Erythema patch test

Urticaria following internal exposure to nickel has been reported [418] the urticaria might be due to mechanisms other than delayed hypersensitivity. Precipitating antibodies against nickel sulphate bound to human albumin was found in some patients with widespread erythema after oral challenge. Moreover, patients with immediate patch test reactions to nickel and chronic urticaria have been reported [419]. 

Application to the face as lotion for acne treatment in two persons caused facial erythema and edema patch tests with benzoyl peroxide were positive. In contact with the eyes it may produce irritation, and if allowed to... 

On the skin, g-cymene may cause erythema, dryness, and defatting. However, 4% p-cymene in petroleum did not produce irritation in 25 humans after a 48-hour closed patch test or after 10 daily applications to the same spot on the backs of subjects. Undiluted g-cymene applied to rabbit skin for 24 hours under occlusion was moderately irritating. The LDso by skin absorption is greater than 5 g/% in rabbits. 

Positive patch tests have also been reported in hairdressers who used glutaraldehyde as a disinfectant. Presenting signs and symptoms included erythema with papules on the hands and face, dyspnea, and cough. ... 

Of 20 workers exposed to PCE, 13 had acute skin changes, including second-degree burns, vesicular rash, papules, and edema. In another study of 15 workers with PCE-induced dermatitis, there was erythema with papules and vesicles. Of these 15 workers, 8 reacted positively to patch tests. In addition to skin sensitization PGE can also cause crosssensitization with other glycidyl ethers. 

Repeated and prolonged skin contact with cement can result in dermatitis of the hands, forearms, and feet this is a primary irritant dermatitis and may be complicated in some instances by a secondary contact sensitivity to hexavalent chromium. In a study of 95 cement workers, 15 had a mild dermatitis of the hands, which consisted of xerosis with erythema and mild scaling of 20 workers who were patch tested with 0.25% potassium dichromate, one person had a mild reaction and the others were negative. 

Single applications of 1.0 ml of 1% CS solution were administered to the clipped backs of rabbits.29 They developed mild to moderate erythema chat cleared in 3 d. Monkeys showed no signs of irritation. A 5-d test of the 1% solution caused only moderate erythema that cleared in 8 d. A 0.2-ml application caused only moderate irritation in the rabbits. In monkeys, l-ml and 0.2-ml applications caused no irritation. Patch tests on rabbits and monkeys with similar doses caused somewhat more skin irritation, but generally the lesions were reversible no systemic toxicity was demonstrated. ... 

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. 

In the Draize human sensitization test, an occlusive patch containing the test material is applied to the upper armor upper back of 200 volunteers. The patch remains in place for 24 h and is then removed. The test site is evaluated for erythema and edema at patch removal. Twenty-four hours after the removal of the 1st patch, a 2nd patch test is applied. This... 

Although bar soaps produce erythema when tested by conventional patch test techniques, the typical clinical response is dryness and flaking with occasional erythema and Assuring. Frosch and Kligman (1979) developed the soap chamber test to compare the chapping potential of bar soaps. 

A 37-year-old man developed itchy erythema on his trunk and legs after taking calcium carbimide (dose not specified) for 3 days. He had an eosinophilia of 22%. Patch-testing with calcium carbimide was positive. The eruption subsided after withdrawal. 

A 45-year-old nurse presented with a 6-month history of recurrent periorbital erythema with itching and runny eyes. Each episode lasted abont 5-6 days and settled on withdrawal from her place at work, where she handled a large nnmber of drugs, including meropenem. She was patch-tested with the Enropean standard series, and was negative to aU except meropenem. She had complete remission after qnitting her workplace. 

A 35-year-old man developed a subacute dermatitis with scattered patches of erythema and scahng on the lower legs, ankles, hands, and wrists. He had no history of atopy but a prior history of allergy to a leather watch-strap. He had taken various oral vitamin and mineral formulations for several weeks. Patch-testing showed reactions to potassium dichromate at 48 and 96 hours. 

