Contact dermatitis is an inflammatory skin disease due to contact with different substances and caused by two mechanisms: allergy and irritation. Contact dermatitis is a common skin disease and the most common occupational dermatosis. Differentiating between allergic and irritant contact dermatitis is essential in the identification of etiologic factor(s) and hence, its control and prognosis. This differentiation can be done only by PATCH TEST. Unfortunately, this simple, safe and useful TEST is always neglected. We review the basics of PATCH TEST, the method of performance, reading and interpretation of its results, possible side effects and results of studies done with PATCH TEST in different countries.

Background: Various environmental factors can induce or exaggerate hand eczema. Objective: Evaluation of PATCH TEST results in hand eczema patients. Patients and Methods: In this descriptive study 100 patients with hand eczema referred to Loghman Hakim & Booali Hospital in Tehran underwent PATCH TESTing with 23 allergens obtained from Hennal Company. Results: 240 positive reactions observed in 86 patients. The most common positive reactions were related to nickel sulfate (30 patients, 13.5%) and potassium dichromate (28 patients, 11.7%). In positive group 28 patients were male and 58 were female. In negative group 3 patients were male and 11 were female (P>0.05). The mean age was 31.7±11.9 years and 24.8± 9.2 years for positive group and negative group, respectively (P<0.05). In positive PATCH TEST group 49 patients had subacute and 37 patients had chronic eczema. In negative PATCH TEST 11 patients had subacute eczema and 3 patients had chronic eczema (P>0.05). Conclusion: Performing PATCH TEST, the allergens involved in hand eczema can be detected. Detecting type of allergens, patients will be able to avoid those materials which can lead to improvement of disease.        

Introduction: Contact eczema is a common inflammatory skin disease; different materials with irritant and allergic mechanisms can produce this disease. Although history and physical examination are important in diagnosis of allergen, because of extent of several factors, environmental allergens, were not simply recognized. PATCH TEST is an important diagnostic tool to confirm allergic contact dermatitis and can reduce mistake of clinical diagnoses.Objective: Determine frequency of dermatic allergens in patients with contact or atopic dermatitis who were referred to Razi hospital in Rasht.Materials and Methods: In a descriptive cross sectional study during 22 months, 100 patients with clinical diagnoses of contact and atopic dermatitis who referred to Razi hospital PATCH TESTed with European standard series containing 24 allergens. Their reactions were evaluated after 24, 48 and 72 hours after application of PATCH TEST. Data was collected and were analyzed by SPSS. (P<0.05 was considered significant.Results: Among 100 patients, positive PATCH TEST was seen in 36% which mean age of them was (30.67) years (SD=10.85 The most common involved location was hand (86%) and most common allergens were Nickel sulfate (20%) and potassium dichromate (9%). In this study 6 (25%) of all allergens showed positive reaction.Conclusion: Nickel Sulfate and Potassium Dichromate were the most common contact allergens in our study.

Background and aim: Contact dermatitis is an inflammatory skin response due to contact with environmental materials manifested as acute or chronic eczema. PATCH TEST is the standard TEST to recognize responsible allergen. The objective of this study was to evaluate the frequency of false positive PATCH TEST responses in patients with Exited Skin Syndrome (ESS).Materials and methods: Fourteen patients older than 12 years with allergic contact dermatitis who had more than one positive reaction in first PATCH TEST were re-TESTed with the same allergens at the time of remission of their eczema. The PATCHes were removed after 48 hours and responses read according to ICDRG guidelines.Results: The patients included 5 men and 9 women with a mean age of 34.92 years. The most common allergens in first PATCH TEST were: nickel sulfate (10), cobalt chloride (5), colophony (4), potassium dichromate, PTBF, fragrance mix and MCI/MI (3 each). In the repeated TEST, the most common positive responses were: nickel (10), cobalt and colophony (4 each), potassium dichromate and fragrance mix (3 each). In 6 of 14 patients the results of second TEST was different from first one. Three of these patients had active eczema at the time of first TEST, which in 2 of them one positive response and in one of them, 2 positive responses became negative in second TEST.Conclusion: It is recommended that PATCH TEST be repeated after a while in patients with multiple positive reactions in first TEST, particularly after remission of active eczema.

Background and aim: PATCH TESTing is an important diagnostic tool to confirm allergic contact dermatitis. Determination of the validity and usefulness of a standard PATCH TEST allergen series with consideration of age, sex and race difference can reduce diagnostic errors in patients with allergic contact dermatitis. This study was done to determine the frequency of contact sensitization to 28 common allergens in patients with clinical diagnoses of contact and/or atopic dermatitis. Materials and Methods: In a cross sectional study during 6 months, 250 patients with contact and/or atopic dermatitis were PATCH TESTed with DKG standard PATCH TEST series and evaluated after 24, 48 and 72 hours after application of PATCH TEST. Data were analyzed using SPSS. 11 software by X2, Fisher's exact and t TESTs. Results: Positive PATCH TEST results were seen in 32% of all evaluated patients. 45.8% of patients with age above 40 years and 28.0% of patient with age below 40 years had a positive PATCH TEST. Potassium dichromate and nikel sulfate were the most common allergens in our study. In this study only 13 of 18 (46.4%) TESTed allergens showed positive reaction. Conclusion: Low positive rate of standard DKG series in this study shows that allergen series of standard PATCH TEST should be revised based on regional conditions, allergens and social habits.      

