title: Analysis of patch test referrals: influence of appropriateness of referrals on sensitization rate.
abstract: BACKGROUND
  Few studies have addressed the frequency and the consequences of the appropriateness of referrals for patch testing.
  
  
  OBJECTIVE
  To analyse the appropriateness of referrals for patch testing among patients seen in the Allergy Unit, University of Ferrara, and to evaluate whether this selection influences the results of the test.
  
  
  METHODS
  One thousand six hundred and twenty-seven consecutive patients were enrolled, and 1528 patients were patch tested. On the basis of the history and clinical picture, the appropriateness of referrals for patch testing was judged.
  
  
  RESULTS
  Of the patients, 82.30% attended the Allergy Unit with a clinical presentation and/or history considered to be an appropriate indication for patch testing. The rate of appropriate referrals for patch testing from dermatologists was significantly higher (p < 0.001) than that for referrals from other physicians. The sensitization rate was significantly higher among the appropriate referrals than among the inappropriate ones, both in the entire sample (p < 0.001) and in atopic patients (p = 0.012).
  
  
  CONCLUSIONS
  Clinical experience was seen to be crucial for the appropriate selection of patients. Furthermore, appropriate referral for patch testing was shown to influence the sensitization rate.
authors.affiliation: Section of Dermatology, Department of Clinical and Experimental Medicine, University of Ferrara, Via Savonarola 9, 44100 Ferrara, Italy. czm@unife.it
authors.forename: Monica
authors.initials: M
authors.lastname: Corazza
authors.forename: Alessandro
authors.initials: A
authors.lastname: Borghi
authors.forename: Lucia
authors.initials: L
authors.lastname: Mantovani
authors.forename: Annarosa
authors.initials: A
authors.lastname: Virgili
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010328:Patch Tests; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012680:Sensitivity and Specificity; D019564:Unnecessary Procedures; D055815:Young Adult