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Published on: July 13, 2009
Quantitative relationships between patch test reactivity and use test reactivity: an overview
Danny Zaghi1, Howard I Maibach
1Department of Dermatology, School of Medicine, University of California San Francisco, San Francisco, California 94143-0989, USA. maibachh@derm.ucsf.edu
Cutaneous and Ocular Toxicology
|November 7, 2008
Summary
Use tests like the provocative use test (PUT) and repeated open application test (ROAT) better reflect real-world allergen exposure. Increased patch test sensitivity correlated with use test sensitivity for most allergens, aiding allergic contact dermatitis understanding.
Area of Science:
- Dermatology
- Allergology
- Toxicology
Background:
- Patch testing is a standard diagnostic tool for allergic contact dermatitis.
- Use tests (provocative use test [PUT], repeated open application test [ROAT]) aim to mimic real-life allergen exposure.
- These use tests may reduce irritation and false positives compared to patch tests.
Purpose of the Study:
- To compare and analyze studies evaluating patch test and use test reactivity.
- To assess the correlation between patch test sensitivity and use test sensitivity for various allergens.
- To understand the clinical significance of patch test results in relation to real-world exposure.
Main Methods:
- Comparative analysis of existing studies.
- Examination of data comparing patch test results with provocative use test (PUT) and repeated open application test (ROAT) outcomes.
- Analysis of allergen-specific reactivity trends.
Main Results:
- For colophony, cinnamic aldehyde, methyldibromo glutaronitrile, isothiazolinones, and isoeugenol, increased patch test sensitivity correlated with increased use test sensitivity.
- This trend was not observed for formaldehyde or chromium, with reasons for divergence remaining unclear.
- An increasing relationship was noted between use test reactivity and minimum eliciting concentration in patch testing for methyldibromo glutaronitrile.
Conclusions:
- Patch test and use test data show varying degrees of correlation depending on the allergen.
- Further expansion of databases correlating serial dilution patch test reactivity and use test data is recommended.
- Such data expansion can improve dermatologic management, public health policy, and understanding of allergic contact dermatitis.
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