Richardson, Donna M.

Background: The standard allergen series used in patch testing contains metals that most commonly cause allergic contact dermatitis, but testing with additional metal allergens is warranted for select patients. Objective: To report our experience with patch testing of metals. Methods: We retrospectively analyzed outcomes of 1,112 patients suspected of having metal allergies. Patients were seen from January 1, 2000, through December 31, 2009. Patch testing was performed with 42 metal preparations (6 in the standard series, 36 in the metal series). Results: Patch testing most commonly was performed for patients with oral disease (almost half the patients), hand dermatitis, generalized dermatitis, and dermatitis affecting the lips, legs, arms, trunk, or face. At least one positive reaction was reported for 633 patients (57%). Metals with the highest allergic patch-test reaction rates were nickel, gold, manganese, palladium, cobalt, Ticonium, mercury, beryllium, chromium, and silver. Metals causing no allergic patch-test reactions were titanium, Vitallium, and aluminum powder. Metals with extremely low rates of allergic patch-test reactions included zinc, ferric chloride, and tin. Reaction rates varied depending on metal salt, concentration, and timing of readings. Conclusion: Many metals not in the standard series were associated with allergic patch-test reactions. The many questions raised by these findings, concerning patch testing with individual metals, will be the subject of future studies.

Background: Hairdressing chemicals may be associated with allergic contact dermatitis. Objective: To review our experience of patch-testing with hairdressing chemicals. Methods: We reviewed results from patients who underwent patch testing with our standard allergen series (including 15 hairdressing chemicals) and a supplementary “hairdresser series” (18 additional hairdressing chemicals) at Mayo Clinic (Rochester, MN; Scottsdale, AZ; and Jacksonville, FL) from January 1, 2000, through December 31, 2008. Results: Two hundred ten patients (mean age, 53.8 years [SD, 16.9 yr]; female, 94.8%) were patch-tested. The most common sites of dermatitis were the scalp, face, and hands. Patients had widely varying occupations. The most common occupations were cosmetologist (10.5%), housewife (9.5%), and beautician (5.2%); 14.3% were retired. The hairdresser series detected 13 additional patients with allergies (6.4%; 204 patients tested with both series) who would not have been detected with the standard allergen series alone. The highest allergic patch-test rates in the supplemental hairdresser series were with ammonium persulfate (14.4%), 4-aminoazobenzene (13.4%), and pyrogallol (9.1%). Conclusions: Patch-testing with hairdressing-specific chemicals (standard series plus supplemental hairdresser series) was appropriate for numerous clinical situations and was not limited to patients in hair care occupations. The supplemental hairdresser series helped identify more patients than would have been identified with the standard series alone.

Background Recognition of allergic contact dermatitis attributed to textile dyes and resins is steadily increasing. Objective This study aims to review the results of patch testing with a textile series at our institution and to compare with previously published reports. Methods We performed a retrospective review of results in patients who underwent patch testing using a series of textile dyes and resins from January 1, 2000, through September 30, 2011. Results A total of 671 patients (mean age, 56.5 years; female, 65.9%) were patch tested with the textile series (42 dyes and resins). These patients were also generally tested with the standard patch test series (n = 620). Of the patients, 219 (32.6%) demonstrated allergic reaction to 1 or more textile dyes and resins, and 71 (10.6%) manifested irritant reactions. The most frequent allergens were disperse blue 106 1% (8.3%), disperse blue 124 1% (8.0%), and melamine formaldehyde 7% (8.0%). Of patients tested with the standard series, 36 (5.8%) showed a positive reaction to the traditional textile screening allergen p -phenylenediamine 1%. Conclusions Supplementing the standard series with the textile series increased detection of textile allergies. In patients suspected of textile allergy, addition of the textile series is necessary for appropriate diagnosis.