The angry back syndrome: eczema creates eczema

Area of Science:

• Dermatology
• Immunology
• Allergy Testing

Background:

• False positive patch test reactions are frequent in individuals with hyper-reactive skin.
• These reactions can interfere with accurate identification of specific sensitivities and cross-sensitivities to contact allergens.

Purpose of the Study:

• To discuss the pathogenesis of hyper-reactive skin, also known as the 'angry back' phenomenon.
• To postulate a mechanism explaining how eczema at one site may induce eczematous tendencies at other body sites.

Main Methods:

• Literature review and discussion of existing research on skin hyper-reactivity.
• Postulation of a theoretical mechanism for the 'angry back' phenomenon and its implications.

Main Results:

• Hyper-reactive skin is a common cause of false positive patch test results.
• A proposed mechanism suggests that localized eczema can lead to a generalized eczematous tendency.

Conclusions:

• The 'angry back' phenomenon requires consideration in patch testing to ensure accurate allergy diagnosis.
• Further research into the proposed mechanism could elucidate systemic influences on eczematous conditions.