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The strip patch test--indication in occupational dermatology demonstrated with a case history
Heinrich Dickel1, Nina Scola, Peter Altmeyer
1Department of Dermatology and Allergology, Division of Allergology, Occupational and Environmental Dermatology, St. Josef-Hospital, Ruhr-University, Bochum, Germany. dickel@derma.de
Summary
The strip patch test (SPT) can diagnose allergic contact dermatitis missed by standard patch tests. This method confirmed a potassium dichromate allergy, impacting a patient's disability and pension.
Area of Science:
- Occupational Dermatology
- Allergic Contact Dermatitis
- Diagnostic Immunology
Background:
- Repeat patch testing is common in occupational dermatology for expert opinions.
- Discrepancies in patch test results can affect insurance claims and disability assessments.
- Standard patch tests may yield false-negative results for weak sensitizers or those with poor skin penetration.
Observation:
- A 30-year-old industrial mechanic with a history of potassium dichromate sensitization faced challenges with standard patch tests.
- Initial patch tests in 2005 confirmed sensitization, but subsequent tests in 2006 and 2008 were negative.
- The strip patch test (SPT), performed in a standardized manner, successfully reconfirmed the potassium dichromate sensitization.
Findings:
- The strip patch test (SPT) identified a sensitization to potassium dichromate that standard patch tests missed.
- This confirmed allergy was crucial for the patient's occupational disease claim and insurance evaluation.
- The SPT results led to an adjustment in the patient's disability severity and established pension entitlement.
Implications:
- The strip patch test (SPT) is a valuable tool for diagnosing allergic contact dermatitis when standard patch tests are negative.
- Accurate diagnosis through SPT can significantly impact legal and insurance outcomes for patients with occupational skin diseases.
- Standardized SPT protocols are essential for reliable detection of weak sensitizations in occupational dermatology.
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