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Related Concept Videos

Hypersensitivity Reactions: Delayed Hypersensitivity Reactions01:29

Hypersensitivity Reactions: Delayed Hypersensitivity Reactions

Delayed-Type Hypersensitivity (DTH), or Type IV hypersensitivity, is a cell-mediated immune response. It occurs when T cells, rather than antibodies, mediate a reaction to specific antigens. It is characterized by a delayed onset (1-2 days) and involves the recruitment of macrophages to the inflammation site.The initiation of a DTH response begins with the sensitization of T cells. During this phase, which lasts at least 1-2 weeks, antigen-specific T cells are activated, clonally expanded, and...

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Related Experiment Video

Updated: Jul 4, 2026

Precision Implementation of Minimal Erythema Dose (MED) Testing to Assess Individual Variation in Human Inflammatory Response
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Published on: October 3, 2019

Delayed patch test reading after 5 days: the Mayo Clinic experience.

Mark D P Davis1, Ketaki Bhate, Audrey L Rohlinger

  • 1Department of Dermatology, Mayo Clinic, Rochester, Minnesota 55905, USA. davis.mark2@mayo.edu

Journal of the American Academy of Dermatology
|June 3, 2008
PubMed
Summary

Delayed allergic patch test reactions can be missed with standard 5-day readings. Late readings (day 7-9) are beneficial for metals and topical antibiotics, but not corticosteroids, improving allergic contact dermatitis diagnosis.

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Last Updated: Jul 4, 2026

Precision Implementation of Minimal Erythema Dose (MED) Testing to Assess Individual Variation in Human Inflammatory Response
06:31

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Published on: October 3, 2019

Minimal Erythema Dose (MED) Testing
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Published on: May 28, 2013

Trans-vivo Delayed Type Hypersensitivity Assay for Antigen Specific Regulation
11:49

Trans-vivo Delayed Type Hypersensitivity Assay for Antigen Specific Regulation

Published on: May 2, 2013

Area of Science:

  • Dermatology
  • Allergology
  • Contact Dermatitis

Background:

  • Standard patch testing protocols may miss delayed allergic reactions.
  • Some patients exhibit delayed hypersensitivity responses beyond the typical 5-day reading period.

Purpose of the Study:

  • To identify allergens causing delayed-positive patch test reactions.
  • To evaluate the utility of late (day 7-9) patch test readings as a substitute for day-5 readings.

Main Methods:

  • Retrospective review of patient records undergoing patch testing for suspected allergic contact dermatitis (October 1997-December 2006).
  • Analysis focused on patients with delayed readings between days 7 and 10 or later.
  • Included patients with suspected allergies to metals and corticosteroids.

Main Results:

  • Of 36,064 reactions, 170 allergens tested in at least 50 patients were analyzed.
  • Gold sodium thiosulfate, dodecyl gallate, palladium chloride, and neomycin sulfate showed the highest rates of delayed-positive reactions.
  • Reactions to preservatives and fragrances often dissipated by day 5, while new reactions appearing after day 5 were typically strong.

Conclusions:

  • Late patch test readings (day 7+) are valuable for metals and topical antibiotics but not for corticosteroids.
  • Standard patch testing should include readings on days 3 and 5.
  • An additional reading on day 7 or later is recommended when testing for metal and topical antibiotic allergies.