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patch tests
By : Muhammed Abdulaziz Alghurery
PATCH TEST
• Used for diagnosis of allergic contact
dermatitis
• Basis of the testing is to elicit an immune
response by challenging already sensitized
persons to defined amount of allergen and
assessing the degree of response
INDICATIONS FOR PATCH TESTING
 Eczematous disorders where contact allergy
is suspected or to be excluded
 Eczematous disorders failing to respond to
treatment as expected
 Chronic hand and foot eczema
 Persistent or intermittent eczema of face,
eyelids, ear and perineum
 Varicose eczema
PATCH TEST MATERIALS
• Finn Chamber
• Aluminium - 8 mm diameter & 0.5 mm depth
• Tight apposition
Patch Test Units
Tapes
• Non – allergenic
• Non - Irritant
Vehicles
Allergens
• Petrolatum
• Suitable concentration
• Stored properly
PATCH TEST PROCEDURE
0 hours
Antigens applied
0 hours
Occluded
immediately
48 hours
Occlusion removed
48 hours
Reading after half
an hour
96 hours
Reading at 96
hours
PATCH TEST GRADING
GRADING DESCRIPTION PICTURE INTERPRETATION
- No erythema orpapules Negative
+/-or ? Erythemaonly Doubtful Positive
+ Erythema, mild infiltration,
discrete papules
WeakPositive
++ Erythema, infiltration, papules
and vesicles
Strong Positive
+++ Intense erythema, coalescingvesicles Extreme Positive
IR Sharply demarcated erythema
or epidermal necrosis
Irritant reaction
NT Not Tested
FALSE POSITIVE AND FALSE NEGATIVE
FALSE POSITIVE PATCH TEST
 Wrong Test Substance
 Excited Skin Syndrome/Angry back Syndrome/Status eczematicus –
Occurs in patients presenting with multiple concomitant positive reactions
to diagnostic patch tests for ACD in whom a single repeated challenge
reveals some of them to be non reproducible
 Artifact
FALSE NEGATIVE PATCH TEST
 Insufficient amount
 Non occlusion
 Corticosteroids
 Refractory state
THANK
YOU

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Patch test

  • 1. patch tests By : Muhammed Abdulaziz Alghurery
  • 2. PATCH TEST • Used for diagnosis of allergic contact dermatitis • Basis of the testing is to elicit an immune response by challenging already sensitized persons to defined amount of allergen and assessing the degree of response
  • 3. INDICATIONS FOR PATCH TESTING  Eczematous disorders where contact allergy is suspected or to be excluded  Eczematous disorders failing to respond to treatment as expected  Chronic hand and foot eczema  Persistent or intermittent eczema of face, eyelids, ear and perineum  Varicose eczema
  • 4. PATCH TEST MATERIALS • Finn Chamber • Aluminium - 8 mm diameter & 0.5 mm depth • Tight apposition Patch Test Units Tapes • Non – allergenic • Non - Irritant Vehicles Allergens • Petrolatum • Suitable concentration • Stored properly
  • 5. PATCH TEST PROCEDURE 0 hours Antigens applied 0 hours Occluded immediately 48 hours Occlusion removed 48 hours Reading after half an hour 96 hours Reading at 96 hours
  • 6. PATCH TEST GRADING GRADING DESCRIPTION PICTURE INTERPRETATION - No erythema orpapules Negative +/-or ? Erythemaonly Doubtful Positive + Erythema, mild infiltration, discrete papules WeakPositive ++ Erythema, infiltration, papules and vesicles Strong Positive +++ Intense erythema, coalescingvesicles Extreme Positive IR Sharply demarcated erythema or epidermal necrosis Irritant reaction NT Not Tested
  • 7. FALSE POSITIVE AND FALSE NEGATIVE FALSE POSITIVE PATCH TEST  Wrong Test Substance  Excited Skin Syndrome/Angry back Syndrome/Status eczematicus – Occurs in patients presenting with multiple concomitant positive reactions to diagnostic patch tests for ACD in whom a single repeated challenge reveals some of them to be non reproducible  Artifact FALSE NEGATIVE PATCH TEST  Insufficient amount  Non occlusion  Corticosteroids  Refractory state