Eczema patch test

Among 290 patients with eczema, patch testing with 5% Roman chamomile elicited a positive reaction in only one person (Meneghini et al. 1971). Patch testing with Roman chamomile in individuals with prior allergy to different Compositae plants indicated that 2 of 25 patients were allergic to Roman chamomile (Hausen 1979). A maximization... 

Eczema caused by cement is the most widespread occupational dermatosis in Switzerland as well as in other countries (Musso and coll., 1962). The association between sensitivity to cement and to potassium bichromate, is universally acknowledged. In masons suffering from eczema, patch tests with cement were less often positive, than those with 0.5% potassium bichromate. Brun (1963 and 1964) in our department,... 

A 22-year-old man with a history of fixed drug eruptions, seasonal rhinitis, and mild atopic dermatitis took one tablet of desloratadine and on the next day developed generalized eczema. Patch tests performed 2 months later were strongly positive and were followed during the next 24 hours by a relapse of the pruriginous eczematous lesions spreading on the trunk. 

Nickel itch is a dermatitis resulting from sensitization to nickel the first symptom is usually pruritis, which occurs up to 7 days before skin eruption appears. The primary skin eruption is erythematous, or follicular it may be followed by superficial discrete ulcers that discharge and become crusted or by eczema. The eruptions may spread to areas related to the activity of the primary site such as the elbow flexure, eyelids, or sides of the neck and face. In the chronic stages, pigmented or depigmented plaques may be formed. Nickel sensitivity, once acquired, is apparently not lost of 100 patients with positive patch tests to nickel, all reacted to the metal when retested 10 years later. ... 

A 27-year-old woman, a pharmacist, had dermatitis on three separate occasions a few hours after she started to take oral deflazacort 6 mg for vesicular hand eczema (185). On each occasion, her symptoms included a widespread macular rash mainly on the inner aspects of her arms and legs and buttocks. She also had severe scaling, fever, nausea, vomiting, malaise, and hypotension. A skin biopsy was consistent with erythema multiforme, and direct immunofluorescence showed granular deposits at the dermoepidermal junction. Patch tests to the commercial formulation of deflazacort 6 mg (1% aqueous solution) and to pure deflazacort (1% aqueous solution) were positive, but there were no cross-reactions to other glucocorticoids. 

Chronic lichenified eczema has been attributed to prolonged use of topical methylprednisolone aceponate and budesonide (strength and duration of therapy not stated) in a 26-year-old woman (425). Patch tests were positive for methylprednisolone aceponate and budesonide cream, but negative for all other topical glucocorticoids. 

Agner, T. Non-invasive measuring methods for the investigation of irritant patch test reactions a study of patients with hand eczema, atopic dermatitis and controls. Acta Derm. Venereol. 173 (Suppl.), 1-26 (1992). 

A 47-year-old woman developed eczema of the face, consisting initially of edematous lesions on the eyelids and then spreading to the rest of the face and the folds of the neck. Patch tests to a cosmetic cream she had used before the start of the eczema (Active C dry skin. La Roche Posay Laboratory) gave positive results (++D2... 

A 37-year-old woman developed intense burning and pruritic eczema where she had applied a cream containing benzoxonium for seborrheic dermatitis for 5 months (3). The reaction disappeared on withdrawal of the cream. Patch tests were positive to benzoxonium chloride 0.1% aqueous on days 2 and 4. Patch tests with benzalkonium chloride and benzoxonium chloride in 20 controls were negative. 

A 33-year-old woman with atopic hand eczema and allergic rhinitis was given Noviform, an eye ointment containing bibrocathol (bismuth oxide and tetrabromo-cathechol), for periorbital dermatitis and noticed an exacerbation of her dermatitis (32). A patch test was positive for bismuth oxide. 

A woman developed severe eczema of the ears, neck, and upper chest after having applied Earex ear drops. Patch tests with rectified camphor oil were positive on days 2 and 4 (4). 

