Patch Testing and Prick Testing : A Practical GuideOfficial Publication of the ICDRG

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  • Edition: 2nd
  • Format: Hardcover
  • Copyright: 2009-04-03
  • Publisher: Springer Verlag
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Knowledge in the field of allergic contact dermatitis has grown to a great extent, due to recent advances in the chemical, immunological and clinical fields. These advances include the improved techniques of patch testing and prick testing, e.g. additional tests such as open, semi-open, repeated open application test (ROAT) and use tests, photopatch tests, atopy patch tests and provocative tests. Further, due to the ongoing changes in our environment, the series of patch tests ' the so-called standards ' are also regularly renewed.This new edition is completely revised, updated and expanded, with more colour illustrations. It is a universally useful and superb guide in the management of positive and negative patch test and prick test reactions, for all practicing dermatologists, from the beginner to the well-trained expert.

Table of Contents

The International Contact Dermatitis Research Groupp. 1
Historical Backgroundp. 1
Current Tasks of the ICDRGp. 2
ICDRG Membersp. 2
Referencesp. 3
Patch Testing
The Spectrum of Diseases for Which Patch Testing is Recommendedp. 7
Allergic Contact Dermatitisp. 7
Pathomechanisms in Allergic Contact Dermatitisp. 7
Clinical Signs and Symptomsp. 9
Histopathological Featuresp. 11
The Allergic Contact Dermatitis Syndromep. 12
Stage 1 of ACDSp. 14
Stage 2 of ACDSp. 16
Stage 3 of ACDSp. 18
Allergic Contact Dermatitis vs. Irritant Contact Dermatitis: Criteria for Differential Diagnosisp. 22
Other Skin Diseases in Which Patch Testing is of Major Interestp. 23
An Algorithmic Approach: The Key Role of Patch Testingp. 24
Hand Dermatitis: Procedures Applied in Differential Diagnosisp. 24
Hand Dermatitis: Exogenous and Endogenous Factorsp. 24
A Classification of Hand Dermatitisp. 24
Tools of Investigationp. 29
Hand Dermatitis: Some Examples of an Algorithmic Approachp. 29
Management of Chronic Hand Dermatitisp. 29
Referencesp. 31
Patch Testing Methodologyp. 33
Historical Backgroundp. 33
Definition and Aimsp. 34
Requirements for an Ideal Patch Testing Procedurep. 34
Is Patch Testing the "Gold Standard" to Investigate Patients with Allergic Contact Dermatitis?p. 34
Patch Test Unitsp. 35
Finn Chamberp. 35
Plastic Square Chambersp. 37
Reinforcement of Patch Test Unitsp. 39
A General Overview of Allergensp. 39
Allergensp. 39
Bioavailability of Allergensp. 41
Quality Control of Allergensp. 42
Appropriate Amounts of Petrolatum to be Applied at Patch Testingp. 42
Appropriate Amounts of Liquids to be Applied at Patch Testingp. 42
Specific Recommendations when Considering Patch Testing Patientsp. 42
Patch Testing on Intact Skin is Criticalp. 43
Medicaments and Patch Testingp. 43
Pregnancy and Patch Testingp. 44
Patch Testing in Childrenp. 44
Application of Patch Tests on the Skin: Some Practical Suggestionsp. 45
Test Sitesp. 45
Removal of Hairp. 46
Degreasing of Test Sitep. 46
Application of Test Stripsp. 46
Instructions to Patientsp. 46
Reading Timep. 46
Standard Patch Test Occlusion and Reading Timep. 47
Conventional Patch Test Reading Timep. 47
Reading at Day 2, Day 3, Day 4p. 47
Reading at Day 7p. 47
Single Reading vs. Multiple Readingp. 48
Day 3 vs. Day 4 Readingp. 48
One-Day Occlusion vs. Two-Day Occlusionp. 48
Marking the Skinp. 48
Immediate Urticarial Reactions to Some Allergensp. 49
Reading and Scoring Patch Test Resultsp. 50
Nomenclature: Scoring Codesp. 50
Rating Patch Test Reactions Based on Digital Imagesp. 50
Some Remarks About Reading and Scoringp. 50
Irritant Patch Test Reactionsp. 54
False-Positive Patch Test Reactionsp. 56
False-Negative Patch Test Reactionsp. 57
Compound Allergyp. 57
Cross-Sensitization, Concomitant Sensitization, Polysensitizationp. 58
Cross-Sensitizationp. 58
Concomitant Sensitizationp. 59
Polysensitizationp. 59
Unwanted Adverse Reactions of Patch Testingp. 59
Patch Test Sensitization ("Active Sensitization")p. 61
Excited Skin Syndrome ("Angry Back")p. 61
Patch Test Readings in Different Ethnic Populationsp. 62
Patch Test Reading in Oriental Populationsp. 62
Patch Test Reading in Black Populationsp. 63
Patch Testing Techniques in Different Climatic Environmentsp. 64
Temperate Climatesp. 65
Tropical Climatesp. 65
Patch Testing Procedures in the Tropicsp. 65
Additional Note: Proposal for Modified Scoring Codes of Positive Patch Test Reactionsp. 66
Referencesp. 67
The Standard Series of Patch Testsp. 71
Historical Backgroundp. 71
Advantages and Disadvantages of Using a Standard Series of Patch Testsp. 72
Advantagesp. 72
Disadvantagesp. 72
The Three Major Standard Series Used Throughout the Worldp. 72
Some Remarks About the "Mixes" of the Standard Seriesp. 73
