A non-randomized, controlled study evaluating the effect of patch tests position on reactivity of the antigens

Ida Duarte; Rosana Lazzarini

2007, Number 2

<< Back Next >>

Med Cutan Iber Lat Am 2007; 35 (2)

A non-randomized, controlled study evaluating the effect of patch tests position on reactivity of the antigens

Duarte I, Lazzarini R

Full text

How to cite this article

Language: Spanish
References: 30
Page: 76-83
PDF size: 161.79 Kb.

Text Extraction

Introduction: The objective of this study was to check if the proximity of substances included in the test series interferes in patch test results.
Methods: The series used were recommended by the Brazilian Contact Dermatitis Research Group and called V1. The substances included in test series V1 were redistributed in two new configurations: V2, with substances known as inducers, or those indicating cross-reaction or cosensitization, applied separated from each other and V3, where the substances with chemical affinity were applied close to each other. A protocol was arranged and applied in 300 patients with hypothesis of contact dermatitis. In 150 patients V1 was applied on the left back and V2 on the right simultaneously. The others 150 patients were tested with V1 on the left and V3 on the right side.
Results: In 150 patients tested with V1/V2 there were 255 positive tests out of 4,500 in V1 and 179/4,500 positive tests in V2 (p = 0.002). In this group, 19 (64%) elements tested presented unmatched results, with positive tests in V1 and negative in V2. In the remaining 150 patients, they were applied V1 and V3. In V1, there were 191/4,500 positive tests and in V3 298/4,500 (p = 0.0001). Approximately 23 out of 30 elements tested (77%) had more positive tests in V3.
Conclusions: The substances with chemical affinity may interfere in the tests applied in close positions. The patch test techniques are well known; however, the position of substances comprising the test series should be determined —those with chemical affinity should be tested away from each other, thus avoiding induction of false-positive tests.

REFERENCES

Rietschel RL, Fowler Junior JF. Fisher’s Contact Dermatitis. 5th Edition. Baltimore, Williams & Wilkins, 2001.
2.Mclelland J, Shuster S. Contact Dermatitis With Negative Patch Tests: The Additive Effect Of Allergens In Combination. Br J Dermatol 1990; 122:623-30.
3.Basketter DA. Chemistry of Contact Allergens And Irritants. Am J Contact Dermatitis 1998;9:119-24.
4.Ridings JE, Barrat MD, Cary R, Earnshaw CE et al. Computer Prediction Of Possible Toxic Action From Chemical Structure: An Update On The Derek System. Toxicology 1996;106:267-79.
5.Duarte I, Almeida FA, Proença NG. Excited Skin Syndrome. Am J Contact Dermatitis 1996;7:24-34.
6.Duarte I, Lazzarini R, Buense R. Interference of the Position of the Substances Present in na Epicutaneos Patch Test Series with Occurrence of False-positive Results. Am J of Contact Dermatitis 2002; 13(3):125-132.
Grupo Brasileiro de Estudo em Dermatite de Contato (GBEDC). Estudo multicêntrico para elaboração de uma bateria-padrão brasileira de teste de contato. An Bras Dermatol 2000;75 (2):147-156.
Fisher AA. Lack of Cross-Reaction Between Promethazine And Ethylenediamine. Contact Dermatitis 1987;16:236.
9.Burry JN. Colophony, Perfumes and Paper Handkerchiefs. Contact Dermatitis 1986;15: 304-5.
10.Karlberg AT. Identification and Sensitization Studies Of Colophony Components. Contact Dermatitis 1994;31:279-80.
11.Van Den Akker TW. Contact Allergy to Spices. Contact Dermatitis 1990;22:267-272.
12.Bruze M. Simultaneous Reactions to Phenol-Formaldehyde Resins Colophony/Hydroabietyl Alcohol And Balsam Of Peru/Fragrance-Mixture. Contact Dermatitis 1986;14:119-20.
13.Caro I. Contact Allergy/Photo Allergy To Glyceryl Paba And Benzocaine. Contact Dermatitis 1978;4:381-2.
14.Fisher AA. Dermatitis Due To Benzocaine Present In Sunscreens Containing Glyceryl Paba (Escalol 106). Contact Dermatitis 1977;3:170-1.
15.Ford GP, Beck MH. Reactions To Quaternium 15, Bronopol And Germal 115 In A Standard Series. Contact Dermatitis 1986;14:271-4.
16.Hectorne KJ, Fransway AF. Diazolidinyl Urea: incidence Of Sensitivity, Patterns Of Cross-Reactivity And Clinical Relevance. Contact Dermatitis 1994;30:16-9.
17.Conde-Salazar L. Type IV Allergy To Rubber Additives: A 10 Years Study Of 686 Cases. J Am Acad Dermatolol 1993;29:176-80.
Knudsen BB, Larsen E, Egsgaard H, Menné T. Release of Thiurams And Carbamates From Rubber Gloves. Contact Dermatitis 1993;28:63-9.
Basketter DA. Nickel, Cobalt And Chromium In Consumer Products. A Role In Allergic Contact Dermatitis? Contact Dermatitis 1993;28:15-25.
20.Cavelier C, Foussereau J, Gille P, Zissu D. Allergy To Nickel Or Cobalt: Tolerance To Nickel And Cobalt Samples In Man And In The Guinea Pig Allergic Or Sensitized To These Metals. Contact Dermatitis 1989;21:72-8.
21.Kiec-Swierczynska M. Allergy To Chromate, Cobalt And Nickel In Lodz,1977-1988. Contact Dermatitis 1990;22:229-31.
22.Linden C, Walberg JE. Cross-Reactivity To Metal Compounds Studied In Guinea Pigs Induced With Chromate Or Cobalt. Acta Dermato-Venereologica 1994;74:341-3.
23.Massone L. Positive Patch Tests Reactions To Nickel, Cobalt And Potassium Dichroma- te in a series of 576 Patients. Cutis 1991;47:119-22.
Santucci B. Interaction Of Metals In Nickel-Sensitive Patients. Contact Dermatitis 1993;29:251-3.
25.Fischer T. Design Considerations For Patch Testing. Am J Contact Dermatitis 1994;5:70-5.
26.Fregert S. Manual Of Contact Dermatitis. 2. Ed., Year Book Of Medical Publishers, Munksgaard, 1981, p. 139.
27.Mitchell J, Maibach HI. Managing The Excited Skin Syndrome: Patch Testing Hyperirritable Skin. Contact Dermatitis 1997;37:193-9.
Grosshans E, Foussereau J. Complications et complexités de lectura des tests épicutanés. Ann Dermatol Venereol 1983;110:259-68.
29.Nethercott JR. Sensitivity and specificity of patch tests. Am J Contact Dermatitis 1994;5:136-42.
30.Barrat MD, Basketter DA, Chamberlain M, Adamns GD, Langowski JJ. An Expert System Rule Base For Identifying Contact Allergens. Toxic In Vitro 1994;8:1053-60.