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The Final Patch Test Read: Day 5 or Day >7?

Hafsa M Cantwell1, Lisa A Drage, Rokea A El-Azhary

  • 1From the *Department of Dermatology, Mayo Clinic, Rochester, MN †Department of Dermatology, Mayo Clinic, Jacksonville, FL ‡Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN §Department of Dermatology, Mayo Clinic, Scottsdale, AZ.

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Summary
This summary is machine-generated.

Optimal patch testing requires careful timing of readings. This study found that some allergens show delayed reactions after day 5, suggesting later readings are crucial for accurate allergy diagnosis.

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Area of Science:

  • Dermatology
  • Allergy Testing
  • Contact Dermatitis

Background:

  • Current patch testing protocols involve readings on days 3 and 5, with extended readings for specific allergens.
  • The optimal timing for final patch test readings remains a key clinical question.
  • Variability in allergen reactions necessitates evaluating different reading schedules.

Purpose of the Study:

  • To identify allergens with delayed positive reactions (negative on day 5, positive on day 7+).
  • To identify allergens with waning reactions (positive on day 5, negative on day 7+).
  • To inform optimal patch testing reading schedules.

Main Methods:

  • Retrospective review of patient records from Mayo Clinic (January 2007 - December 2016).
  • Analysis included patients with patch test readings on day 5 and day 7 or later.
  • Comparison of reaction patterns across different reading time points.

Main Results:

  • 131 allergens showed positive reactions on day 5 that were negative on day 7 or later.
  • 58 allergens showed negative reactions on day 5 that were positive on day 7 or later.
  • 25 allergens demonstrated significantly higher reaction rates on day 5 compared to day 7 or later.

Conclusions:

  • Standard practice includes day 5 readings and extended readings for metals.
  • Consideration of day 7 or later readings for acrylates is recommended.
  • Extended reading times may improve diagnostic accuracy for certain allergens.