Patch Testing and Prick Testing : A Practical Guide Official Publication of the ICDRG
Lachapelle, Jean-Marie (EDT)
Maibach, Howard I. (EDT)
240 p. 100 illus. in color
The fourth edition of this important book, which includes additional color illustrations, has been extensively revised, updated, and expanded to reflect the most recent developments. Prev. ed.: 2012.
This third edition of the essential guide has been extensively revised and updated and includes additional color illustrations. It reflects the rapid expansion in knowledge of the subject due to progress in the chemical, immunological, and clinical fields.
Table of Contents
Contents Introductory Remarks Part I Patch Testing1 Pathophysiology of Allergic and Irritant Contact Dermatitis 1.1 Introduction 1.2 Pathophysiology of Irritant and Allergic Skin Inflammation 1.2.1 Irritant and/or Allergic Chemicals 1.2.2 Skin Irritation: Activation of Innate Immunity 1.3 Skin Allergy: The Role of Specific Immunity 1.3.1 Antigen-Specific Immunity 1.3.2 Skin Allergy: Mechanisms of Action 1.3.3 Indirect Responsibility of Chemicals in Skin Irritation 1.4 Pathophysiology of Skin Inflammation: The Connection Between Innate and Acquired Immunity References 2 Diseases for Which Patch Testing Is Recommended: Patients Who Should Be Investigated2.1 Allergic Contact Dermatitis 2.1.1 Clinical Signs and Symptoms 2.1.2 Histopathological Features 2.2 Allergic Contact Dermatitis Syndrome 2.2.1 Stage 1 of ACDS 2.2.2 Stage 2 of ACDS 2.2.3 Stage 3 of ACDS 2.3 Allergic Contact Dermatitis Versus Irritant Contact Dermatitis: Criteria for Differential Diagnosis 2.4 Other Skin Diseases in Which Patch Testing Is of Major Interest 2.5 Algorithmic Approach: Key Role of Patch Testing 2.6 Hand Dermatitis: Definition and Procedures Applied in Differential Diagnosis 2.6.1 Hand Dermatitis: Exogenous and Endogenous Factors 2.6.2 A Classification of Hand Dermatitis 2.6.3 Tools of Investigation 2.6.4 Hand Dermatitis: Some Examples of an Algorithmic Approach 2.6.5 Hand Eczema: A Controversial Issue References 3 Patch Testing Methodology 3.1 Historical Background 3.2 Definition and Aims 3.2.1 Requirements for an Ideal Patch Testing Procedure 3.2.2 Is Patch Testing the "Gold Standard" to Investigate Patients with Allergic Contact Dermatitis? 3.3 Patch Test Units 3.3.1 Nonchamber Patch Tests 3.3.2 Chamber Patch Tests 3.3.3 Plastic Square Chambers 3.3.4 Reinforcement of Patch Test Units 3.4 A General Overview of Allergens 3.4.1 Allergens 3.4.2 Bioavailability of Allergens 3.4.3 Quality Control of Allergens 3.4.4 Appropriate Amounts of Petrolatum to Be Applied at Patch Testing 3.4.5 Appropriate Amounts of Liquids to Be Applied at Patch Testing 3.5 Specific Recommendations When Considering Patch Testing Patients 3.5.1 Patch Testing on Intact Skin Is Critical 3.5.2 Medicaments and Patch Testing 3.5.3 Pregnancy and Patch Testing 3.5.4 Patch Testing in Children 3.6 Application of Patch Tests on the Skin: Some Practical Suggestions 3.6.1 Test Sites 3.6.2 Removal of Hair 3.6.3 Degreasing of Test Site 3.6.4 Application of Test Strips 3.6.5 Instructions to Patients 3.7 Reading Time 3.7.1 Standard Patch Test Occlusion and Reading Time 3.7.2 Conventional Patch Test Reading Time 3.7.3 Reading at Day 2, Day 3, and Day 4 3.7.4 Reading at Day 7 3.7.5 Single Reading Versus Multiple Reading 3.7.6 Day 3 Versus Day 4 Reading 3.7.7 One-Day Occlusion Versus Two-Day Occlusion 3.7.8 Marking the Skin 3.7.9 Positive Control 3.7.10 Immediate Urticarial Reactions to Some Allergens 3.8 Reading and Scoring Patch Test Results 3.8.1 Scoring Codes According to the ICDRG 3.8.2 Proposal for Modified