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M Bruze - One of the best experts on this subject based on the ideXlab platform.
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thoughts on how to improve the quality of multicentre Patch Test studies
Contact Dermatitis, 2016Co-Authors: M BruzeAbstract:Multicentre Patch Test studies (MPTSs) can contribute useful information for diagnostic and preventive measures. The aim of the present paper is to propose how to perform high-quality MPTSs. To this end, factors of significance for the Patch Test result are discussed with regard to the standardization and calibration of high-quality MPTSs. The 16 factors discussed are scored 0, 1, 2, or 3, depending on the relative importance of a particular factor for the Patch Test result. The total score of an MPTS allows it to be ranked as having doubtful, acceptable, high or excellent quality. A total score of 30 is possible. Depending on the total score the MPTSs are grouped into those with a doubtful, acceptable, high, and excellent quality. In conclusion, high-quality MPTSs can be performed and are facilitated if a guideline and check list are followed when the study is being planned. The scoring enables the calculation of a total score, which can be used for quality ranking.
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recommendation to include formaldehyde 2 0 aqua in the european baseline Patch Test series
Contact Dermatitis, 2013Co-Authors: Ann Ponten, An Goossens, M BruzeAbstract:The currently used Patch Test concentration of formaldehyde (1.0% aqua; 0.30 mg/cm(2) ) has been shown to fail to detect ˜ 50% of contact allergies to formaldehyde.
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stability of fragrance Patch Test preparations applied in Test chambers
British Journal of Dermatology, 2012Co-Authors: Martin Mowitz, Cecilia Svedman, Erik Zimerson, M BruzeAbstract:Background: Petrolatum Patch Test preparations are for practical reasons often applied in Test chambers in advance, several hours or even days before the patient is Tested. As many fragrance compounds are volatile it may be suspected that petrolatum preparations applied in Test chambers are not stable over time. Objectives: To investigate the stability of petrolatum preparations of the 7 chemically defined components in the fragrance mix (FM I) when stored in Test chambers. Material and methods: Samples of petrolatum preparations applied in Test chambers stored at room temperature and in a refrigerator between 4 and 144 h were analyzed using liquid chromatographic methods. Results: The concentration decreased by ≥20% within 8 h in 4 out of 7 preparations stored in Finn chambers at room temperature. When stored in a refrigerator only the preparation of cinnamal had decreased by ≥20% within 24 h. The stability of preparations of cinnamal stored in IQ chambers with a plastic cover was slightly better, but like the preparations applied in Finn chambers, the concentration decreased by ≥20% within 4 h at room temperature and within 24 h in a refrigerator. Cinnamal and cinnamyl alcohol were found to be more stable when analyzed as ingredients in FM I compared to when analyzed in individual preparations. Conclusions: Within a couple of hours several fragrance allergens evaporate from Test chambers to an extent that may affect the outcome of the Patch Test. Application to the Test chambers should be performed as close to the Patch Test occasion as possible and storage in a refrigerator is recommended.
