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Related Experiment Videos

Managing the excited skin syndrome: patch testing hyperirritable skin

J Mitchell1, H I Maibach

  • 1University California Medical School, San Francisco 94143, USA.

Contact Dermatitis
|December 31, 1997
PubMed
Summary

Inflammation-modulating phenomena (IMPs) fluctuate in contact dermatitis, affecting skin irritability. Repeated patch testing is crucial for accurate diagnosis in patients with dermatitis due to potential false positives from excited skin syndrome.

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Area of Science:

  • Dermatology
  • Immunology

Background:

  • Contact dermatitis involves fluctuating inflammation-modulating phenomena (IMPs) that impact skin irritability.
  • The patch test is a biological assay measuring IMPs, but can yield variable results in patients with dermatitis (PDs).

Observation:

  • A single patch test represents a snapshot of an evolving process.
  • Excited skin syndrome (ESS) causes temporary skin hyperirritability, leading to false-positive patch test reactions.
  • During ESS, the skin's irritancy threshold decreases, increasing reactions to irritants.

Findings:

  • Patch testing in PDs with enhanced IMPs requires careful concentration determination and ESS investigation.
  • False-positive patch test reactions during ESS are not reproducible once dermatitis and IMPs subside.

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  • Variable reproducibility is inherent in patch testing, particularly in PDs.

    • Implications:

    • Patch test concentrations must be carefully determined and ESS investigated in PDs.
    • Retesting is recommended for important patch test results to ensure accuracy.
    • Managing ESS through appropriate testing and retesting is essential for reliable dermatological diagnosis.