Background and aim: Eczema is a common inflammatory skin disease. Although history and physical examination are important in diagnosis of allergen, because of extent of environmental allergens, those are not simply recognized. The objective of this study was to determine allergens in patients with contact or atopic dermatitis referred to Razi hospital.Materials and Methods: This descriptive, cross sectional study was performed on patients with contact or atopic dermatitis in 2003-2004 with European Standard Series PATCH TEST containing 24 allergens.Results: In this study 223 patients were TESTed with a mean age of 31 years (SD=12). The most common involved location was hand (59%). The most common allergens were nickel sulphate (23/2%), cobalt (11/4%) and thiuram (8/3%).Conclusion: Nickel sulphate was the most common contact allergen in this study.

Background and Aim: Allergic contact dermatitis is the most frequent cause of eyelid dermatitis,but it is often misdiagnosed. This study aims to evaluate the characteristics of patients with eyelid dermatitis who referred for PATCH TEST. Methods: This was a retrospective study. Three major subgroups were made: patients with only eyelid involvement, involvement of eyelids and other areas, and without eyelid involvement. Collected data included past history, diagnoses, personal care product & make-up use, occupational dermatitis, and positive allergens. Chi-squared, independent tTEST, and one-way ANOVA were used for analysis. Results: 139 patients with eyelid dermatitis who referred for PATCH TEST were included in the study. Allergic contact dermatitis was the most common diagnosis in all three groups referred for PATCH TEST. Use of shaving cream and hair conditioner was significantly higher in patients with only eyelid involvement and nickel sulphate was the most common allergen among them. Conclusion: PATCH TESTing is an important tool in the evaluation of the common dermatologic disease of eyelid contact dermatitis, as the gold standard. It is a necessity in the treatment of eyelid dermatitis, because of accurate identification of responsible allergens.

Introduction: Allergic and irritant compounds are frequent in nature, and the environmental allergic factors which can induce or exacerbate eczema are different and often unknown in different areas. The aim of this study was to determine the frequency of contact dermatitis in patients with chronic dermatitis referring to dermatology clinics in kerman.Methods: In this descriptive study, standard PATCH TEST containing 24 allergens was done for 156 cases (56 males and 69 females) with confirmed chronic dermatitis who had been referred to Afzalipoor Hospital Dermatology Clinics. Evaluation of the results was done for every case 24, 48 and 72 hours after application of the PATCH TEST.Results: In whole, 153 positive PATCH TESTs were seen in 66 (52.8%) cases of 125 patients who had been examined. The most common allergic agent was nickel sulfate detected in 20 (13.1%) patients (17 females and 3 males). The hypersensitivity reaction to this agent was significantly more common in females than males (P<0.05). Potassium dichromate with frequency of 11.1% (12 males and 5 females) was the second common allergic agent and males showed significantly more positive reaction to this agent than females (p<0.05). There was no statistically significant difference according to the age and sex between groups with positive and negative PATCH TEST results (P>0.05).Conclusion: As the causative agents of contact dermatitis are different in various areas, by doing PATCH TEST in each area the allergic agents can be detected for more appropriate preventive measures and treatment strategies. In this study, the first and second common allergens were respectively Nickel and Chrome compounds. Thiorum, Cobalt, benzocaine and theazolin compounds were in the third rank.

Background: An investigation of the prevalence of occupational hand dermatitis in Loghman Hakim, a large teaching hospital in Tehran, was conducted.Materials and Methods: Information concerning the presence of occupational hand dermatitis, frequency of hand-washing and glove consumption, duration of contact with glove and wet environment, past history of hand eczema, personal and family history of atopy, kind of ward, kind of used detergent, underling systemic disease, history of systemic drug consumption, duration of employment, cigarette consumption, and demographic factors (including age, gender, hobbies, and occupation) was collected via a questionnaire and physical examination by dermatologist. To determine the type of occupational hand dermatitis, allergic or irritant, PATCH TEST was performed.Results: The prevalence of occupational hand dermatitis was found to be 44% in total population. No relationship was found between occupational hand dermatitis and age, hobbies, frequency of hand-washing and glove consumption, duration of contact with glove and wet environment, cigarette consumption, duration of employment, type of ward, kind of used detergent, underling systemic disease, history of systemic drug consumption, and duration of employment. There were statistically significant differences between two groups of stuff (with and without occupational hand dermatitis) in their gender, past history of hand eczema, and personal and family history of atopy. Out of 43 stuff underwent PATCH TEST, 50% had allergic occupational hand dermatitis. The most common positive allergen was nickel.Conclusion: The high prevalence rate of occupational hand dermatitis among intra-hospital staff causes great concern about the health risks of these workers when they would expose to blood-borne diseases.

Objective: Celiac disease is an inTESTinal disorder identified by mucus inflammation, villous atrophy and crypt hyperplasia. This disorder can be controlled by elimination of gluten from daily diet. Patients with celiac disease are at greater risk of gastroinTESTinal malignancy and non-Hodgkin lymphoma than are the general population. This study tries to present the value of gluten PATCH TEST for diagnosis of celiac disease.Methods: In this investigation, the study population was divided into case and control groups. The case group consisted of patients with celiac disease. The control group were patients involved in celiac disease but suffering from other gastroinTESTinal disorders. Both gluten PATCH and placebo PATCH were attached to the skin between the scapulas. The results were read twice: 48 hours and 96 hours after the PATCH was applied. Patients who showed irritation reactions were withdrawn from this study. The results were analysed by SPSS software, Spearman’s TEST, chi square, and Mann–Whitney TESTs.Findings: The value obtained from the gluten PATCH TEST after 96 hours are as follows: specification at 95%, sensitivity at 8%, positive prediction value at 67%, and negative prediction value at 43%.Conclusion: It can be concluded that the gluten PATCH TEST is not an efficient TEST for screening of celiac disease, however, it can be useful for diagnosis of celiac disease if employed and studied with clinical symptoms and serologic and biopsy TESTs. Furthermore, we should doubt our judgment if the result of gluten PATCH TEST for the patient with celiac disease is positive.