North American Contact Dermatitis Group Patch Test Results 2013-2014

Patch testing is the most important diagnostic tool for the assessment of allergic contact dermatitis. This study documents the North American Contact Dermatitis Group (NACDG) patch testing results from January 1, 2013, to December 31, 2014. At 13 centers in North America, patients were tested in a...

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Bibliographic Details
Published in:	Dermatitis Vol. 28; no. 1; p. 33
Main Authors:	DeKoven, Joel G, Warshaw, Erin M, Belsito, Donald V, Sasseville, Denis, Maibach, Howard I, Taylor, James S, Marks, James G, Fowler, Jr, Joseph F, Mathias, C G Toby, DeLeo, Vince A, Pratt, Melanie D, Zirwas, Matthew J, Zug, Kathryn A
Format:	Journal Article
Language:	English
Published:	United States 01-01-2017
Subjects:	Adolescent Adult Aged Aged, 80 and over Allergens - administration & dosage Allergens - adverse effects Child Child, Preschool Coloring Agents - adverse effects Cosmetics - adverse effects Dermatitis, Allergic Contact - diagnosis Dermatitis, Allergic Contact - etiology Dermatitis, Occupational - diagnosis Dermatitis, Occupational - etiology Female Humans Male Middle Aged North America Patch Tests - standards Preservatives, Pharmaceutical - adverse effects
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Summary:	Patch testing is the most important diagnostic tool for the assessment of allergic contact dermatitis. This study documents the North American Contact Dermatitis Group (NACDG) patch testing results from January 1, 2013, to December 31, 2014. At 13 centers in North America, patients were tested in a standardized manner with a screening series of 70 allergens. Data were manually verified and entered into a central database. Descriptive frequencies were calculated, and trends were analyzed using χ test. A total of 4871 patients were tested. There were 3255 patients (66.8%) who had at least 1 positive reaction and 2412 patients (49.5%) who were ultimately determined to have a primary diagnosis of allergic contact dermatitis. A total of 434 patients (8.9%) had occupationally related skin disease. There were 9726 positive allergic reactions. Compared with the previous reporting periods (2011-2012 and 2001-2012, including at least three 2-year cycles), positive reaction rates for the top 25 screening allergens statistically increased for 2 allergens: methylchloroisothiazolinone/methylisothiazolinone (6.4%; risk ratios, 1.26 [1.07-1.50] and 2.08 [1.84-2.37]) and hydroxyethyl methacrylate (2.6%; risk ratios, 1.34 [1.02-1.76] and 1.23 [1.00-1.51]). Methylisothiazolinone, which was added to the screening series for this 2013-2014 cycle, had the third highest positive reaction rate of allergens tested (10.9%). Four other newly added allergen preparations-formaldehyde 2% (7%), diphenylguanidine (3.8%), propylene glycol 100% (2.8%), and benzophenone-4 (2.1%)-all had reaction rates greater than 2%. Twenty-one percent of tested patients had at least 1 relevant allergic reaction to an allergen not on the NACDG series; 14.6% of these were occupationally related. The T.R.U.E. TEST (SmartPractice Denmark, Hillerød, Denmark) would have hypothetically missed one quarter to one third of reactions detected by the NACDG screening series. These results confirm that the epidemic of sensitivity to methylisothiazolinone previously documented in Europe is also occurring in North America. Patch testing with allergens beyond a standard screening tray is necessary for the complete evaluation of occupational and nonoccupational allergic contact dermatitis.
ISSN:	2162-5220
DOI:	10.1097/DER.0000000000000225