area and reading paradigms for gold patch testing are controversial and not standardized worldwide.
The aims of this study were to determine the optimum patch test dose of gold sodium thiosulfate (GST) in a hydrogel (HYD) and to establish GST HYD safety/efficacy and further characterize normal morphology and time course of GST reactions.
Twenty gold-allergic patients were patch tested with a dilution series of GST HYD and with GST 2% petrolatum (pet). Furthermore, this previously determined optimal dose was compared with GST 0.5% pet in 19 known-allergic and 216 consecutive subjects.
The optimal GST HYD dose was 0.075 mg/cm, not statistically different from GST 2% pet (P = 0.4795). Gold sodium thiosulfate HYD outperformed GST 0.5% pet in both known-allergic subjects (79% vs 63%, P = 0.2482) and consecutive subjects (30% vs 9%, P < 0.0001). Late reactions were common in consecutive patients with both HYD and pet. Significantly more persistent reactions were associated with GST HYD than with GST 0.5% pet.
Gold sodium thiosulfate HYD 0.075 mg/cm is the optimal dose for diagnosis of gold contact allergy with GST. Gold sodium thiosulfate 0.5% pet yielded false-negatives in some patients, suggesting inadequate dose per centimeter squared. Late reads are normal, expected, and necessary for diagnosis of gold contact allergy in this cohort.
金贴试验的剂量/面积和读取模式在全球范围内存在争议且尚未标准化。
本研究旨在确定金钠硫代硫酸（GST）水凝胶（HYD）的最佳贴斑试验剂量，并确定 GST HYD 的安全性/疗效，进一步描述 GST 反应的正常形态和时程。
对 20 例金过敏患者进行 GST HYD 稀释系列和 GST 2%凡士林（pet）的贴斑试验。此外，将先前确定的最佳剂量与 19 例已知过敏和 216 例连续患者的 GST 0.5% pet 进行比较。
GST HYD 的最佳剂量为 0.075mg/cm，与 GST 2% pet 无统计学差异（P = 0.4795）。GST HYD 在已知过敏患者（79%比 63%，P = 0.2482）和连续患者（30%比 9%，P < 0.0001）中均优于 GST 0.5% pet。HYD 和 pet 连续患者均常见迟发反应。与 GST 0.5% pet 相比，GST HYD 与更多持续性反应相关。
GST HYD 0.075mg/cm 是诊断 GST 引起的金接触过敏的最佳剂量。GST 0.5% pet 在一些患者中出现假阴性，提示每平方厘米的剂量不足。在本队列中，迟发读数是金接触过敏诊断的正常、预期和必要的。