Scoring Codes of Positive Patch Test Reactions, According to ESCD and EECDRG 3.8.3 Rating Patch Test Reactions Based on Digital Images 3.8.4 Bioengineering Methods for Evaluating Skin Irritation and Allergic Reactions. A Comparison with Visual Scoring 3.8.5 Remarks About Reading and Scoring Patch Test Results 3.9 Irritant Patch Test Reactions 3.10 False-Positive Patch Test Reactions 3.11 False-Negative Patch Test Reactions 3.12 Compound Allergy 3.13 Cross-Sensitization, Concomitant Sensitization, and Polysensitization 3.13.1 Cross-Sensitization 3.13.2 Concomitant Sensitization 3.13.3 Polysensitization 3.14 Unwanted Adverse Reactions of Patch Testing 3.14.1 Patch Test Sensitization ("Active Sensitization") 3.14.2 Excited Skin Syndrome ("Angry Back") 3.15 Patch Test Readings in Different Ethnic Populations 3.15.1 Patch Test Reading in Oriental Populations 3.15.2 Patch Test Reading in Black Populations 3.16 Patch Testing Techniques in Different Climatic Environments 3.16.1 Temperate Climates 3.16.2 Tropical Climates 3.16.3 Patch Testing Procedures in the Tropics 3.17 Is Self-assessment of Allergic Contact Dermatitis by Patients Recommendable? 3.17.1 Self-assessment by Questionnaires 3.17.2 Self-readings of Patch Tests by Patients References 4 Baseline Series of Patch Tests 4.1 Historical Background 4.2 Advantages and Disadvantages of Using a Baseline Series of Patch Tests 4.2.1 Advantages 4.2.2 Disadvantages 4.3 The Different Baseline Series of Patch Tests 4.3.1 ICDRG-Revised International Minimal Baseline Series of Patch Tests 4.3.2 The Updated 2019 European Baseline Series on Behalf of the ESCD and EECDRG 4.3.3 The Updated 20109 North American Baseline Series on Behalf of the NACDG 4.3.4 The Updated 2019 Japanese Baseline Series on Behalf of the JCDS 4.4 "Mixes" of Baseline Series 4.5 Concise Information About Allergens Included in the Updated 2011 Minimal Baseline Series of the ICDRG4.6 Concise Information on Other Common Allergens Included in the Updated 2011 Minimal Baseline Series of the ICDRG 4.7 Additional Series of Patch Tests4.8 The Preservative Methylisothiazolinone : The New Star of Allergic Contact DermatitisReferences 5 Photopatch Testing 5.1 Definition and Aims 5.2 Photoallergic Contact Dermatitis 5.3 Photoallergic Contact Dermatitis Versus Airborne Allergic Contact Dermatitis: Criteria for Differential Diagnosis 5.4 Photoallergic Drug Eruptions 5.5 Photopatch Testing Methodology 5.6 Light Sources 5.7 Proposal for a Photopatch Test Series References 6 The T.R.U.E. Test (R) Methodology 6.1 Introduction 6.2 The T.R.U.E. Test (R) Methodology6.3 More Practical Information About the Technology of The T.R.U.E. Test (R) 6.4 Regulatory Information 6.5 Standard The T.R.U.E. Test (R) Series 6.6 New Additions 6.7 Methodology of Use 6.8 Additional Information6.9 Note References 7 Additional Testing Procedures and Spot Tests 7.1 Strip Patch Test 7.2 Open Test 7.3 Semi-open (or Semi-occlusive) Tests 7.4 Repeated Open Application Test 7.5 Testing Procedures with Unknown Substances 7.5.1 Strategy 7.5.2 Steps Required Prior to Any Testing Procedure 7.5.3 Testing Procedures with Solid Products and Extracts 7.5.4 The Use of Ultrasonic Bath Extracts in the Search of the Culprit(s) Allergen(s) present in Solid Products7.5.5 Testing Procedures with Cosmetics and Other Related Products7.6 Oral Provocation Test (Oral Challenge) 7.7 Other Investigations 7.7.1 pH Measurement 7.7.2 Spot Tests 7.7.3 Chemical Analysis 7.8 Additional Remarks About Chemistry and Immunology in Relationship with Allergic Contact Dermatitis References 8 Clinical Relevance of Patch Test Reactions 8.1 Introduction 