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calibration of our Patch Test reading technique is necessary
Contact Dermatitis, 2012Co-Authors: Cecilia Svedman, Marlene Isaksson, Jonas Bjork, Martin Mowitz, M BruzeAbstract:Background: Patch Testing has been used for more than 100 years as the best means to diagnose contact allergy. The increased use of the technique makes standardization of the methodology most important. Progress in the standardization of the Patch Test technique has been made through guidelines. Objectives: To investigate the intra-individual and inter-individual differences in reading of Patch Tests in order to validate the actual Patch Test reading when reading is performed according to the same guidelines, and to determine whether information on guidelines actually improves the outcome of the Patch Test readings Patients/materials/methods. A Patch Test course for dermatologists was performed. Volunteers were Patch Tested with irritants and allergens in different concentrations. The Patch Test reader did not know what substances had been Tested. Results: Irritant reactions/doubtful reactions and weak allergic reactions are difficult to differentiate (accordance for these reactions 21%, 19%, and 44%). Information and education have a beneficial effect on results, as shown by an improved kappa value. Conclusions: Standardization of Patch Test reading is important. Information on the classification system resulted in a significant improvement. Interpretation of guidelines should be continuously evaluated. (Less)
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Patch Test concentrations doses in mg cm2 for the 12 non mix fragrance substances regulated by european legislation
Contact Dermatitis, 2012Co-Authors: M Bruze, Cecilia Svedman, Klaus Ejner Andersen, Jeanne D Johansen, An Goossens, D P Bruynzeel, Mihaly Matura, David Orton, M ViganAbstract:Background. According to EU legislation, 26 fragrance substance allergens must be labelled on cosmetic products. For 12 of them, the optimal Patch Test concentration/dose has not been evaluated. Objectives. To establish the optimal Patch Test doses in mg/cm(2) for the 12 fragrance substances that are not included in fragrance mix I or II in the European baseline Patch Test series. Materials and Methods. Patch Testing with the 12 fragrance substances was performed in a stepwise manner encompassing up to five rounds in at least 100 dermatitis patients for each round. Before Patch Testing, an individual maximum concentration/dose was determined for each fragrance substance. Results. The predetermined maximum Patch Test concentrations/doses could be Tested for all 12 fragrance substances, with no observable adverse reactions being noted. Conclusions. For each fragrance substance investigated, it is recommended that half of the maximum Patch Test dose (mg/cm(2) ) be used for aimed and screening Patch Testing. (Less)
Wolfgang Uter - One of the best experts on this subject based on the ideXlab platform.
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skin irritability to sodium lauryl sulfate is associated with increased positive Patch Test reactions
British Journal of Dermatology, 2014Co-Authors: Judith Schwitulla, Axel Schnuch, Jochen Brasch, Johannes Geier, Harald Loffler, Wolfgang UterAbstract:Summary Background As previous observations have indicated an inter-relationship between irritant and allergic skin reactions we analysed data of synchronous allergen and sodium lauryl sulfate (SLS) Patch Tests in terms of a relationship between SLS responsiveness and allergic Patch Test reactions. Objectives To analyse differences in terms of allergen-specific and overall reaction profiles between patients with vs. those without an irritant reaction to SLS. Methods Clinical data of 26 879 patients Patch Tested from 2008 to 2011 by members of the Information Network of Departments of Dermatology were analysed. After descriptive analyses, including the MOAHLFA index, the positivity ratio and the reaction index, a negative binomial hurdle model was adopted to investigate the correlation between SLS reactivity and positive Patch Test reactions. Results Men, patients aged ≥ 40 years and patients with an occupational dermatitis background were over-represented in the SLS-reactive group. Patients with an irritant reaction to SLS showed a higher proportion of weak positive reactions, as well as more questionable and irritant reactions to contact allergens than patients not reactive to SLS. The risk of an additional positive Patch Test reaction increased by 22% for SLS-reactive patients compared with those who were SLS negative. Conclusions The marked association between SLS reactivity and the number of positive reactions in Patch Test patients may be due to nonspecific increased skin reactivity at the moment of Patch Testing only. However, increased SLS reactivity could also be due to longer-lasting enhanced skin irritability, which may have promoted (poly-)sensitization. Further studies, for example with longitudinal data on patients repeatedly Patch Tested with SLS and contact allergens, are necessary.
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Extreme Patch Test reactivity to p-phenylenediamine but not to other allergens in children.
