Division of Allergy and Immunology, Department of Medicine, Albany Medical College, Albany, NY.
Division of Internal Medicine, Department of Medicine, Albany Medical College, Albany, NY.
Ann Allergy Asthma Immunol. 2019 May;122(5):502-507. doi: 10.1016/j.anai.2019.02.028. Epub 2019 Mar 6.
Patch testing is the "gold standard" to identify culprit allergen(s) causing allergic contact dermatitis (ACD), but there are limited studies of patch testing from allergy practice settings.
We sought to explore patch test findings in a large academic allergy practice, including patch testing results, history of atopy, location of dermatitis, and referral source. We also wanted to determine whether patch testing using an extended panel, such as the North American screening series, compared with a limited series, such as the Thin-Layer Rapid-Use Epicutaneous (T.R.U.E.) Test, increased the sensitivity.
A retrospective chart review was conducted of patients referred for patch testing over a 6-year period.
A total of 585 patients (mean age 48.7 years, 71.6 % female) underwent patch testing over the 6-year period, of which 369 (63%) had a positive test. Of those who tested positive, 202 (55%) reported a history of atopy. The extremities were the most commonly involved site, followed by the head/neck and trunk. The 5 most common positive allergens were nickel sulfate, gold sodium thiosulfate, methylchloroisothiazolinone, thimerosal, and bacitracin. Three hundred fourteen (53.6%) patients were positive to at least 1 allergen on TRUE testing. Extended screening series identified an additional 10.8% of patients with positive tests who were negative to T.R.U.E. test allergens.
Patch testing is a valuable diagnostic tool for the practicing allergist and provides early identification of culprit allergens in ACD. Performing an extended screening series such as the North American Contact Dermatitis Group (NACDG) or supplemental panel of allergens increased sensitivity when compared with a limited series.
斑贴试验是识别引起变应性接触性皮炎（ACD）的罪魁祸首过敏原的“金标准”，但从过敏实践环境中进行斑贴试验的研究有限。
我们旨在探索大型学术过敏实践中的斑贴试验结果，包括斑贴试验结果、特应性病史、皮炎位置和转诊来源。我们还想确定使用北美筛选系列等扩展斑贴试验与使用薄层快速经皮（T.R.U.E.）测试等有限系列相比是否会提高敏感性。
对 6 年内因斑贴试验而转诊的患者进行回顾性图表审查。
在 6 年内共有 585 名患者（平均年龄 48.7 岁，71.6%为女性）进行了斑贴试验，其中 369 名（63%）的试验结果为阳性。在阳性患者中，202 名（55%）报告有特应性病史。最常受累的部位是四肢，其次是头/颈部和躯干。最常见的 5 种阳性过敏原是硫酸镍、金钠硫代硫酸、甲基氯异噻唑啉酮、汞和杆菌肽。314 名（53.6%）患者在 TRUE 测试中至少对 1 种过敏原呈阳性。扩展筛选系列在对 TRUE 测试过敏原呈阴性的患者中又发现了 10.8%的阳性患者。
斑贴试验是执业过敏学家的有价值的诊断工具，可早期识别 ACD 的罪魁祸首过敏原。与有限系列相比，进行扩展筛选系列（如北美接触性皮炎组（NACDG）或补充过敏原系列）可提高敏感性。
