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Description
The fourth edition of this important book, which includes additional color illustrations, has been extensively revised, updated, and expanded to reflect the most recent developments. These include advances in patch testing methodology, in particular the new chambers that are appearing on the market, revision of the baseline series of patch tests to reflect the latest evidence-based work, and additional testing procedures. Other additions include sections on key allergens and concentrations, with the result is a superb guide to the current management of positive and negative patch test and prick test reactions that will be invaluable for all practicing dermatologists, from the beginner to the well-trained expert.
The fourth edition continues the tradition of partnering with the ICDRG (International Contact Dermatitis Research Group). The ICDRG was formed in 1966 to promote the understanding of contact dermatitis. It has had major roles in the standardization of patch testing and the facilitation of regular scientific meetings, for over forty years and thirty five years respectively. It has also been involved in the authorship of a number of publications on contact dermatitis. Both Drs. Maibach and Lachapelle are members and the ICDRG is now comprised of representatives from all over the world, and currently includes members from Belgium, Sweden, Denmark, the United Kingdom, USA, Germany, Singapore, Korea, India, Japan, Canada, Uruguay and Australia.
From the reviews of the previous editions:
"The aim is to balance brevity and clarity with sufficient details for beginners in the field of diagnostic patch and prick testing. … the book also will be of use to dermatology residents or anyone wishing to gain better knowledge of contact dermatitis. … There are many high-quality photographs and useful algorithms and tables. … It is clearly and concisely written and will serve as an indispensable guide for any dermatologist interested in contact dermatitis." (Renata H. Mullen, Doody’s Review Service, August, 2009)
