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Archives of Toxicology Nov 2023Critical to the evaluation of non-animal tests are reference data with which to assess their relevance. Animal data are typically used because they are generally... (Review)
Review
Critical to the evaluation of non-animal tests are reference data with which to assess their relevance. Animal data are typically used because they are generally standardized and available. However, when regulatory agencies aim to protect human health, human reference data provide the benefit of not having to account for possible interspecies variability. To support the evaluation of non-animal approaches for skin sensitization assessment, we collected data from 2277 human predictive patch tests (HPPTs), i.e., human repeat insult patch tests and human maximization tests, for skin sensitization from 1555 publications. We recorded protocol elements and positive or negative outcomes, developed a scoring system to evaluate each test for reliability, and calculated traditional and non-traditional dose metrics. We also traced each test result back to its original report to remove duplicates. The resulting database, which contains information for 1366 unique substances, was characterized for physicochemical properties, chemical structure categories, and protein binding mechanisms. This database is publicly available on the National Toxicology Program Interagency Center for the Evaluation of Alternative Toxicological Methods website and in the Integrated Chemical Environment to serve as a resource for additional evaluation of alternative methods and development of new approach methodologies for skin sensitization assessments.
Topics: Humans; Patch Tests; Reproducibility of Results; Skin; Benchmarking; Databases, Factual
PubMed: 37615678
DOI: 10.1007/s00204-023-03530-3 -
Contact Dermatitis Jan 2023Commercial patch test substances do not cover all occupational contact allergens. Workplace materials and in-house test substances are tested to complement the...
BACKGROUND
Commercial patch test substances do not cover all occupational contact allergens. Workplace materials and in-house test substances are tested to complement the investigation of occupational skin disease (OSD).
OBJECTIVES
To quantify the additional value of testing workplace materials and non-commercial in-house test substances in the diagnosis of OSD.
MATERIALS AND METHODS
Patients files of 544 patients patch tested at the Finnish Institute of Occupational Health in 2015-2019 were reviewed for occupation, diagnoses and patch test results.
RESULTS
OSD was diagnosed in 353 (64.9%) of the patients. A total of 206 (37.9%) patients had occupational allergic contact dermatitis (OACD). In 19 (3.5%) patients, the only clues to the diagnoses of OACD were positive reactions to workplace materials, and in 20 (3.7%) patients, the diagnosis of OACD was based on commercially unavailable test substances. In 167 OACD cases diagnosed by commercial test substances, additional causes were found in 17 by testing patients' own and non-commercial test substances. In 43 (7.9%) cases, positive reactions to workplace materials reinforced diagnoses based on commercial test substances. The overall additive value of testing own products was 16.7% (91 cases).
CONCLUSION
We would have missed 39 (18.9%) of our 206 OACD cases if we had solely used commercial test substances.
Topics: Humans; Patch Tests; Dermatitis, Allergic Contact; Dermatology; Dermatitis, Occupational; Occupations; Allergens
PubMed: 35864599
DOI: 10.1111/cod.14191 -
European Annals of Allergy and Clinical... Jul 2021Different clinical pictures are related to corticosteroids (CS) non immediate hypersensitivity and the frequency of these reactions can be underestimated. The...
Different clinical pictures are related to corticosteroids (CS) non immediate hypersensitivity and the frequency of these reactions can be underestimated. The classification of CS in 3 groups and the identification of two patient's profiles has been proposed by Baeck to help clinicians in the management of these cases. Data of 14 patients with clinical history of delayed reactions to various CS and positive skin test and/or oral challenge are retrospectively analyzed. Three different patterns of patients are identified evaluating history, clinical picture and tests results. The first one (6 pts, 43%) is characterized by cutaneous and/or mucosal reaction due to inhaled Budesonide and patch test positive only to topical molecules belonging to the group 1 of CS. The second pattern (4 pts) has clinical history of local and systemic skin reactions to the topic and parenteral administration of the same or other steroid drugs. Patients belonging to the third pattern (4 pts) have a history of systemic reactions to general administration of CS without previous contact reaction. Pattern 2 and 3 show a wide sensitization to molecules belonging to the 3 groups of CS. All the patients show patch test positive to Budesonide. Although the lack of standardization, the allergy workup proves useful to differentiate patients sensitized to one or few molecules from polysensitized and to identify the culprit drugs. Intradermal and challenge test are necessary to complete the diagnostic workup. The results suggest the possibility of a different management of patients. Patients of pattern one can be only patch tested with a limited series of CS belonging to the 3 groups. They don't need an extensive exclusion of steroids use. The pattern 2 and 3 must be submitted instead to a complete allergological individual evaluation to identify alternative tolerated drugs, because of the risk of systemic reactions. The Baeck's classification shows limited usefulness in these cases.