A woman had received intralesional paramethasone and other topical glucocorticoids several times for alopecia between the ages of 7 and 18 years (381). When she was 30 she was again treated with intralesional paramethasone for a relapse of alopecia. She developed pruritus after the first intralesional injection and erythema, edema, and vesicles 6-8 hours later. A biopsy showed spongiform lymphocytic folliculitis with spongiosis and exocytosis in the sweat gland ducts and in the pilosebaceous unit. She was treated with triamcinolone cream and her skin lesions resolved. Patch tests were positive for paramethasone, with cross-reactivity to tixocortol pivalate, hydrocortisone, and hydrocortisone butyrate. 

A 43-year-old woman, who had taken antibiotics and analgesics, including dextropropoxyphene, for parotitis, developed generalized erythema with numerous pustules on the trunk followed by a pyrexia. Patch testing was positive with dextropropoxyphene only and negative with paracetamol, spiramycin, aspirin, and tenoxicam. 

Patch tests with these drugs showed a positive reaction on flavoxate 10% on day 3. Rechallenge with flavoxate caused generalized pruritic erythema with fever. 

There is a risk of sensitization from paraphenylenediamine when it is applied to the skin in combination with henna (4—6). This can result in contact allergic reactions as well as persistent contact leukoderma, as illustrated in five patients with paint-on henna tattoos (7). AH were positive on patch-testing with paraphenylenediamine. One developed erythema multiforme 4 weeks after the last application and the authors found no other causes of erythema multiforme. 

A 35-year-old woman had a 3-week history of pruritic erythema, edema, and linear vesiculation of the upper arms where she had applied fluocinonide cream (1). Patch tests with the cream were positive, but the active ingredient fluocinonide (0.05% in petrolatum) was negative, while 1,2,6-hexanetriol 5% showed strong positive reactions on days 3 and 7. 

Skin reactions, including erythema multiforme in three patients and a lichenoid eruption in one, were attributed to infliximab (17). One patient had similar lesions after etanercept. Patch tests with infliximab in three patients were negative, but produced a flare-up of lesions in one patient and recurrence of malaise and nausea in another patient, suggesting that infliximab is well absorbed per-cutaneously. 

A 54-year-old woman and a 68-year-old man developed rashes 24 hours after intravascular injection of iohexol (a non-ionic monomer) (205). The woman developed widespread pruritic erythema and eyelid edema. The man developed a maculopapular rash involving the trunk and legs. Both patients were treated with antihistamines, which resulted in complete recovery within 1 week. The man had slight desquamation of the affected area after his rash resolved. Patch tests were positive to iohexol in both patients. The man also had a positive patch test to iodixanol and the woman was positive to the non-ionic monomer ioversol. 

In a 38-year-old non-atopic man, a generalized prurigi-nous maculopapular eruption with hp edema and facial erythema developed after 10 days of treatment with oral clindamycin phosphate (300 mg qds) and amoxicillin (500 mg qds) for bronchopneumonia (24). A patch test was positive 2 months later for clindamycin phosphate but negative for peniciUin, amoxiciUin, ampiciUin, and erythromycin. Prick tests and intradermal tests were all negative. Oral rechallenge with chndamycin phosphate 300 mg was positive. 

A 17-year-old woman developed pruritic edematous erythema on her lips after using a lipstick containing isopalmitate (4). A patch test with 10% isopahnitate in petrolatum was positive on day 3, with six negative controls. 

A 50-year-old man had local infiltrations a few days after an injection of lidocaine and dexamethasone (43). Prick and intradermal tests were negative after 20 minutes. However, lidocaine produced a positive patch test after 2 days, with erythema and papules. 

In one case, allergic contact dermatitis to tea tree oil presented with an extensive erythema multiforme-like reaction (16). However, a skin biopsy from a target-like lesion showed a spongiotic dermatitis without the features of erythema multiforme. Five months after treatment with systemic and topical glucocorticoids, patch testing elicited a 3+ reaction to old, oxidized tea tree oil, a 2+ reaction to fresh tea tree oil, a 2+ reaction to colophony, a 1+ reaction to abitol, and a 1+ reaction to balsam of Peru. 

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