Table of Contents
Contents
Introductory Remarks
Part I Patch Testing
1 Pathophysiology of Allergic and Irritant Contact Dermatitis
1.1 Introduction
1.2 Pathophysiology of Irritant and Allergic Skin Inflammation
1.2.1 Irritant and/or Allergic Chemicals
1.2.2 Skin Irritation: Activation of Innate Immunity
1.3 Skin Allergy: The Role of Specific Immunity
1.3.1 Antigen-Specific Immunity
1.3.2 Skin Allergy: Mechanisms of Action
1.3.3 Indirect Responsibility of Chemicals in Skin Irritation
1.4 Pathophysiology of Skin Inflammation: The Connection Between Innate and Acquired Immunity
References
2 Diseases for Which Patch Testing Is Recommended: Patients Who Should Be Investigated
2.1 Allergic Contact Dermatitis
2.1.1 Clinical Signs and Symptoms
2.1.2 Histopathological Features
2.2 Allergic Contact Dermatitis Syndrome
2.2.1 Stage 1 of ACDS
2.2.2 Stage 2 of ACDS
2.2.3 Stage 3 of ACDS
2.3 Allergic Contact Dermatitis Versus Irritant Contact Dermatitis: Criteria for Differential Diagnosis
2.4 Other Skin Diseases in Which Patch Testing Is of Major Interest
2.5 Algorithmic Approach: Key Role of Patch Testing
2.6 Hand Dermatitis: Definition and Procedures Applied in Differential Diagnosis
2.6.1 Hand Dermatitis: Exogenous and Endogenous Factors
2.6.2 A Classification of Hand Dermatitis
2.6.3 Tools of Investigation
2.6.4 Hand Dermatitis: Some Examples of an Algorithmic Approach
2.6.5 Hand Eczema: A Controversial Issue
References
3 Patch Testing Methodology
3.1 Historical Background
3.2 Definition and Aims
3.2.1 Requirements for an Ideal Patch Testing Procedure
3.2.2 Is Patch Testing the “Gold Standard” to Investigate Patients with Allergic Contact Dermatitis?
3.3 Patch Test Units
3.3.1 Nonchamber Patch Tests
3.3.2 Chamber Patch Tests
3.3.3 Plastic Square Chambers
3.3.4 Reinforcement of Patch Test Units
3.4 A General Overview of Allergens
3.4.1 Allergens
3.4.2 Bioavailability of Allergens
3.4.3 Quality Control of Allergens
3.4.4 Appropriate Amounts of Petrolatum to Be Applied at Patch Testing
3.4.5 Appropriate Amounts of Liquids to Be Applied at Patch Testing 3.5 Specific Recommendations When Considering Patch Testing Patients
3.5.1 Patch Testing on Intact Skin Is Critical
3.5.2 Medicaments and Patch Testing
3.5.3 Pregnancy and Patch Testing
3.5.4 Patch Testing in Children 3.6 Application of Patch Tests on the Skin: Some Practical Suggestions
3.6.1 Test Sites
3.6.2 Removal of Hair
3.6.3 Degreasing of Test Site
3.6.4 Application of Test Strips
3.6.5 Instructions to Patients
3.7 Reading Time
3.7.1 Standard Patch Test Occlusion and Reading Time
3.7.2 Conventional Patch Test Reading Time
3.7.3 Reading at Day 2, Day 3, and Day 4
3.7.4 Reading at Day 7 3.7.5 Single Reading Versus Multiple Reading
3.7.6 Day 3 Versus Day 4 Reading
3.7.7 One-Day Occlusion Versus Two-Day Occlusion
3.7.8 Marking the Skin
3.7.9 Positive Control
3.7.10 Immediate Urticarial Reactions to Some Allergens
3.8 Reading and Scoring Patch Test Results
3.8.1 Scoring Codes According to the ICDRG
3.8.2 Proposal for Modified Scoring Codes of Positive Patch Test Reactions, According to ESCD and EECDRG
3.8.3 Rating Patch Test Reactions Based on Digital Images
3.8.4 Bioengineering Methods for Evaluating Skin Irritation and Allergic Reactions. A Comparison with Visual Scoring
3.8.5 Remarks About Reading and Scoring Patch Test Results
3.9 Irritant Patch Test Reactions
3.10 False-Positive Patch Test Reactions
3.11 False-Negative Patch Test Reactions
3.12 Compound Allergy
3.13 Cross-Sensitization, Concomitant Sensitization, and Polysensitization
3.13.1 Cross-Sensitization
3.13.2 Concomitant Sensitization
3.13.3 Polysensitization
3.14 Unwanted Adverse Reactions of Patch Testing
3.14.1 Patch Test Sensitization (“Active Sensitization”)
3.14.2 Excited Skin Syndrome (“Angry Back”)
3.15 Patch Test Readings in Different Ethnic Populations
3.15.1 Patch Test Reading in Oriental Populations
3.15.2 Patch Test Reading in Black Populations 3.16 Patch Testing Techniques in Different Climatic Environments
3.16.1 Temperate Climates
3.16.2 Tropical Climates
3.16.3 Patch Testing Procedures in the Tropics
3.17 Is Self-assessment of Allergic Contact Dermatitis by Patients Recommendable?
3.17.1 Self-assessment by Questionnaires
3.17.2 Self-readings of Patch Tests by Patients
References
4 Baseline Series of Patch Tests
4.1 Historical Background
4.2 Advantages and Disadvantages of Using a Baseline Series of Patch Tests
4.2.1 Advantages
4.2.2 Disadvantages
4.3 The Different Baseline Series of Patch Tests
4.3.1 ICDRG-Revised International Minimal Baseline Series of Patch Tests
4.3.2 The Updated 2019 European Baseline Series on Behalf of the ESCD and EECDRG 4.3.3 The Updated 20109 North American Baseline Series on Behalf of the NACDG
4.3.4 The Updated 2019 Japanese Baseline Series on Behalf of the JCDS
4.4 “Mixes” of Baseline Series
4.5 Concise Information About Allergens Included in the Updated 2011 Minimal Baseline Series of the ICDRG
4.6 Concise Information on Other Common Allergens Included in the Updated 2011 Minimal Baseline Series of the ICDRG
4.7 Additional Series of Patch Tests
4.8 The Preservative Methylisothiazolinone : The New Star of Allergic Contact Dermatitis