Topics: Adrenal Cortex Hormones; Adult; Budesonide; Drug Hypersensitivity; Female; Humans; Hypersensitivity, Delayed; Male; Middle Aged; Patch Tests; Retrospective Studies; Young Adult
PubMed: 32729318
DOI: 10.23822/EurAnnACI.1764-1489.164 -
Indian Journal of Dermatology,... 2013Sensitive skin is less tolerant to frequent and prolonged use of cosmetics and toiletries. It is self-diagnosed and typically unaccompanied by any obvious physical signs... (Review)
Review
Sensitive skin is less tolerant to frequent and prolonged use of cosmetics and toiletries. It is self-diagnosed and typically unaccompanied by any obvious physical signs of irritation. With the change in lifestyle and also with increased opportunity to use many new brands of cosmetics and toiletries, there has been an increase in females complaining of unique sensation in their facial skin. Sensitive skin presents as smarting, burning, stinging, itching, and/or tight sensation in their facial skin. The condition is found in more than 50% of women and 40% of men, creating a sizable demand for products designed to minimize skin sensitivity. Good numbers of invasive and non-invasive tests are designed to evaluate and predict the sensitive skin. Management includes guidelines for selecting suitable cosmetics and toiletries in sensitive skin individuals.
Topics: Cosmetics; Dermatitis, Contact; Face; Humans; Hypersensitivity, Immediate; Patch Tests; Skin; Skin Irritancy Tests; Skin Physiological Phenomena
PubMed: 23254724
DOI: 10.4103/0378-6323.104664 -
European Journal of Pediatrics Aug 2023The "Atopy Patch Test" (APT) has been proposed as a diagnostic tool for food allergies (FA), especially in children with FA-related gastrointestinal symptoms. However,... (Meta-Analysis)
Meta-Analysis Review
The "Atopy Patch Test" (APT) has been proposed as a diagnostic tool for food allergies (FA), especially in children with FA-related gastrointestinal symptoms. However, its diagnostic accuracy is debated, and its usefulness is controversial. The aim of this systematic review was to evaluate the APT diagnostic accuracy compared with the diagnostic gold standard, i.e., the oral food challenge (OFC), in children affected by non-IgE mediated gastrointestinal food allergies, including the evaluation in milk allergic subgroup. Both classical non-IgE mediated clinical pictures and food induced motility disorders (FPIMD) were considered. The search was conducted in PubMed and Scopus from January 2000 to June 2022 by two independent researchers. The patient, intervention, comparators, outcome, and study design approach (PICOS) format was used for developing key questions, to address the APT diagnostic accuracy compared with the oral food challenge (OFC). The quality of the studies was assessed by the QUADAS-2 system. The meta-analysis was performed to calculate the pooled sensitivity, specificity, DOR (diagnostic odds ratio), PLR (positive likelihood ratio), and NLR (negative likelihood ratio) with their 95% confidence intervals (CI). Out of the 457 citations initially identified via the search (196 on PubMed and 261 on Scopus), 37 advanced to full-text screening, and 16 studies were identified to be included in the systematic review. Reference lists from relevant retrievals were searched, and one additional article was added. Finally, 17 studies were included in the systematic review. The analysis showed that APT has a high specificity of 94% (95%CI: 0.88-0.97) in the group of patients affected by FPIMD. Data showed a high pooled specificity of 96% (95% CI: 0.89-0.98) and the highest accuracy of APT in patients affected by cow's milk allergy (AUC = 0.93). Conclusion: APT is effective in identifying causative food in children with food-induced motility disorders. What is Known: • Atopy patch test could be a useful diagnostic test for diagnosing food allergy, especially in children with food allergy-related gastrointestinal symptoms. What is New: • Atopy patch test may be a useful tool in diagnosing non IgE food allergy, especially in children with food-induced gastrointestinal motility disorders and cow's milk allergy.
Topics: Female; Animals; Cattle; Child; Humans; Patch Tests; Milk Hypersensitivity; Sensitivity and Specificity; Food Hypersensitivity; Hypersensitivity, Immediate; Allergens; Gastrointestinal Diseases
PubMed: 37249680
DOI: 10.1007/s00431-023-04994-2 -
Journal of Investigational Allergology... Oct 2022
Topics: Dermatitis, Allergic Contact; Humans; Patch Tests
PubMed: 36219549
DOI: 10.18176/jiaci.0782 -
Contact Dermatitis Feb 2021Clinical surveillance of the prevalence of contact allergy in consecutively patch tested patients is a proven instrument to continually assess the importance of contact...