Contact Dermatitis, 2011Co-Authors: Petra Spornraft-ragaller, Axel Schnuch, Wolfgang UterAbstract:Background. According to clinical impression, extreme Patch Test reactions (+++) to p-phenylenediamine (PPD) are not uncommon in children. Objectives. To investigate the Patch Test reactivity in children (aged 1–14 years) in comparison with other age groups and other allergens. Methods. A retrospective analysis was performed of data from the German Information Network of Departments of Dermatology, including all patients consecutively Patch Tested between 1994 and 2004 with PPD, and, for comparison, nickel, fragrance mix I, and methylchloroisothiazolinone (MCI)/methylisothiazolinone (MI). The distribution of +, ++ and +++ grades of positive reactions among those with a positive reaction were analysed in five age strata. Results. We found a strikingly higher proportion of +++ reactions to PPD in children than in all other age groups (p < 0.001). No such difference was observed for the other allergens. The main suspected exposures associated with extreme reactions to PPD in children were hair dyes and ‘henna tattoos'. Conclusions. The high proportion of extreme Patch Test reactions to PPD, but not to other important allergens, in children reflects intense sensitization, probably because of a high induction dose from PPD-containing ‘henna tattoos'. In children with a history of contact allergy to ‘henna tattoos' or hair dyes, the standard Patch Test concentration of PPD 1% should be drastically reduced.
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strong allergic Patch Test reactions may indicate a general disposition for contact allergy
Allergy, 2006Co-Authors: Jochen Brasch, Axel Schnuch, Wolfgang UterAbstract:Background: Patch Test patients have two or more positive reactions to unrelated allergens more often than to be expected by chance. This study evaluates synchronous Patch Test reactions to Test the hypothesis that in such cases an allergen-independent disposition for contact sensitization may be involved. Methods: Data of 87 834 patients Tested with a standard Patch Test series in 42 centers of a Central European Network were retrospectively evaluated. Analyses were done for synchronous positive reactions of graded strength to nickel sulfate, fragrance mix, and to those five allergens that followed in frequency of positive results. All seven allergens selected were not related by chemical structure or exposure. Descriptive univariate and bivariate analyses as well as a polytomous logistic regression analysis were performed. Odds ratios with 95% confidence intervals were calculated. Results: With an increasing strength of a positive reaction to nickel or to fragrance mix the likelihood of further positive reactions to unrelated contact allergens increased significantly, and the mean strength of such additional reactions raised steadily with an increasing strength of a nickel or fragrance reaction. Conclusions: Our findings support the idea that patients who respond with a strong Patch Test reaction may have a particular general disposition to acquire contact sensitivity to additional unrelated allergens. They should therefore not only be advised to avoid their known allergen but in addition to minimize exposure other contact allergens.
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A high-positive Patch Test load correlates with further positive Patch Test reactions irrespective of their location.
Allergy, 2006Co-Authors: Jochen Brasch, Axel Schnuch, Johannes Geier, Wolfgang UterAbstract:Background: Patch Testing is the standard clinical procedure to prove contact sensitization. It is a common practice to attach multiple Patch Tests at the same time. However, synchronous reactions to unrelated allergens may not be completely unassociated. If so, the reaction in a given Test field might be influenced by other positive Test reactions in a distance-related degree. This article analyses whether there is a distance-related effect of synchronous positive Patch Test reactions on the outcome of a target Patch Test. Methods: Data collected from patients Patch Tested for diagnostic purposes with 15 standard allergens attached in a specific pattern between 1992 and 2004 in 20 centres in a Central European network were retrospectively evaluated. The association between the target Patch Test result (allergic vs negative reaction to the thiuram mix) and the number and cumulated strength of synchronous positive reactions (positive Patch Test load) to allergens placed in nearby or distant positions to the target Patch was analysed by using logistic regression analysis. Results: The likelihood of a positive reaction to thiuram mix significantly increased with an increasing synchronous positive Patch Test load generated by positive reactions to allergens unrelated to thiuram mix. The effect of allergens neighbouring the target allergen was not significantly stronger than that of allergens placed in distant positions. Conclusion: For the interpretation of Patch Test results, the potentially enhancing effects of a synchronous positive Patch Test load should be considered. The local distribution of the Patches on the back is, however, not critical.
Cecilia Svedman - One of the best experts on this subject based on the ideXlab platform.