References
5 Photopatch Testing
5.1 Definition and Aims
5.2 Photoallergic Contact Dermatitis
5.3 Photoallergic Contact Dermatitis Versus Airborne Allergic Contact Dermatitis: Criteria for Differential Diagnosis
5.4 Photoallergic Drug Eruptions
5.5 Photopatch Testing Methodology
5.6 Light Sources
5.7 Proposal for a Photopatch Test Series
References
6 The T.R.U.E. Test® Methodology
6.1 Introduction
6.2 The T.R.U.E. Test® Methodology
6.3 More Practical Information About the Technology of The T.R.U.E. Test®
6.4 Regulatory Information
6.5 Standard The T.R.U.E. Test® Series
6.6 New Additions
6.7 Methodology of Use
6.8 Additional Information6.9 Note
References
7 Additional Testing Procedures and Spot Tests
7.1 Strip Patch Test
7.2 Open Test
7.3 Semi-open (or Semi-occlusive) Tests
7.4 Repeated Open Application Test
7.5 Testing Procedures with Unknown Substances
7.5.1 Strategy
7.5.2 Steps Required Prior to Any Testing Procedure
7.5.3 Testing Procedures with Solid Products and Extracts
7.5.4 The Use of Ultrasonic Bath Extracts in the Search of the Culprit(s) Allergen(s) present in Solid Products
7.5.5 Testing Procedures with Cosmetics and Other Related Products
7.6 Oral Provocation Test (Oral Challenge)
7.7 Other Investigations
7.7.1 pH Measurement
7.7.2 Spot Tests 7.7.3 Chemical Analysis
7.8 Additional Remarks About Chemistry and Immunology in Relationship with Allergic Contact Dermatitis
References
8 Clinical Relevance of Patch Test Reactions
8.1 Introduction
8.2 General Principles
8.3 Past and Current Relevance
8.4 Scoring System
8.5 Strategies
8.5.1 Clinical History
8.5.2 Environmental Evaluation
8.5.3 Further Correlations
8.5.4 Additional Investigations
8.6 Suggestions for Improved Evidence-Based Diagnosis of Relevance
8.7 Additional Remark
References
9 Atopic Dermatitis, Irritant Contact Dermatitis, and Allergic Contact Dermatitis 9.1 Preliminary Remarks
9.2 Etiopathogenic Advances
9.3 Disruption of the Skin Barrier
9.4 Increased Disruption of the Skin Barrier in AD
9.5 Hand Eczema
9.6 Other Skin Typical Locations of Lesions in AD
9.7 Guidelines for the Practice of Patch Testing
References
Part II Prick Testing
10 Spectrum of Diseases for Which Prick Testing and Open (Non-prick) Testing Are Recommended: Patients Who Should Be Investigated
10.1 Contact Urticaria Syndrome
10.1.1 Clinical Symptoms and Stages of CUS
10.1.2 Etiology and Mechanisms of CUS
10.1.3 Contact Urticaria to Natural Rubber Latex
10.2 Protein Contact Dermatitis
References
11 Methodology of Open (Non-prick) Testing, Prick Testing, and Its Variants 11.1 Introductory Remarks
11.2 Open (Non-prick) Testing
11.3 Prick Test: Technical Modalities and Reading
11.3.1 Technique of Puncture
11.3.2 Control Solutions
11.3.3 Reading Time
11.3.4 Reading Prick Test Results
11.3.5 Medicaments and Prick Testing
11.3.6 False-Negative Reactions
11.3.7 False-Positive Reactions
11.3.8 Prick Tests in Children and Babies
11.4 Prick-by-Prick Test
11.5 Scratch Test
11.5 Scratch-Chamber Test
11.7 Comparative Indications of Open (Non-prick) Testing, Prick Testing, and Other Related Tests
11.8 Intradermal Testing for Type 1 Hypersensitivity
11.9 Prick Testing: Allergens of Interest for Skin Problems
11.9.1 Latex
11.9.2 Airborne Environmental per Annum Allergens
11.9.3 Airborne Environmental Seasonal Allergens
11.9.4 Food Allergens (Trophallergens)
11.9.5 Occupational Allergens
11.9.6 Fungi
11.9.7 Miscellaneous (Immunological and/or Non-immunological) Urticariogens
References
Part III Testing in Cutaneous Systemic Immune-Related Adverse Drug Reactions: Interest and Limitations
12 Testing Procedures in Cutaneous Systemic Immune-Related Adverse Drug Reactions
12.1 General Considerations
12.2 Proposal of a Classification of CADR
12.3 Tools of Investigation in CADR
12.4 Histopathological Limitations in Diagnosis of a CADR
12.5 Patch Testing in CADR
12.5.1 Spectrum of CADRs for Which Patch Testing Is Recommended
12.5.2 Spectrum of CADRs for Which Patch Testing Can Be Performed (Being Still Controversial)
12.5.3 Spectrum of CADRs for Which Patch Testing Is of No Interest
12.5.4 Guidelines in Drug Patch Testing: General Rules
12.5.5 Technical Aspects of Drug Patch Testing
12.5.6 Readings of Drug Patch Tests
12.5.7 False-Negative Patch Test Reactions
12.5.8 False-Positive Patch Test Reactions
12.6 Prick Testing in CADR
12.7 Intradermal Testing in CADR
12.8 Oral Provocation Test (Oral Challenge) in CADR
References
Appendices
Appendix A: Additional Series of Patch Tests
A.1 Introductory Remarks
A.2 Bakery Series
A.3 Corticosteroid Series
A.4 Cosmetic Series
A.5 Epoxy Resin Series
A.6 Hairdressing Series
A.7 Isocyanate Series
A.8 Metal Series
A.9 (Meth)Acrylate Series
A.10 Plastics and Glues Series
A.11 Rubber Additives Series
A.12 Textile Dyes and Finish Series
A.13 Other Series
References Appendix B: The International Contact Dermatitis Research Group
B.1 Historical Background
B.2 Current Tasks and Strategy of the ICDRG
B.3 ICDRG Members
References
Appendix C: A List of Companies Producing and/or Distributing Patch and/or Prick Test Materials and/or Allergens
C.1 Introductory Remarks
C.2 List of Companies