BACKGROUND
Clinical surveillance of the prevalence of contact allergy in consecutively patch tested patients is a proven instrument to continually assess the importance of contact allergens (haptens) assembled in a baseline series.
OBJECTIVES
To present current results from the European Surveillance System on Contact Allergies, including 13 countries represented by 1 to 11 departments.
METHODS
Anonymized or pseudonymized patch test and clinical data from various data capture systems used locally or nationally as transferred to the Erlangen data centre were pooled and descriptively analysed after quality control.
RESULTS
In the 4 years (2015-2018), data from 51 914 patients patch tested with the European baseline series (EBS) of contact allergens were analysed. Contact allergy to nickel was most frequent (17.6% positive), followed by contact allergy to fragrance mix I (6.9%), methylisothiazolinone (MI; 6.2%), and Myroxylon pereirae resin (balsam of Peru; 5.8%).
CONCLUSIONS
While the prevalence of MI contact allergy decreased substantially following regulatory intervention, the persistently high levels of allergy to metals, fragrances, other preservatives, and rubber chemicals point to problems needing further research and, potentially, preventive efforts. Results with national additions to the baseline series provide important information on substances possibly to be considered for inclusion in the EBS.
Topics: Allergens; Balsams; Dermatitis, Allergic Contact; Europe; Humans; Nickel; Odorants; Patch Tests; Population Surveillance; Prevalence; Thiazoles
PubMed: 32945543
DOI: 10.1111/cod.13704 -
Indian Journal of Dermatology,... 2023Patch test helps in identifying the allergen causing allergic contact dermatitis. Proper identification of the site of individual patch test allergen is very important...
Patch test helps in identifying the allergen causing allergic contact dermatitis. Proper identification of the site of individual patch test allergen is very important for identifying the positive allergen. In this article, various techniques for markings patch test sites are discussed.
Topics: Humans; Patch Tests; Dermatitis, Allergic Contact; Allergens
PubMed: 36461809
DOI: 10.25259/IJDVL_948_2021 -
Acta Clinica Croatica Jun 2020Allergic reactions sometimes participate in the development of perioral and oral diseases, indicating the need for appropriate allergen assessment. This review discusses... (Review)
Review
Allergic reactions sometimes participate in the development of perioral and oral diseases, indicating the need for appropriate allergen assessment. This review discusses current knowledge on the potential allergic reactions to different dental materials in patients with oral and perioral diseases. Aside from allergies to various dental materials, similar non-allergic, non-immune contact reactions (irritant or toxic) can occur. Among dental materials, the most frequent allergens are alloys, followed by rubber materials, polymers and acrylates. Allergic reactions to dental alloys that contain nickel, cobalt and amalgam are especially frequent since dentists use them for prosthetic and other restorations. There is a broad spectrum of clinical presentations of oral and perioral diseases possibly related to allergies, such as lichenoid reactions, cheilitis, perioral dermatitis, burning sensations, etc. Despite some limitations, patch test is crucial in the diagnosis and recognition of causative allergens because it reveals contact allergies, and is still superior in differentiating allergic and irritant contact reactions. It is important to examine patient medical histories (e.g., occurrence of symptoms after dental therapy or food consumption), and in consultation with their dentist, carry out allergy tests to specific dental allergens which are used or planned to be used in subsequent treatment.
Topics: Allergens; Cheilitis; Dermatitis, Allergic Contact; Dermatitis, Perioral; Humans; Hypersensitivity; Patch Tests
PubMed: 33456120
DOI: 10.20471/acc.2020.59.02.16 -
Actas Dermo-sifiliograficas Jan 2023Interpreting patch test reactions is not easy. It requires experience and is characterized by high intraobserver and interobserver variability. It can sometimes be truly...
Interpreting patch test reactions is not easy. It requires experience and is characterized by high intraobserver and interobserver variability. It can sometimes be truly difficult to discern between a weak allergic reaction and an irritant reaction. A number of recent studies have investigated the dermoscopic features of patch test reactions. Homogeneous erythema is the main feature observed in patients with a positive allergic reaction, although dotted vessels, vesicles, crusts and yellow-orange areas may also provide clues. These features are somewhat similar to those observed in inflammatory conditions, such as eczema. In patients with an irritant reaction, the most common dermoscopic findings are the pore reaction pattern and perifollicular erythema. Dermoscopy could be useful for establishing a diagnosis in the case of doubtful patch test reactions.
Topics: Humans; Irritants; Dermoscopy; Dermatitis, Allergic Contact; Erythema; Eczema; Patch Tests
PubMed: 35483422
DOI: 10.1016/j.ad.2022.03.005