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clinical relevance of positive Patch Test reactions to lanolin a roat study
Contact Dermatitis, 2021Co-Authors: Ada Uldahl, Malin Engfeldt, Cecilia SvedmanAbstract:Background: Lanolin is often included when Patch Testing for common contact allergens. The clinical relevance of a positive Patch Test reaction to lanolin markers is, however, still a subject for debate. Objectives: To evaluate Amerchol L101 as a marker of lanolin allergy and investigate the clinical impact of lanolin-containing moisturizers on healthy and damaged skin using the repeated open application Test (ROAT). Methods: Twelve Test subjects and 14 controls were Patch Tested with Amerchol L 101 and additional lanolin markers. Subsequently, a blinded ROAT was performed on the arms of the study participants for 4 weeks. Each participant applied a lanolin-free cream base and two different lanolin-containing Test creams twice daily on one arm with intact skin and on the other arm with irritant dermatitis, induced by sodium lauryl sulfate (SLS). Results: Eleven Test subjects (92%) had positive Patch Test reactions to Amerchol L 101 when reTested and one Test subject (8%) had a doubtful reaction. None of the study participants had any skin reactions to the ROAT on intact skin and all participants healed during the ROAT on damaged skin. Conclusions: Lanolin-containing emollients do not cause or worsen existing dermatitis when performing ROAT in volunteers Patch Test positive to Amerchol L101. (Less)
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stability of fragrance Patch Test preparations applied in Test chambers
British Journal of Dermatology, 2012Co-Authors: Martin Mowitz, Cecilia Svedman, Erik Zimerson, M BruzeAbstract:Background: Petrolatum Patch Test preparations are for practical reasons often applied in Test chambers in advance, several hours or even days before the patient is Tested. As many fragrance compounds are volatile it may be suspected that petrolatum preparations applied in Test chambers are not stable over time. Objectives: To investigate the stability of petrolatum preparations of the 7 chemically defined components in the fragrance mix (FM I) when stored in Test chambers. Material and methods: Samples of petrolatum preparations applied in Test chambers stored at room temperature and in a refrigerator between 4 and 144 h were analyzed using liquid chromatographic methods. Results: The concentration decreased by ≥20% within 8 h in 4 out of 7 preparations stored in Finn chambers at room temperature. When stored in a refrigerator only the preparation of cinnamal had decreased by ≥20% within 24 h. The stability of preparations of cinnamal stored in IQ chambers with a plastic cover was slightly better, but like the preparations applied in Finn chambers, the concentration decreased by ≥20% within 4 h at room temperature and within 24 h in a refrigerator. Cinnamal and cinnamyl alcohol were found to be more stable when analyzed as ingredients in FM I compared to when analyzed in individual preparations. Conclusions: Within a couple of hours several fragrance allergens evaporate from Test chambers to an extent that may affect the outcome of the Patch Test. Application to the Test chambers should be performed as close to the Patch Test occasion as possible and storage in a refrigerator is recommended.