Proposal for an ICDRG Revised International Series of Patch Testsp. 73
List of Allergens Proposed for an Extended ICDRG Series, Which May be Required According to Each Individual Situationp. 77
List of Allergens Proposed to Be Deleted from the Revised and Extended ICDRG Seriesp. 77
Succinct Information about Allergensp. 78
Allergens Listed in Sect. 4.5p. 78
Allergens Listed in Sect. 4.6p. 80
Additional Series of Patch Testsp. 81
Referencesp. 81
Photopatch Testingp. 83
Definition and Aimsp. 83
Photoallergic Contact Dermatitisp. 83
Photoallergic Contact Dermatitis vs. Airborne Allergic Contact Dermatitis: Criteria for Differential Diagnosisp. 86
Photoallergic Drug Eruptionsp. 86
Photopatch Testing Methodologyp. 86
Light Sourcesp. 87
Proposal for a Photopatch Test Seriesp. 87
Referencesp. 88
The TRUE Test Systemp. 89
Introductionp. 89
The TRUE Test Systemp. 89
The Standard TRUE Test Seriesp. 90
Methodology of Usep. 91
Regulatory Informationp. 92
Additional Practical Informationp. 94
Conventional Patch Testing vs. TRUE Test: The Current Situationp. 94
Referencesp. 97
Additional Testing Proceduresp. 99
Stripping Testp. 99
Open Testp. 99
Semi-Open Testp. 100
Repeated Open Application Testp. 102
Testing Procedures with Unknown Substancesp. 103
Strategyp. 104
Steps Required Prior to Any Testing Procedurep. 104
Testing Procedures with Solid Products and Extractsp. 105
Testing Procedures with Cosmetics and Other Related Productsp. 106
Oral Provocation Test (Oral Challenge)p. 106
Other Investigationsp. 107
pH Measurementp. 107
Spot Testsp. 107
Chemical Analysisp. 110
Referencesp. 110
Clinical Relevance of Patch Test Reactionsp. 113
Introductionp. 113
General Principlesp. 113
Past and Current Relevancep. 114
Scoring Systemp. 114
Strategiesp. 115
Clinical Historyp. 116
Environmental Evaluationp. 117
Further Correlationsp. 118
Additional Investigationsp. 118
Suggestions for Improved Evidence-Based Diagnosis of Relevancep. 119
Referencesp. 120
The Atopy Patch Test in Atopic Dermatitisp. 121
Introductionp. 121
Atopy Patch Test Techniquep. 122
Atopy Patch Test Readingp. 123
Atopy Patch Test Relevance, Patient Subgroups, and Pitfallsp. 124
Referencesp. 126
Prick Testing
The Spectrum of Diseases for Which Prick Testing and Open (Non-Prick) Testing are Recommendedp. 131
The Contact Urticaria Syndromep. 131
Clinical Symptoms and Stages of CUSp. 131
Etiology and Mechanisms of CUSp. 134
Contact Urticaria to Natural Rubber Latexp. 136
Protein Contact Dermatitisp. 137
Referencesp. 139
The Methodology of Open (Non-Prick) Testing, Prick Testing, and its Variantsp. 141
Open (Non-Prick) Testingp. 141
Prick Test: Technical Modalities and Readingp. 141
Technique of Puncturep. 142
Control Solutionsp. 143
Reading Timep. 143
Reading Prick Test Resultsp. 143
Medicaments and Prick Testingp. 144
False-Negative Reactionsp. 144
False-Positive Reactionsp. 145
Prick Tests in Children and Babiesp. 145
Prick-by-Prick Testp. 145
Scratch Testp. 145
Scratch-Chamber Testp. 146
Comparative Indications of Open (Non-Prick) Testing, Prick Testing, and Other Related Testsp. 146
Intradermal Testingp. 146
Prick Testing: Allergens of Interest for Skin Problemsp. 147
Latexp. 147
Airborne Environmental per Annum Allergensp. 148
Airborne Environmental Seasonal Allergensp. 148
Food Allergens (Trophallergens)p. 149
Occupational Allergensp. 149
Fungip. 149
Miscellaneous (Immunological and/or Non-Immunological) Urticariogensp. 150
Referencesp. 151
Testing in Cutaneous Systemic Adverse Drug Reactions: Interest and Limitations
Testing Procedures in Cutaneous Systemic Adverse Drug Reactionsp. 155
General Considerationsp. 155
Tools of Investigation in CADRp. 155
Histopathological Limitations in Diagnosis of a CADRp. 156
Patch Testing in CADRp. 156
The Spectrum of CARDs for Which Patch Testing is Recommendedp. 157
The Spectrum of CARDs for Which Patch Testing can be Performed (Being Still Controversial)p. 160
The Spectrum of CARDs for Which Patch Testing is of No Interestp. 160
Guidelines in Drug Patch Testing: General Rulesp. 160
Technical Aspects of Drug Patch Testingp. 161
Readings of Drug Patch Testsp. 163
False-nagative Patch Test Reactionsp. 163
False-Positive Patch Test Reactionsp. 164
Prick Testing in CADRp. 165
Intradermal Testing in CADRp. 165
Oral Provocation Test (Oral Challenge) in CADRp. 165
Referencesp. 166
Appendixp. 167
Introductory Remarksp. 167
Bakery Seriesp. 168
Corticosteroid Seriesp. 169
Cosmetic Seriesp. 171
Epoxy Resin Seriesp. 173
Hairdressing Seriesp. 175
Isocyanate Seriesp. 176
Metals Seriesp. 177
(Meth) Acrylate Seriesp. 177
Plastics and Glues Seriesp. 178
Rubber Additives Seriesp. 179
Textile Dyes and Finish Seriesp. 180
Disperse Dyesp. 182
Other Dyesp. 183
Textile Finish Resin Allergensp. 183
Other Seriesp. 183
Shoe Dermatitisp. 183
Plant Dermatitisp. 184
Referencesp. 188
Suggested Readingp. 189
Indexp. 191
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