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North American Contact Dermatitis Group Patch Test Results: 2017-2018.

Joel G DeKoven1, Jonathan I Silverberg2, Erin M Warshaw3

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Dermatitis : Contact, Atopic, Occupational, Drug
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Summary

Patch testing is crucial for diagnosing allergic contact dermatitis (ACD). Results show methylisothiazolinone remains a key allergen, highlighting the need for updated screening series and broader testing for accurate ACD evaluation.

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Area of Science:

  • Dermatology
  • Allergology
  • Toxicology

Background:

  • Patch testing is a vital diagnostic method for allergic contact dermatitis (ACD).
  • The North American Contact Dermatitis Group (NACDG) collects and analyzes patch test data.
  • Understanding allergen prevalence is key to managing ACD.

Purpose of the Study:

  • To document NACDG patch testing results from March 2017 to December 2018.
  • To identify common allergens and trends in ACD.
  • To evaluate the effectiveness of standard screening series.

Main Methods:

  • Standardized patch testing with 70 screening allergens and supplemental allergens across 14 North American centers.
  • Data collection via a central database with manual verification.
  • Statistical analysis including descriptive statistics and trend analysis using chi-squared tests.

Main Results:

  • 4947 patients were tested, with 65.4% showing at least one positive reaction.
  • Nickel, methylisothiazolinone, and methylchloroisothiazolinone/methylisothiazolinone were the most common allergens.
  • Newer allergens like hydroperoxides of linalool and benzisothiazolinone showed significant prevalence (>2%).
  • A substantial percentage of reactions (19.7%) were to allergens not included in the standard screening series.

Conclusions:

  • Regularly updated screening allergen series are essential for accurate ACD diagnosis.
  • Methylisothiazolinone remains a significant allergen in North America.
  • Comprehensive ACD evaluation requires patch testing beyond standard screening allergens, including for occupational causes.