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calibration of our Patch Test reading technique is necessary
Contact Dermatitis, 2012Co-Authors: Cecilia Svedman, Marlene Isaksson, Jonas Bjork, Martin Mowitz, M BruzeAbstract:Background: Patch Testing has been used for more than 100 years as the best means to diagnose contact allergy. The increased use of the technique makes standardization of the methodology most important. Progress in the standardization of the Patch Test technique has been made through guidelines. Objectives: To investigate the intra-individual and inter-individual differences in reading of Patch Tests in order to validate the actual Patch Test reading when reading is performed according to the same guidelines, and to determine whether information on guidelines actually improves the outcome of the Patch Test readings Patients/materials/methods. A Patch Test course for dermatologists was performed. Volunteers were Patch Tested with irritants and allergens in different concentrations. The Patch Test reader did not know what substances had been Tested. Results: Irritant reactions/doubtful reactions and weak allergic reactions are difficult to differentiate (accordance for these reactions 21%, 19%, and 44%). Information and education have a beneficial effect on results, as shown by an improved kappa value. Conclusions: Standardization of Patch Test reading is important. Information on the classification system resulted in a significant improvement. Interpretation of guidelines should be continuously evaluated. (Less)
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Patch Test concentrations doses in mg cm2 for the 12 non mix fragrance substances regulated by european legislation
Contact Dermatitis, 2012Co-Authors: M Bruze, Cecilia Svedman, Klaus Ejner Andersen, Jeanne D Johansen, An Goossens, D P Bruynzeel, Mihaly Matura, David Orton, M ViganAbstract:Background. According to EU legislation, 26 fragrance substance allergens must be labelled on cosmetic products. For 12 of them, the optimal Patch Test concentration/dose has not been evaluated. Objectives. To establish the optimal Patch Test doses in mg/cm(2) for the 12 fragrance substances that are not included in fragrance mix I or II in the European baseline Patch Test series. Materials and Methods. Patch Testing with the 12 fragrance substances was performed in a stepwise manner encompassing up to five rounds in at least 100 dermatitis patients for each round. Before Patch Testing, an individual maximum concentration/dose was determined for each fragrance substance. Results. The predetermined maximum Patch Test concentrations/doses could be Tested for all 12 fragrance substances, with no observable adverse reactions being noted. Conclusions. For each fragrance substance investigated, it is recommended that half of the maximum Patch Test dose (mg/cm(2) ) be used for aimed and screening Patch Testing. (Less)
Ian R White - One of the best experts on this subject based on the ideXlab platform.
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Patch Test frequency to p phenylenediamine follow up over the last 6 years
Contact Dermatitis, 2007Co-Authors: Sheena Patel, David A Basketter, R J G Rycroft, Ian R White, Donna Jefferies, J P McfaddenAbstract:While the frequency of Patch Test reactivity to many cosmetic allergens has decreased over the last 20 years, we have previously shown that in our clinic, the Patch Test reactivity to p-phenylenediamine (PPD) has remained stubbornly high between 2.5% and 4.2% in the years when Patch Testing was performed with 1% PPD. Further retrospective analysis of the PPD Patch Test frequency over the last 6 years shows an increasing rate of PPD Patch Test frequency, showing an upward linear trend. This increasing trend cannot be fully explained by any increase in Patch Testing of Southern Asian patients or of sensitization caused by PPD exposure from 'temporary henna tattoos'. An alternative explanation may be the increasing use of permanent hair dyes.
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analysis of para phenylenediamine allergic patients in relation to strength of Patch Test reaction
British Journal of Dermatology, 2005Co-Authors: S G Y Ho, David A Basketter, D Jefferies, R J G Rycroft, Ian R White, J P McfaddenAbstract:Summary Background Despite having a positive Patch Test reaction to para-phenylenediamine (PPD), some patients continue to dye their hair, while others are forced to give up or abandon this practice. This difference in patient behaviour could be due to the degree of sensitization. Objectives To establish whether the ability to continue dyeing hair in PPD allergic patients is related to the strength of Patch Test reaction. To note differences in other clinical features in relation to the strength of Patch Test reaction. Methods We analysed retrospectively the Patch Test records of 400 sequential PPD-positive patients for the strength of Patch Test reaction (+, ++, +++) and different clinical features. Data were analysed using Cochran–Mantel–Haenszel χ2 Tests. Results There was a strong linear relationship between the strength of Patch Test reaction and continuation with hair dyeing. Patients were more likely to report a history of hair dye reaction with increasing strength of Patch Test reaction. There was no difference in strength of Patch Test reaction in relation to age, site of rash, occupation (hairdressing) or history of atopic eczema. Overall concomitant reactivity with related aromatic amine allergens (benzocaine, N-isopropyl-N-phenyl-para-phenylenediamine, para-aminobenzoic acid) was infrequent. Conclusions Patients with stronger Patch Test reactions (++, +++) are more likely to have a clear history of reacting to hair dye and are less likely to still be dyeing their hair.
