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The detection of clinically relevant contact allergens with a standard screening tray of 28 allergens
Author(s) -
Patel Devika,
Belsito Donald V.
Publication year - 2012
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.1600-0536.2011.02022.x
Subject(s) - medicine , allergen , patch test , allergic contact dermatitis , contact dermatitis , dermatology , patch testing , allergy , test (biology) , immunology , paleontology , biology
Background. A standard method for diagnosing allergic contact dermatitis in the United States is the Thin‐layer Rapid Use Epicutaneous (TRUE) test (TRUE Test™), which consists of three panels containing 20 individual allergens and eight allergen mixes. Previous studies had raised concern regarding the adequacy of the initial two‐panel TRUE Test™ system (16 individual allergens and seven allergen mixes) in fully assessing patients with possible allergic contact dermatitis. Objectives. We sought to investigate the effectiveness of the current three‐panel TRUE Test™ as the sole diagnostic tool for detecting allergic contact dermatitis. Patients/materials/methods. This study was a retrospective analysis of 2088 patients who underwent patch testing between 1995 and 2010. Study groups were analysed to determine whether positive reactions were to allergens and/or mixes present in the TRUE Test™ panels. Results. Of the 2088 patch‐tested patients, 1385 had at least one positive reaction. Among these 1385 patients, 27.6% were fully evaluated by use of only the TRUE Test™ series, 49.9% were partially evaluated, and 22.5% did not have any of their allergens detected. On assessment for clinical relevance, similar percentages were observed. Conclusion. In our study, the current TRUE Test™ series of 28 allergens would have completely identified allergens in only 27.6% of patients. Broadening the standard panel to include common allergens causing >50% of allergic contact dermatitis cases in a given geographical location and aim testing allergens on the basis of the patient's history will increase the test's sensitivity.