Laser-assisted penetration of allergens for patch testing.
BACKGROUND
Patch-test patients often complain of itching and inconvenience.


OBJECTIVE
To demonstrate (1) the usefulness of laser-assisted alteration of the stratum corneum to enhance allergen delivery and (2) patient satisfaction with this procedure.


METHODS
The LAD-01 (erbium:yttrium-aluminum-garnet) laser unit was used to alter stratum corneum from patients with known sensitivity to nickel or Kathon CG. These allergens were then applied to the laser-pretreated sites for 60 minutes. Results were observed at 24, 48, and 96 hours and at 1 week. One patient who refused conventional patch testing was tested with an entire modified North American standard series tray with the laser patch-test technique. An additional patient with previously demonstrated positive atopy patch-test reactions to environmental organisms was retested with laser pretreatment to the same antigens.


RESULTS
Three of three patients known to be sensitive to Kathon CG and eight of eleven known nickel-sensitive patients had positive reactions at the laser-pretreated sites. The patient who was tested with the entire standard series demonstrated relevant positive reactions to formaldehyde and to a textile resin. One subject with known reactions to three environmental organisms reproduced patch-test responses with laser pretreatment. No irritant reactions were noted. Patients reported no pain.


CONCLUSIONS
With further modification, laser pretreatment may improve patient convenience and decrease irritant test reactions owing to occlusion.
Veremis-Ley
Mary
M
University Hospitals of Cleveland/Case Western Reserve University, Cleveland, OH, USA.
Ramirez
Haydee
H
Baron
Elma
E
Hanneman
Kaija
K
Lankerani
Lela
L
Scull
Heather
H
Cooper
Kevin D
KD
Nedorost
Susan T
ST
D000328:Adult; D000485:Allergens / Q000008:administration & dosage / Q000009:adverse effects*; D001707:Biopsy, Needle; D015331:Cohort Studies; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis; D004817:Epidermis / Q000187:drug effects / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D028022:Low-Level Light Therapy / Q000379:methods*; D008297:Male; D010328:Patch Tests / Q000379:methods*; D012016:Reference Values; D012680:Sensitivity and Specificity; D012867:Skin / Q000187:drug effects / Q000473:pathology* / Q000528:radiation effects*; D012869:Skin Absorption / Q000528:radiation effects
D000485:Allergens