title: Patch testing custom isocyanate materials from the workplace.
abstract: BACKGROUND
  Patch testing with standard trays of commercially available allergens is the current practice for investigating suspected cases of isocyanate-induced allergic contact dermatitis (ACD). In some facilities, these standard trays are further supplemented with custom preparations of isocyanate-containing materials.
  
  
  OBJECTIVE
  The aim was to determine whether added value exists in patch testing patients to custom isocyanate preparations in suspected cases of ACD.
  
  
  METHODS
  We performed a retrospective analysis of 11 patients referred to our specialty clinic between January 2003 and March 2011 for suspected patients of ACD who had custom testing with isocyanate materials from their workplace. In addition to standard trays of allergens, all patients were patch tested with custom isocyanate materials from their workplaces.
  
  
  RESULTS
  Three (27%) of 11 patients showed an added value in testing to custom isocyanate allergens. Of these 3 patients, one had a reaction that reinforced positive reactions to the standard isocyanate tray, but the other 2 (18%) had no reactions to any of the commercially available allergens.
  
  
  CONCLUSIONS
  Because of the high proportion of reactions (27%), we recommend the use of custom testing to workplace isocyanate products as a supplement to current standard patch testing procedures.
authors.affiliation: From the *Queen's University, Kingston; †Department of Occupational and Environmental Health, St Michael's Hospital, Toronto, Ontario; ‡Division of Dermatology, Department of Medicine, Hotel-Dieu de Québec, Université Laval, Québec City, Québec; §Dalla Lana School of Public Health, and ∥Department of Medicine, University of Toronto, Ontario, Canada.
authors.forename: Dianne
authors.initials: D
authors.lastname: Burrows
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Houle
authors.forename: D Linn
authors.initials: DL
authors.lastname: Holness
authors.forename: Joel
authors.initials: J
authors.lastname: DeKoven
authors.forename: Sandy
authors.initials: S
authors.lastname: Skotnicki
mesh_terms: D000328:Adult; D000485:Allergens / Q000009:adverse effects*; D015331:Cohort Studies; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis / Q000209:etiology*; D009783:Dermatitis, Occupational / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D007221:Industry; D017953:Isocyanates / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010328:Patch Tests; D012189:Retrospective Studies; D017132:Workplace
chemical_list: D000485:Allergens; D017953:Isocyanates