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Dermatitis. 2018 Nov/Dec;29(6):297-309. doi: 10.1097/DER.0000000000000417.

North American Contact Dermatitis Group Patch Test Results: 2015-2016.

Author information

1
Dartmouth-Hitchcock Medical Center, Lebanon, NH.
2
Department of Dermatology, University of California San Francisco, San Francisco, CA.
3
Department of Dermatology, Columbia University, New York, NY.
4
Division of Dermatology, Royal Victoria Hospital, McGill University, Montreal, Quebec, Canada.
5
Department of Dermatology, Cleveland Clinic, Cleveland, OH.
6
University of Louisville, Louisville, KY.
7
Department of Dermatology, University of Cincinnati, Cincinnati, OH.
8
Department of Dermatology, Pennsylvania State University, State College, PA.
9
Division of Dermatology, University of Ottawa, Ottawa, Ontario, Canada.
10
Ohio State University, Columbus, OH.
11
Department of Dermatology, Keck School of Medicine, Los Angeles, CA.

Abstract

BACKGROUND:

Patch testing is an important diagnostic tool for the assessment of allergic contact dermatitis (ACD).

OBJECTIVE:

This study documents the North American Contact Dermatitis Group (NACDG) patch testing results from January 1, 2015, to February 28, 2017.

METHODS:

At 13 centers in North America, patients were tested in a standardized manner with a screening series of 70 allergens. Data were manually verified and entered into a central database. Descriptive frequencies were calculated, and trends were analyzed using χ test.

RESULTS:

A total of 5597 patients were tested. There were 3725 patients (66.6%) who had at least 1 positive reaction, and 2798 patients (50.2%) were ultimately determined to have a primary diagnosis of ACD. A total of 572 patients (10.2%) had occupationally related skin disease. There were 10,983 positive allergic reactions. Nickel remained the most commonly detected allergen (17.5%). Methylisothiazolinone, which was added to the screening series for the 2013-2014 cycle, had the second highest positive reaction rate of allergens tested (13.4%). Compared with the previous reporting periods (2013-2014) and (2005-2014), positive reaction rates for the top 35 screening allergens statistically increased for only 1 allergen: hydroxyethyl methacrylate (3.4%; risk ratios, 1.24 [confidence interval, 1.00-1.54] and 1.46 [confidence interval, 1.23-1.73]). Three newly added allergen preparations-ammonium persulfate (1.7%), chlorhexidine (0.8%), and hydroquinone (0.3%)-all had a reaction rate of less than 2%. Twenty-three percent of the tested patients had at least 1 relevant allergic reaction to an allergen not on the NACDG series; 12% of these were occupationally related. T.R.U.E. Test (SmartPractice Denmark, Hillerød, Denmark) would have hypothetically missed one quarter to almost 40% of reactions detected by the NACDG screening series.

CONCLUSIONS:

These results confirm that the epidemic of sensitivity to methylisothiazolinone has continued in North America. Patch testing with allergens beyond a screening tray is necessary for a complete evaluation of occupational and nonoccupational ACD.

PMID:
30422882
DOI:
10.1097/DER.0000000000000417
[Indexed for MEDLINE]

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