title: The perceived obstacles in performing patch test to detect allergic contact dermatitis: a comparison between community allergists and directors of allergy training programs.
abstract: BACKGROUND
  Patch testing (PT) is the gold standard test to detect allergic contact dermatitis. Despite its usefulness, it is not universally performed in allergy practices.
  
  
  OBJECTIVE
  To determine obstacles in performing PT and to evaluate the differences in perception of these obstacles between community allergists and directors of training programs.
  
  
  METHODS
  Two anonymous Web-based questionnaires were distributed to 65 program directors (PDs) across the United States and to 200 community allergists in the mid-Atlantic region. Program directors and community allergists were categorized based on PT performance. Community allergists were categorized based on type of practice. Comparisons between categories were made using the chi2 test.
  
  
  RESULTS
  Perceived obstacles among community allergists and PDs were similar; this remained unchanged regardless of performing PT. When community allergists in solo practice were compared with those in group private practice, the difference in perception was significant (P < .01). Previous training in PT among PDs and community allergists was associated with a higher likelihood of performing PT.
  
  
  CONCLUSIONS
  Previous training in PT among PDs and community allergists was associated with a higher likelihood of performing PT. We recommend that training in the application and interpretation of PT for diagnosis of allergic contact dermatitis should be an integral part of the curriculum of allergy fellowship training programs and should also be incorporated into the continuing medical education program of practicing allergists. Furthermore, although allergists may continue to rely on dermatologists for more comprehensive PT, use of the thin-layer rapid use epicutaneous test is a simple screening tool that should be available to all allergy practices.
authors.affiliation: Allergy, Asthma and Immunology Clinic, Penn State College of Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033-0850, USA. gghaffari@psu.edu
authors.forename: Gisoo
authors.initials: G
authors.lastname: Ghaffari
authors.forename: Timothy
authors.initials: T
authors.lastname: Craig
mesh_terms: D000328:Adult; D000486:Allergy and Immunology / Q000193:education; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010328:Patch Tests / Q000379:methods*; D010820:Physicians; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires