Overview

Patch testing may be a common outpatient procedure employed by dermatologists and allergists to assess if a rash is caused by a suspected substance, referred to as an allergen, when it comes in contact with the patient's skin. In addition to patch testing, a careful evaluation of the patient's exposures additionally to the situation and pattern of the rash on the body (clinical history) is important to determine the underlying allergen.

Who's at risk?

Unexplained or persistently inflamed skin that is often itchy may be due to an allergic contact dermatitis caused by any of the following (to name a few):

Ø     Use of prescription or non-prescription products applied to the skin, including topical ointments, creams, and lotions.

Ø     Exposure to metals (eg, nickel, which can be found in jewelry, belts, buttons, etc)

Ø     Chemicals such as paraphenylenediamine found in hair dye

Ø     Fragrances found in perfumes and detergents

Ø     Preservatives such thimerosal found in contact lens solution

Ø     Rubber ingredients such as latex

Dermatitis may result if a patient's skin is allergic or sensitive in any thanks to the substance it comes in touch with. A simple skin test guided by the clinical history can help determine if a substance is causing or aggravating the rash.

Signs and Symptoms

Before testing, to get the simplest results, patients should:

Ø  Not use a topical steroid (eg, cortisone) cream on the back

Ø  Not take oral steroids

Ø  Discontinue any ultraviolet light (UVA or PUVA) treatment

Ø  Not have a current rash on the back

The doctor performing the procedure will recommend the allergens that a patient's skin are going to be tested for, which is typically a typical selection of common allergens that cause the bulk of allergic skin reactions also as any specific allergen that the patient's skin may have inherit contact with. Once the allergen selection is ready using small plastic or aluminum discs, these are placed on the patient's upper back in a neighborhood of skin unaffected by any current rash. Adhesive tape is used to secure the discs.

During the time that the allergen patches are in direct contact with the skin, the patient should avoid vigorous activity or washing the world until the ultimate reading is completed 96 hours later. Sun exposure should be avoided during this era of your time . The diagnostic test is examined 48 and 96 hours later, at which era the tape and discs are removed to assess for any response.

Self-Care Guidelines

When patch testing is completed, a record of the results is usually provided for the patient to elucidate which allergens to avoid and therefore the products during which these allergens could also be found. Avoiding the causative allergen within the future will likely completely eliminate or a minimum of help improve the skin inflammation. Depending on the results, the doctor can determine if any of the allergens tested for are causing or worsening the dermatitis.

Patients may look after their skin with gentle soap and water, ensuring to avoid the allergens identified within the results of the patch testing. The doctor may prescribe a topical steroid cream for the rear to scale back the skin reaction caused by a positive skin test.

When to Seek Medical Care

An exaggerated allergic or irritant skin reaction may occur at the location of patch testing, including a rash and a burn-like reaction. It is important that an experienced physician in patch testing read the results to avoid potential misinterpretation. Patch testing might not always explain the explanation for the dermatitis.

Treatments Your Physician May Prescribe

Patch testing is generally required to verify an allergic or irritant reaction to a suspected allergen. However, if the physician's suspicion and therefore the pattern of the inflammation on the skin (exposure pattern) support the association between an allergen and a patient's dermatitis, simply avoiding the suspected allergen may suffice. For example, if a patient has a rash only on the earlobe and wrist, perhaps a nickel allergy may be considered due to the use of earrings and watches.

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