From the Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV.
Department of Dermatology, Minneapolis Veterans Affairs Medical Center.
Dermatitis. 2020 Mar/Apr;31(2):99-105. doi: 10.1097/DER.0000000000000498.
Identification of the etiological chemical agent(s) associated with a case(s) of allergic contact dermatitis (ACD) is important for both patient management and public health surveillance. Traditional patch testing can identify chemical allergens to which the patient is allergic. Confirmation of allergen presence in the causative ACD-associated material is presently dependent on labeling information, which may not list the allergenic chemical on the product label or safety data sheet. Dermatologists have expressed concern over the lack of laboratory support for chemical allergen identification and possibly quantification from patients' ACD-associated products. The aim of this review was to provide the clinician a primer to better understand the analytical chemistry of contact allergen confirmation and unknown identification, including types of analyses, required instrumentation, identification levels of confidence decision tree, limitations, and costs.
鉴定与变应性接触性皮炎（ACD）病例相关的病因化学剂对于患者管理和公共卫生监测都很重要。传统的斑贴试验可以识别患者过敏的化学过敏原。目前，在引起 ACD 的相关物质中确认过敏原的存在取决于标签信息，而产品标签或安全数据表上可能并未列出致敏化学物质。皮肤科医生对缺乏实验室支持来从患者的 ACD 相关产品中鉴定和（可能）定量化学过敏原表示担忧。本综述的目的是为临床医生提供一个入门指南，以更好地了解接触过敏原确认和未知物鉴定的分析化学，包括分析类型、所需仪器、鉴定置信度决策树、局限性和成本。
