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Evaluation and Management of Patch Test-Negative Patients With Generalized Dermatitis
Alison Spiker1, Christen M Mowad
1From the Geisinger Medical Center, Danville, PA.
Dermatitis : Contact, Atopic, Occupational, Drug
|May 25, 2017
Summary
Managing generalized dermatitis can be difficult when patch testing is negative. This survey reveals common physician approaches and highlights the need for improved strategies for these complex cases.
Area of Science:
- Dermatology
- Contact Dermatitis
- Clinical Practice
Background:
- Generalized dermatitis is a frequent dermatological condition.
- Allergic contact dermatitis is often suspected, leading to patch testing.
- Challenges arise in evaluating and managing patients with negative patch test results.
Purpose of the Study:
- To survey American Contact Dermatitis Society members.
- To understand the evaluation and management of patch test-negative patients with generalized dermatitis.
Main Methods:
- Survey of dermatologists regarding patient evaluation and treatment.
- Analysis of diagnostic and therapeutic approaches for generalized dermatitis.
Main Results:
- Physicians often use 'generalized dermatitis' for diffuse, patch test-negative cases.
- Common additional tests include skin biopsy and blood work; prednisone and methotrexate are frequent systemic treatments.
- Narrow-band UVB and antihistamines are commonly used; food allergy is rarely considered causative. Patients report significant quality of life impairment.
Conclusions:
- Management of patch test-negative generalized dermatitis is complex.
- The study identifies practice gaps and underscores the need for evidence-based guidelines.
- Further research is required to optimize evaluation and treatment strategies for this patient group.
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