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The “strip” patch test: results of a multicentre study towards a standardization

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Abstract

Background

The “strip” patch test (SPT) is a variant of patch testing which is used for substances with a poor percutaneous penetration. Penetration of the substances is enhanced by repeated applications of adhesive tape prior to their application to the skin. However, no guidelines exist for standardized performance of the SPT.

Objectives

The aim of this multicentre study was to obtain a first practical approach towards a standardized SPT procedure.

Methods

Intact noninflamed skin of the upper back of 83 healthy volunteers was tape-stripped. For sequential strips, a 25-mm diameter 3M Blenderm surgical tape was vertically applied and gently pressed downward using the fingertips for about 2 s. The tape was removed in one quick movement at an angle of 45° in the direction of adherence. Each strip was performed with a new piece of tape on exactly the same skin area.

Results

In each subject, we first determined the number of strips (A) until the skin surface started to glisten and calculated the median number of strips (Ā) in the sample (Ā=26 strips). We then ascertained the median number of strips (ā) in the sample that was necessary to achieve a statistically significant and twofold increase in TEWL (ā=11 strips), revealing a “critical” stratum corneum strip depth. The unknown number of strips (a) for each subject was finally calculated from the formula a/A=ā/Ā, i.e. the individual number of strips (A) until the skin surface started to glisten was multiplied by a derived tape-specific correction factor (cf=ā/Ā=11/26=0.4). The increase in percutaneous penetration in strip patch testing by performing “a” strips versus conventional patch testing was shown by scoring of clinical and subjective SLS irritant reactions.

Conclusions

The present multicentre study outlines an experimentally derived approach for a uniform SPT procedure, which does not require the use of complex technical equipment. This first approach now requires validation by a study involving the application of allergens to obtain evidence of enhancement in the sensitivity of patch testing.

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Abbreviations

PT:

“Conventional” patch test

SBL:

Shoulder blade left

SBR:

Shoulder blade right

SC:

Stratum corneum

SL:

Stratum lucidum

SLS:

Sodium lauryl sulphate

SPT:

“Strip” patch test

TEWL:

Transepidermal water loss

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Acknowledgements

The coordinating investigator (H.D.) is deeply grateful to Dr. Doris Schwindt, Hoffmann-La Roche AG, Germany, for fruitful discussion in the preliminary stages of the study. The multicentre study was supported by the German Contact Dermatitis Research Group (DKG).

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Authors and Affiliations

  1. Department of Dermatology, Environmental Medicine, and Health Theory, University of Osnabrück, Sedanstr. 115, 49090, Osnabrück, Germany

    Heinrich Dickel & Hans J. Schwanitz

  2. Department of Clinical Social Medicine, Occupational and Environmental Dermatology, University Hospital of Heidelberg, Heidelberg, Germany

    Thomas M. Bruckner & Elke Weisshaar

  3. Department of Dermatology and Allergology, University Hospital, RWTH Aachen, Aachen, Germany

    Stephan M. Erdmann & Hans F. Merk

  4. Department of Dermatology and Allergology, Friedrich Schiller University Jena, Jena, Germany

    Joachim W. Fluhr

  5. Department of Dermatology, Hospital Dortmund, University of Witten/Herdecke, Dortmund, Germany

    Peter J. Frosch & Claudia Pirker

  6. Department of Dermatology, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany

    Jürgen Grabbe

  7. Department of Dermatology, Philipp University of Marburg, Marburg, Germany

    Harald Löffler

  8. Department of Dermatology and Allergology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany

    Jochen Brasch

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  1. Heinrich Dickel
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  10. Hans J. Schwanitz
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  12. Jochen Brasch
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Corresponding author

Correspondence to Heinrich Dickel.

Additional information

This work is presented on behalf of the German Contact Dermatitis Research Group (DKG).

Parts of the work have been presented before in oral presentations at the 42nd Meeting of the German Dermatology Society (DDG) in Berlin, Germany, in May 2003, at the 7th Meeting of the Working Group on Occupational and Environmental Dermatology (ABD) of the DDG in Heidelberg, Germany, in September 2003, and at the 7th Congress of the European Society of Contact Dermatitis (ESCD) in Copenhagen, Denmark, in June 2004.

We regret to report the recent death of Hans Joachim Schwanitz.

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Dickel, H., Bruckner, T.M., Erdmann, S.M. et al. The “strip” patch test: results of a multicentre study towards a standardization. Arch Dermatol Res 296, 212–219 (2004). https://doi.org/10.1007/s00403-004-0496-x

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  • DOI: https://doi.org/10.1007/s00403-004-0496-x

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