8.2 General Principles 8.3 Past and Current Relevance 8.4 Scoring System 8.5 Strategies 8.5.1 Clinical History 8.5.2 Environmental Evaluation 8.5.3 Further Correlations 8.5.4 Additional Investigations 8.6 Suggestions for Improved Evidence-Based Diagnosis of Relevance 8.7 Additional Remark References 9 Atopic Dermatitis, Irritant Contact Dermatitis, and Allergic Contact Dermatitis 9.1 Preliminary Remarks9.2 Etiopathogenic Advances9.3 Disruption of the Skin Barrier9.4 Increased Disruption of the Skin Barrier in AD 9.5 Hand Eczema9.6 Other Skin Typical Locations of Lesions in AD 9.7 Guidelines for the Practice of Patch Testing References Part II Prick Testing10 Spectrum of Diseases for Which Prick Testing and Open (Non-prick) Testing Are Recommended: Patients Who Should Be Investigated 10.1 Contact Urticaria Syndrome 10.1.1 Clinical Symptoms and Stages of CUS 10.1.2 Etiology and Mechanisms of CUS 10.1.3 Contact Urticaria to Natural Rubber Latex 10.2 Protein Contact Dermatitis References 11 Methodology of Open (Non-prick) Testing, Prick Testing, and Its Variants 11.1 Introductory Remarks11.2 Open (Non-prick) Testing 11.3 Prick Test: Technical Modalities and Reading 11.3.1 Technique of Puncture 11.3.2 Control Solutions 11.3.3 Reading Time 11.3.4 Reading Prick Test Results 11.3.5 Medicaments and Prick Testing 11.3.6 False-Negative Reactions 11.3.7 False-Positive Reactions 11.3.8 Prick Tests in Children and Babies 11.4 Prick-by-Prick Test 11.5 Scratch Test 11.5 Scratch-Chamber Test 11.7 Comparative Indications of Open (Non-prick) Testing, Prick Testing, and Other Related Tests 11.8 Intradermal Testing for Type 1 Hypersensitivity 11.9 Prick Testing: Allergens of Interest for Skin Problems 11.9.1 Latex 11.9.2 Airborne Environmental per Annum Allergens 11.9.3 Airborne Environmental Seasonal Allergens 11.9.4 Food Allergens (Trophallergens) 11.9.5 Occupational Allergens 11.9.6 Fungi 11.9.7 Miscellaneous (Immunological and/or Non-immunological) Urticariogens References Part III Testing in Cutaneous Systemic Immune-Related Adverse Drug Reactions: Interest and Limitations12 Testing Procedures in Cutaneous Systemic Immune-Related Adverse Drug Reactions 12.1 General Considerations 12.2 Proposal of a Classification of CADR 12.3 Tools of Investigation in CADR 12.4 Histopathological Limitations in Diagnosis of a CADR 12.5 Patch Testing in CADR 12.5.1 Spectrum of CADRs for Which Patch Testing Is Recommended 12.5.2 Spectrum of CADRs for Which Patch Testing Can Be Performed (Being Still Controversial) 12.5.3 Spectrum of CADRs for Which Patch Testing Is of No Interest 12.5.4 Guidelines in Drug Patch Testing: General Rules 12.5.5 Technical Aspects of Drug Patch Testing 12.5.6 Readings of Drug Patch Tests 12.5.7 False-Negative Patch Test Reactions 12.5.8 False-Positive Patch Test Reactions 12.6 Prick Testing in CADR 12.7 Intradermal Testing in CADR 12.8 Oral Provocation Test (Oral Challenge) in CADR References Appendices Appendix A: Additional Series of Patch Tests A.1 Introductory Remarks A.2 Bakery Series A.3 Corticosteroid Series A.4 Cosmetic Series A.5 Epoxy Resin Series A.6 Hairdressing Series A.7 Isocyanate Series A.8 Metal Series A.9 (Meth)Acrylate Series A.10 Plastics and Glues Series A.11 Rubber Additives Series A.12 Textile Dyes and Finish Series A.13 Other Series References Appendix B: The International Contact Dermatitis Research Group B.1 Historical Background B.2 Current Tasks and Strategy of the ICDRG B.3 ICDRG Members References Appendix C: A List of Companies Producing and/or Distributing Patch and/or Prick Test Materials and/or Allergens C.1 Introductory Remarks C.2 List of Companies