In a collaborative Danish study, 2061 patients were patch-tested with chlorhexidine gluconate 1% in water. There was a positive reaction in 2.3% of the patients. This was more common in patients with leg eczema (6.8%) or leg ulcer (10.6%) than in those with eczema of the hands (1.9%) or at other sites (1.6%). Of the 14 patients who were retested with chlorhexidine, only one was positive to the 1% solution and none to a solution of 0.01%. This apparent loss of sensitivity may be due to irritable skin at the initial testing, the so-called excited skin syndrome. This study suggests that the sensitizing potential of chlorhexidine is very low, but that it should be used with caution in dressings for leg ulcers. 

Croton is also the name given to Codiaeum variegatum, a highly decorative potted plant. Handhng this plant over a period of 6 months produced contact eczema of the hands in a nursery gardener. Patch tests with croton leaves were positive (5). 

Of 1216 patients who were patch tested, 14 with eczema had used products (creams, hair products, and essential oils) containing tea tree oil (17). They were patch tested for a standard panel of allergens, topical emulgents, perfumes, plants, topical medications, metal, gloves, topical... 

A 79-year-old woman had an abdominal aortic anenr-ysm repaired with a straight Vangnard R stent, mainly composed of nickel (about 55%) and titaninm (abont 21%) with a reinforcing thread of platinum (25). Three weeks later she developed severe erythema and eczema on the legs with continuons pruritus and excoriated papules. Patch tests were positive to nickel sulfate and cobalt chloride. 

Topical polymyxin B was the predominant allergen in patients who underwent patch-testing for evaluation of eczema of the external ear canal (22). 

Systemic allergic reactions have been reported in eight patients after topical application of a wart formulation containing resorcinol (3). All developed a marked eczematous, sometimes bullous reaction, localized to the site of application in four cases there were generalized urticaria and angioedema, in one pompholyx eczema, and in three generalized eczema with pompholyx. In aU cases there were positive patch tests with resorcinol. 

Patch tests in patients with anogenital eczema should include the standard series cinchocaine HCl, propolis, bufexamac, and other ingredients of topical formulations according to the patient s history. In cases of doubt, the repeated open application test (ROAT) is recommended. Patients should be advised to apply the suspected product three times a day for 3 days to an area of healthy skin on measuring 5 cm x 5 cm the flexural site of the forearm (35). 

An 86-year-old Japanese man received a pacemaker for atrioventricular block, and 2 months later developed a scaly erythema over the implantation site and later widespread nummular eczema. Histologically, the lesions showed slight spongiosis, intracellular edema, moderate acanthosis in the epidermis, and perivascular infiltration with thickened capillary walls in the dermis. The pacemaker contained titanium and a variety of other metals, but patch tests were all negative. However, titanium sensitivity was demonstrated by intracutaneous and lymphocyte stimulation tests. 

A group of 50 catering workers with eczema or dermatitis of the hand or arm were studied for suspected occupational dermatitis. All workers were prick tested with foods that commonly irritated their hands at work, as well as patch tested with garlic 50% in arachis oil, onion 50% in arachis oil, and pieces of the same prick test foods. Seven workers reacted to 50% garlic in oil and one reacted to whole garlic (92). 

One case of allergic contact dermatitis from 1,1,1 -trichloroethane was located in the literature (Ingber 1991). A worker whose job included using 1,1,1-trichloroethane to clean metal plates developed severe acute hand eczema soon after starting the job. The eczema persisted throughout 3 years of employment. Patch tests at that time showed a positive reaction to 1,1,1 -trichloroethane. The eczema disappeared after a few weeks when contact with 1,1,1-trichloroethane was avoided. The possibility the allergic reaction to being caused by 1,1,1-trichloroethane stabilizer was not discussed. 

Vielrrf D, Kunz B, Bieber T, Przybilla B, Ring J Atopy Patch Test with aeroallergens in patients with atopic eczema. Allergo J 1993 2 9-12. 

A 1988 case report describes a female laboratory technician who developed severely pruritic vesicles between the fingers after 6 months of exposure to a medium containing selenium. After 2 years, the severity of the symptoms increased to include eczema on the face and neck, watering eyes, and two asthma attacks within a 2-month period. Sodium selenite or the medium containing selenium were the only positive patch tests (Senff et al. 1988). 

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