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Overcoming False-Negative Patch Tests: A Systematic Literature Review
Shayan Massoumi1, Zehra Rizvi1, Ulysses Cázares2
1From the Department of Dermatology, California University of Science and Medicine, Colton, California, USA.
Dermatitis : Contact, Atopic, Occupational, Drug
|January 5, 2024
Summary
False-negative patch tests can occur in allergic contact dermatitis (ACD) diagnosis. Understanding factors like low concentration and solutions such as repeat testing can improve ACD diagnosis.
Area of Science:
- Dermatology
- Allergology
- Clinical Immunology
Background:
- Allergic contact dermatitis (ACD) is triggered by exogenous allergens in common products.
- Patch testing is crucial for ACD diagnosis but can produce false-negative results.
- Identifying reasons for false negatives is vital when clinical suspicion for ACD is high despite negative patch tests.
Purpose of the Study:
- To review and compile potential reasons for false-negative patch tests in suspected ACD cases.
- To identify and present solutions for improving ACD diagnosis when false-negative patch tests are suspected.
Main Methods:
- A comprehensive literature review was conducted.
- Databases searched included EMBASE, Scopus, PubMed, and Google Scholars.
- 49 articles were selected using keywords related to false-negative patch tests and allergic contact dermatitis.
Main Results:
- Common causes of false-negative patch tests include low allergen concentration, poor skin penetration, procedural errors, immunosuppression, and UV exposure.
- Potential solutions involve adjusting allergen concentration, vehicle, extending reading time, retesting, or using intradermal testing.
Conclusions:
- Recognizing factors contributing to false-negative patch tests is essential for accurate ACD diagnosis.
- Implementing appropriate solutions can help clinicians confirm suspected ACD and guide treatment effectively.
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