The Patch Test in Contact Dermatitis

Schwartz, Louis; Peck, Samuel M.

doi:10.2307/4584864

Cited by 61 publications

(13 citation statements)

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“…For that reason, an elicitation response is typically assessed after a single 48 h exposure application of the test item on the skin surface. [3][4][5] For p-phenylenediamine (PPD, an allergenic component in permanent hair dyes), the dose commonly applied for diagnostic purposes is approximately 400 lg cm )2 in white petrolatum when a Finn chamber is used 6 or 90 lg cm )2 in the 'True test' design with polyvidone as vehicle. 7,8 For these reasons the patch test represents the gold standard for the identification of human allergens and is the most relevant diagnostic tool to help a patient with contact dermatitis to avoid exposure to the causative agent.…”

Section: Discussionmentioning

confidence: 99%

“…This is achieved by using the maximum nonirritant concentration of the suspected allergen under conditions promoting a high availability in the epidermis through occlusion and a relatively long exposure time. For that reason, an elicitation response is typically assessed after a single 48 h exposure application of the test item on the skin surface 3–5 . For p ‐phenylenediamine (PPD, an allergenic component in permanent hair dyes), the dose commonly applied for diagnostic purposes is approximately 400 μg cm −2 in white petrolatum when a Finn chamber is used 6 or 90 μg cm −2 in the ‘True test’ design with polyvidone as vehicle 7,8 .…”

mentioning

confidence: 99%

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Elicitation of the immune response to p -phenylenediamine in allergic patients: the role of dose and exposure time

Goebel

Coenraads

Rothe

et al. 2010

British Journal of Dermatology

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SummaryBackground Usage of hair dye products containing p-phenylenediamine (PPD) is a concern for PPD-allergic individuals. Objectives The present study investigates the role of dose and exposure time on elicitation of allergic contact dermatitis under conditions of permanent hair dyeing. Methods Elicitation responses after application of a typical hair dye product containing 2% PPD for 30 min followed by rinsing were analysed in 38 PPD-allergic individuals with a documented history of hair dye-related allergy. Skin binding experiments in vitro were performed to distinguish the dose available for elicitation from the dose applied. Results A positive reaction was elicited in 20 of 20 patients with grades ++ to +++ and 12 of 18 with grade + according to the classification of the International Contact Dermatitis Research Group. Under conditions of diagnostic patch testing (48 h exposure), the dose available for elicitation is more than 10-fold higher compared with the dose available for hair dyeing (30-min exposure, rinsing of product). Conclusions This investigation demonstrates that under simulated hair dye use conditions the actual exposure to PPD is more than an order of magnitude lower than under diagnostic patch testing, although sufficient to elicit a clearly noticeable reaction in 84% of PPD patch test-positive individuals.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Elicitation of the immune response to p -phenylenediamine in allergic patients: the role of dose and exposure time

Goebel

Coenraads

Rothe

et al. 2010

British Journal of Dermatology

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“…In order to find whether a substance has primary irritancy potential before it is applied extensively on the skin, methods different from those used in contact dermatitis should be employed. Because it is often difficult to evaluate the results of patch testing with the normally used concentration of a substance, higher concentrations (13) have been used for patch testing, or repetitive patch testing (14) has been devised, and two to six substances have been chosen for patch testing with one of these serving as an arbitrary standard of reference (15), or it has been necessary to leave a patch on for 3 or 4 days (16). These methods require a long time and many persons for patch testing, and it is unreasonable to test using a higher concentration of a substance than that for practical use.…”

Section: Methodsmentioning

confidence: 99%

Evaluation of Skin Patch Tests Using Sump Method

Kawai¹

1975

The Journal of Dermatology

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The potential to cause a primary irritant reaction is usually evaluated by clinically recognizable dermatitis at the site of patch testing. Such evaluation is difficult in the case of substances with low irritancy potential which sometimes fail to cause grossly visible signs of dermatitis. In those cases a higher concentration of the test substance may be used in order to produce a visible reaction, but such concentrations may lead to unnecessary irritation and are of little value in determining the safety of the substance in concentrations of practical use. The microscopic appearance of normal human skin observed on a skin replica made by Susuki's Universal Microscopic Printing (SUMP method) has been reported previously by the author (9). In the present study, patch test reactions which fail to produce grossly visible inflammation were observed for microscopic changes by the SUMP method. The patches were applied to the upper arms of normal humans for 24 hours and then the test sites were observed for gross inflammation and microscopically by the SUMP method. Numerical scores were assigned to grade each microscopic change produced in the skin surface and total scores were used to grade the irritancy reaction produced. These scores were compared to results using Zontes TA‐430, which has been used for over 10 years as a softening agent of fibers and was used in this study as a control chemical substance with no irritancy. The results revealed microscopic changes provoked by irritants too weak to produce gross inflammation. A criteria for grading cutaneous primary irritant reactions by microscopic findings was determined.

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“…The term " prophetic patch test " was originally coined by Schwartz and Peck (1944) to describe a method of screening new chemicals for irritancy that were being introduced into the manufacture of clothing, cosmetics or other articles in contact with the skin. They used 200 individuals, whom they presumed had been unexposed to the test chemicals and patch tested them on 2 occasions at intervals of 10-14 days.…”

Section: Human Studiesmentioning

confidence: 99%

“…When investigating a patient with dermatitis suspected of being due to a cosmetic, Schwartz and Peck (1944) advise an open test with the cosmetic for 4 days as being more reliable than a closed patch test because in this way reactions due to harmless volatile substances are avoided.…”

Section: Human Studiesmentioning

confidence: 99%