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Histological distinction between early allergic and irritant patch test reactions: follicular spongiosis may be characteristic of early allergic contact dermatitis
Author(s) -
VESTERGAARD LOUISE,
CLEMMENSEN OLE JACOB,
SØRENSEN FLEMMING BRANDT,
ANDERSEN KLAUS EJNER
Publication year - 1999
Publication title -
contact dermatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.524
H-Index - 96
eISSN - 1600-0536
pISSN - 0105-1873
DOI - 10.1111/j.1600-0536.1999.tb06131.x
Subject(s) - spongiosis , medicine , dermatology , allergic contact dermatitis , allergy , irritant contact dermatitis , patch test , folliculitis , contact dermatitis , pathology , immunology
Comparative light microscopic studies have revealed subtle differences between allergic and irritant reactions in the skin. In the search for specic differences, we focussed on the early inammatory response. This pilot study was conducted to test the hypothesis that follicular spongiosis can differentiate between early allergic and irritant patch test reactions. 8 patients with known contact allergy to either colophony or quarternium‐15 participated in the study. In each patient, allergic and irritant patch tests reactions were elicited, and 4‐mm punch biopsies were taken after 6–8 h from clinically equipotent reactions. Paired sets of slides were assessed blindly by 2 pathologists. 1 patient showing a pityrosporum folliculitis was excluded from the study. All biopsies from allergic patch tests were characterized by follicular spongiosis, while biopsies from irritant patch tests showed no recognizable changes except a slight follicular spongiosis in 1 patient. The 2 pathologists agreed independently on the correct classication in 6 out of 7 cases ( p = 0.0156). We tested an optimized model, selecting non‐irritant allergens and a well‐known irritant. Further investigations are needed to elucidate the diagnostic signicance of the histological classication of allergic and irritant cutaneous reactions in punch biopsies.