title: A multi-center, retrospective review of patch testing for contact dermatitis in allergy practices.
abstract: BACKGROUND
  Studies assessing patch testing (PT) in allergy practices are limited.
  
  
  OBJECTIVE
  To determine whether PT results using a limited panel of allergens such as in the Thin-Layer Rapid-Use Epicutaneous Test (TT) as compared with an expanded panel, such as the addition of supplemental allergens (North American Contact Dermatitis [NACD] Panel, Dormer Cosmetics, hairdressing series, corticosteroid series, and personal products) will miss a significant number of positive PTs. To compare our PT results with published data from dermatology practices.
  
  
  METHODS
  This is a 5-year multicenter retrospective chart review of PT at 3 separate allergy practices.
  
  
  RESULTS
  Four hundred twenty-seven patients (mean age, 49.8 years) were patch tested. Eighty-two percent were female; 54% reported an atopic history. Of the standardized allergens, the 5 most common positives were nickel sulfate, fragrance mix I, p-phenylenediamine (PPD), thimerosal, and cobalt chloride. Two hundred eighteen (56.9%; 95% CI = 51.9-61.8%) patients were positive to at least 1 TT allergen. Ninety-eight (25.6%; 95% CI = 21.5-30.2%) patients were positive to both a TT and a supplemental allergen. Forty-eight (12.5%; 95% CI = 9.6-16.2%) patients were negative to a TT allergen but positive to a supplemental allergen.
  
  
  CONCLUSIONS
  Positive allergens would have been missed in 12.5% of patients when evaluating with TT allergens alone, whereas 25.6% would be partially evaluated. Patch test performance characteristics for these allergy practices appear to parallel that seen for dermatology. The TT remains an adequate screening tool in an allergy practice, but a more comprehensive panel may be needed to fully evaluate contact dermatitis.
authors: Section of Allergy and Clinical Immunology, Winthrop University Hospital, Mineola, New York, USA.
authors: Marie
authors: M
authors: Camacho-Halili
authors: Sara
authors: S
authors: Axelrod
authors: Mary Ann
authors: MA
authors: Michelis
authors: Sebastian
authors: S
authors: Lighvani
authors: Farah
authors: F
authors: Khan
authors: Scherly
authors: S
authors: Leon
authors: Marcella R
authors: MR
authors: Aquino
authors: Mark
authors: M
authors: Davis-Lorton
authors: Luz S
authors: LS
authors: Fonacier
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000485:Allergens / Q000032:analysis* / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis* / Q000276:immunology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010328:Patch Tests / Q000379:methods* / Q000592:standards; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000485:Allergens