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thoughts on sensitizers in a standard Patch Test series the european society of contact dermatitis
Contact Dermatitis, 1999Co-Authors: M Bruze, L Condesalazar, An Goossens, Lasse Kanerva, Ian R WhiteAbstract:Patch Testing is the predominant method of establishing contact allergy. The present Patch Test technique is the result of a continuous process of development and improvement since its first application in the late 19th century. The perfect Patch Test should give no false-positive and no false-negative reactions. The ideal Patch Test should also cause as few adverse reactions as possible, particularly no Patch Test sensitization. Even though the history and examination of a patient with suspected allergic contact dermatitis will give clues to possible sensitizers, it is not sufficient to Patch Test only with initially suspected sensitizers; unsuspected sensitizers used for Patch Testing frequently turn out to be the real cause of the dermatitis. Fortunately, a small number of substances are considered to account for the majority of delayed hypersensitivity reactions. Therefore, generally 20-25 Test preparations consisting of chemically defined compounds, mixes of allergens, and natural and synthetic compounds, are grouped into a standard Test series. The requirements to be fulfilled by a sensitizer in a standard Patch Test series are discussed in this article. A procedure of investigations is proposed before a sensitizer is included in a standard series.
Klaus Ejner Andersen - One of the best experts on this subject based on the ideXlab platform.
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outcome of a second Patch Test reading of true Tests on d6 7
Contact Dermatitis, 2012Co-Authors: Jakob Torp Madsen, Klaus Ejner AndersenAbstract:Background. Two readings of Patch Test reactions are recommended. Objectives. To evaluate the outcome of a second Patch Test reading of TRUE Test® allergens on D6/7 in relation to negative or doubtful reactions on D3/4. Methods. This was a retrospective investigation of Patch Test data from January 1992 to October 2011 from consecutive eczema patients Tested with the TRUE Test® panels. Results. In the period of nearly 20 years, a total of 9997 patients were Tested. The total number of positive reactions to the 29 allergens was 6509; 4.4% were positive on D6/7 and negative on D3/4; and 9.1% were positive on D6/7 after a doubtful (?+) reaction on D3/4. Neomycin was the most frequent allergen giving delayed positive reactions (57%), followed by budesonide (42%) and hydrocortisone-17-butyrate (31%). Conclusion. A total of 4.4% of positive TRUE Test® reactions would be missed, and 9.1% might be missed, if only one reading was performed on D3/4. The results emphasize that many doubtful reactions at D3/4 may develop into positive reactions at a later reading. This may have important implications for evaluation of the clinical relevance of the Test result.
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stability of selected volatile contact allergens in different Patch Test chambers under different storage conditions
Contact Dermatitis, 2012Co-Authors: Kristian Fredlov Mose, Klaus Ejner Andersen, Lars Porskjaer ChristensenAbstract:Background. Patch Test preparations of volatile substances may evaporate during storage, thereby giving rise to reduced Patch Test concentrations. Objectives. To investigate the stability of selected acrylates/methacrylates and fragrance allergens in three different Test chambers under different storage conditions. Methods. Petrolatum samples of methyl methacrylate (MMA), 2-hydroxyethyl methacrylate (2-HEMA), 2-hydroxypropyl acrylate (2-HPA), cinnamal and eugenol in Patch Test concentrations were stored in three different Test chambers (IQ chamber™, IQ Ultimate™, and Van der Bend® transport container) at room temperature and in a refrigerator. The samples were analysed in triplicate with high-performance liquid chromatography. Results. The decrease in concentration was substantial for all five allergens under both storage conditions in IQ chamber™ and IQ Ultimate™, with the exception of 2-HEMA during storage in the refrigerator. For these two chamber systems, the contact allergen concentration dropped below the stability limit in the following order: MMA, cinnamal, 2-HPA, eugenol, and 2-HEMA. In the Van der Bend® transport container, the contact allergens exhibited acceptable stability under both storage conditions, whereas MMA and 2-HPA required cool storage for maintenance of the limit. Conclusion. The Van der Bend® transport container was the best device for storage of samples of volatile contact allergens.
