Bioengineering and the patch test

Berardesca, Enzo; Maibach, Howard I.

doi:10.1111/j.1600-0536.1988.tb05481.x

Cited by 94 publications

(44 citation statements)

References 31 publications

(28 reference statements)

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“…In positive tests, erythematous papules (some clarify follicular in location) become confluent, and even vesicular, with continued allergen application. Grading can be in intensity (none, mild, moderate, and severe) or with skin bioengineering equipment (14,15).…”

mentioning

confidence: 99%

Use tests: ROAT (repeated open application test)/PUT (provocative use test): an overview

2000

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As one step in defining the clinical relevance of exposure to an allergen identified with patch testing, use tests (provocative use test (PUT), and repeated open application test (ROAT)) have been used. In 1 / 2 of the cases of seemingly reliable patch tests, use tests are negative, suggesting that the patient's biologic threshold of response had not been reached with open application dosing. Dramatic differences exist in regional skin reactivity and percutaneous penetration. Negative results of use tests on normal skin may become positive on diseased skin. To refine this assay further, more controlled observations and analysis of reaction differences between normal and damaged skin, and among regional anatomic sites might be performed. In addition, we require a standardized measurement for the results. Use testing has significant potential in refinement of the evidence-based diagnosis of clinical relevance. However, for general validation, we should fill the deficiencies described above.

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confidence: 99%

Use tests: ROAT (repeated open application test)/PUT (provocative use test): an overview

2000

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“…There is a high correlation between LDF and visual scoring of irritant reactions; however, this is not linear and LDF is reported to be more helpful in discriminating between visually negative, doubtful and +1 reactions, whereas for higher visual scores the increase in LDF levels is not proportional [59,60].…”

Section: Commentsmentioning

confidence: 96%

EEMCO Guidance for the Measurement of Skin Microcirculation

Berardesca

Lévêque

Masson³

2002

Skin Pharmacol Physiol

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The blood supply to the skin is provided by a network of arterioles, capillaries and venules organized into a superficial and a deep plexus. The assessment of skin microcirculation is of valuable interest in cosmetology in the quantification of the sun protection factor, skin irritation and efficacy of antiredness treatments. Skin microcirculation can be measured by means of different techniques, based mainly on the quantification of optical and thermal properties of the skin which are modified by the amount of blood perfusion. Relevant and reproducible data can be obtained only through the understanding of the biophysical background of the technique(s) utilized. Standardization of measuring conditions and procedures is particularly required for blood flow assessment. In this paper, the advantages and disadvantages of the main techniques in use are discussed, and optimization of measurements for laser Doppler techniques is described.

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“…TEWL is a measure of skin water barrier function (22,23). Though useful in irritant reactions focusing on the stratum corneum, it is not as sensitive a measure for evaluating allergic reactions.…”

Section: Discussionmentioning

confidence: 99%

An overview of the efficacy of topical corticosteroids in experimental human nickel contact dermatitis

Levin

Maibach

2000

Contact Dermatitis

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We review controlled trials of corticosteroid effect in experimentally elicited acute nickel contact dermatitis in man, in the hope of clarifying optimal efficacy for clinical use. To maximize discrimination and objectivity, we focus on data with 1 well-characterized allergen, nickel, in studies utilizing bioengineering documentation. Higher potency corticosteroids are effective (unlike in experimental irritant contact dermatitis), but optimum schedules still require definition.Key words: allergic contact dermatitis; corticosteroids; man; colorimetry; echography; laser Doppler flowmetry; transepidermal water loss; bioengineering methods; nickel. C Munksgaard, 2000. Accepted for publication 24 May 2000Allergic contact dermatitis (ACD) is an inflammatory disease for which topical corticosteroid therapy is widely utilized. Corticosteroids inhibit antigen-specific activation and proliferation of lymphocytes although their exact mechanism of action remains unclear (1, 2). We review studies that utilized bioengineering techniques to evaluate the efficacy of topical corticosteroid in human experimental nickel contact dermatitis, in the hope that these highly controlled experiments might provide insight into optimum therapy.Application of allergen in sensitized patients elicits a standardized allergic contact dermatitis. Bioengineering instrumentation, such as laser Doppler flowmetry (LDF), colorimetry and echography, is useful in quantifying the skin's allergic response. LDF evaluates the intensity of the inflammatory reaction (3). Colorimetry assesses the blanching effect of corticosteroids (4). Echography evaluates edema and inflammation (5). OverviewDe Lacharriere et al. studied the effects of clobetasol propionate 0.05%, hydrocortisone 1% and an emulsion control on experimentally elicited nickel ACD in 10 nickel-allergic patients (6). ACD was elicited by 2-day (D) patch test application of 5% NiSO 4 to the upper back. 1D following removal of nickel patches, the corticosteroids were occlusively applied for 6 h, evaluation of their efficacy occurring upon corticosteroid patch removal and again 18 h later. The corticosteroids produced a significant decrease in LDF (as well as an increase in transcutaneous pressure of oxygen) when compared to involved skin. As this was an abstract only, we do not know if they could distinguish between the compounds; this abstract also did not include the mass per unit area of corticosteroid applied.Queille-Roussel et al. (7) investigated the efficacy of clobetasol propionate 0.05% cream, hydrocortisone 1% cream and a cream vehicle on ACD,elicited by a 2-D patch application of 5% NiSO 4 on the lower back of 12 nickel-sensitive volunteers. Open application of 26 mg/cm 2 of corticosteroids 2¿ daily for 4D (D 3-6) and 1¿ on the morning of D7 followed nickel patch removal. The effect of corticosteroids was evaluated on the evening of D7. Clobetasol propionate 0.05% cream significantly decreased LDF, colorimetry and visual score values, when compared with untreated skin

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Bioengineering and the patch test

Cited by 94 publications

References 31 publications

Use tests: ROAT (repeated open application test)/PUT (provocative use test): an overview

Use tests: ROAT (repeated open application test)/PUT (provocative use test): an overview

EEMCO Guidance for the Measurement of Skin Microcirculation

An overview of the efficacy of topical corticosteroids in experimental human nickel contact dermatitis

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