Allergic Contact Dermatitis: Patch Testing Beyond the TRUE Test.

Area of Science:

• Dermatology
• Allergology
• Contact Dermatitis

Background:

• Epicutaneous patch testing is the gold standard for diagnosing allergic contact dermatitis (ACD).
• Many dermatologists do not offer in-office patch testing or use limited allergen panels.
• The Thin-Layer Rapid Use Epicutaneous Test (TRUE Test) was introduced in 1995 and expanded in 2007, improving convenience but retaining a relatively low number of allergens.

Purpose of the Study:

• To evaluate the allergen content of the Thin-Layer Rapid Use Epicutaneous Test (TRUE Test) compared to common allergens identified by the North American Contact Dermatitis Group (NACDG).
• To highlight the potential for increased diagnostic yield by incorporating additional allergens into patch testing protocols.

Main Methods:

• Analysis of allergen data reported by the North American Contact Dermatitis Group (NACDG) for 2005-2006.
• Comparison of the NACDG's 65-allergen series with the allergens included in the United States Food and Drug Administration-approved Thin-Layer Rapid Use Epicutaneous Test (TRUE Test).

Main Results:

• The North American Contact Dermatitis Group (NACDG) utilized a series of 65 allergens in 2005-2006.
• Ten of the top 30 allergens identified by the NACDG were not included in the Thin-Layer Rapid Use Epicutaneous Test (TRUE Test).

Conclusions:

• The Thin-Layer Rapid Use Epicutaneous Test (TRUE Test) has a limited allergen selection compared to current diagnostic needs.
• Incorporating additional allergens, identified through large-scale data collection like that from the NACDG, may enhance the diagnostic yield of patch testing for allergic contact dermatitis.