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Patch Test concentrations doses in mg cm2 for the 12 non mix fragrance substances regulated by european legislation
Contact Dermatitis, 2012Co-Authors: M Bruze, Cecilia Svedman, Klaus Ejner Andersen, Jeanne D Johansen, An Goossens, D P Bruynzeel, Mihaly Matura, David Orton, M ViganAbstract:Background. According to EU legislation, 26 fragrance substance allergens must be labelled on cosmetic products. For 12 of them, the optimal Patch Test concentration/dose has not been evaluated. Objectives. To establish the optimal Patch Test doses in mg/cm(2) for the 12 fragrance substances that are not included in fragrance mix I or II in the European baseline Patch Test series. Materials and Methods. Patch Testing with the 12 fragrance substances was performed in a stepwise manner encompassing up to five rounds in at least 100 dermatitis patients for each round. Before Patch Testing, an individual maximum concentration/dose was determined for each fragrance substance. Results. The predetermined maximum Patch Test concentrations/doses could be Tested for all 12 fragrance substances, with no observable adverse reactions being noted. Conclusions. For each fragrance substance investigated, it is recommended that half of the maximum Patch Test dose (mg/cm(2) ) be used for aimed and screening Patch Testing. (Less)
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oral prednisone suppresses allergic but not irritant Patch Test reactions in individuals hypersensitive to nickel
Contact Dermatitis, 2004Co-Authors: Ingegard Anveden, Jan E. Wahlberg, Klaus Ejner Andersen, Marlene Isaksson, M Bruze, Magnus Lindberg, Carola Liden, Mette Sommerlund, John Wilkinson, Carolyn M WillisAbstract:A multicentre, randomized, double-blind, crossover study was designed to investigate the effects of prednisone on allergic and irritant Patch Test reactions. 24 subjects with known allergy to nickel were recruited and Patch Tested with a nickel sulfate dilution series in aqueous solution, 5% nickel sulfate in petrolatum and 2 dilution series of the irritants nonanoic acid and sodium lauryl sulfate. The subjects were Tested x2, both during treatment with prednisone 20 mg oral daily and during placebo treatment. The total number of positive nickel Patch Test reactions decreased significantly in patients during prednisone treatment. The threshold concentration to elicit a Patch Test reaction increased and the overall degree of reactivity to nickel sulfate shifted towards weaker reactions. The effect of prednisone treatment on the response to irritants was divergent with both increased and decreased numbers of reactions, although there were no statistically significant differences compared with placebo. It is concluded that oral treatment with prednisone suppresses Patch Test reactivity to nickel, but not to the irritants Tested.
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Nickel Patch Test reactivity and the menstrual cycle.
Acta dermato-venereologica, 1994Co-Authors: Allan Rohold, Halkier-sørensen L, Klaus Ejner Andersen, Kristian Thestrup-pedersenAbstract:Premenstrual exacerbation of allergic contact dermatitis and varying allergic Patch Test responses have been reported at different points of the period. Using a dilution series of nickel sulphate, we studied the variation in Patch Test reactivity in nickel allergic women in relation to the menstrual cycle. Twenty women with regular periods were Tested on day 7-10 and on day 20-24. Ten nickel Patch Tests with different concentrations were applied using the TRUE Test assay, and the threshold concentration of nickel sulphate eliciting an erythematous reaction was determined. Half of the women were Tested first on day 7-10 and the other half first on day 20-24. There was no difference in the degree of Patch Test reactivity, when the results from day 7-10 and day 20-24 were compared (p > 0.4). However, when we compared the Patch Test results from the first and second Test procedure, we found an increased nickel sensitivity at the second Patch Test (0.02 < p < 0.05), suggesting a booster effect from the first Patch Test procedure. In conclusion, we could not demonstrate an increased sensitivity to nickel sulphate Patch Tests premenstrually in 20 nickel allergic women, but we found that elicitation of positive Patch Tests led to an increased skin reactivity towards the same allergen, when the patients were reTested weeks later.