Update on Contact Dermatitis and Patch Testing in Patients With Skin of Color

Allergic Contact Dermatitis

“…Adjusting the lighting in the examination room, including side lighting, or using a blue background can be helpful in identifying erythema in darker skin tones. 15,16,18 Palpation of the skin also is useful, as even slight texture changes and induration are indicators of a possible skin reaction to the test allergen. 15…”

“…13 Ethnicity and cultural practices influence epidemiologic patterns of ACD. Darker hair dyes used in Black patients 14 and deeply pigmented PPD dye found in henna tattoos used in Indian and Black patients 15 may lead to increased sensitization to PPD. Allergic contact dermatitis due to formaldehyde is more common in White patients, possibly due to more frequent use of formaldehyde-containing moisturizers, shampoos, and creams.…”

“…Allergic contact dermatitis due to formaldehyde is more common in White patients, possibly due to more frequent use of formaldehyde-containing moisturizers, shampoos, and creams. 15…”

American Contact Dermatitis Society Position Statement: Dermatitis and Skin of Color

“…36 Because these changes can be subtle, recommendations include adequate side lightening and palpation when interpreting patch test results in patients with SOC. 36,63,64 Regarding management, given the potential risks of hyperpigmentation in darker skin types, early identification, diagnosis, and management of dermatitis are particularly important. In SOC patients, earlier treatment of AD with dupilumab may accelerate the return of the patient's normal skin tone.…”

“…Studies have shown that patients with darker skin types may demonstrate a lack of erythema and an earlier papular response at positive patch test sites 36 . Because these changes can be subtle, recommendations include adequate side lightening and palpation when interpreting patch test results in patients with SOC 36,63,64 …”