Schmidlin Kristin, Sani Sonam, Bernstein David I, Fonacier Luz
Division of Immunology, Allergy and Rheumatology, University of Cincinnati College of Medicine, Cincinnati, Ohio; Cincinnati VA Medical Center, Cincinnati, Ohio.
NYU Winthrop Hospital, Mineola, NY.
J Allergy Clin Immunol Pract. 2020 Jun;8(6):1883-1893. doi: 10.1016/j.jaip.2020.02.009. Epub 2020 Feb 26.
Contact dermatitis (CD) is a common skin condition caused by contact with an exogenous agent that elicits an inflammatory response. Although history and physical examination can be helpful in distinguishing between irritant CD and allergic CD (ACD), the gold standard for diagnosing ACD is patch testing. Although the actual patch test (PT) procedure and application is relatively straightforward, the decisions involving which allergens to use, interpretation of results, determination of relevant allergens, and subsequent patient management require more skill and expertise. Often, the distribution of the presenting dermatitis can provide insight into the potential causative allergens and should be taken into account when selecting PT allergens. Commercially available PT panels and personal care products can be used for patch testing. Determining the clinical relevance of PT results is a critical component of the PT procedure. Patients must be educated on avoidance of relevant allergens and given guidance on alternative products available for use. Special populations, including children with ACD and occupational CD, and patients with biomedical devices have unique allergen considerations, and PT panels should be directed as such to address all potential allergens.
接触性皮炎（CD）是一种常见的皮肤疾病，由接触引发炎症反应的外源性物质所致。虽然病史和体格检查有助于区分刺激性接触性皮炎和过敏性接触性皮炎（ACD），但诊断ACD的金标准是斑贴试验。尽管实际的斑贴试验（PT）操作过程相对简单，但在选择使用哪些变应原、解读结果、确定相关变应原以及后续的患者管理等方面的决策需要更多技巧和专业知识。通常，所呈现的皮炎分布情况可有助于了解潜在的致病变应原，在选择PT变应原时应予以考虑。市售的PT试剂盒和个人护理产品可用于斑贴试验。确定PT结果的临床相关性是PT操作过程的关键组成部分。必须对患者进行教育，使其避免接触相关变应原，并为其提供可使用的替代产品的指导。特殊人群，包括患有ACD和职业性CD的儿童以及使用生物医学设备的患者，有独特的变应原考虑因素，PT试剂盒应针对性地设计，以涵盖所有潜在变应原。
