Skip to main content
SpringerLink
Log in

Pitfalls and Errors in Patch Testing: Suggestions for Quality Assurance

  • Chapter
  • First Online:
Patch Testing Tips

Abstract

Patch testing is a complex procedure requiring considerable knowledge, experience, and infrastructure. As all comparable medical procedures, it is prone to pitfalls and errors. These relate to patient selection; selection and preparation of patch test allergens; their application, reading, and interpreting the patch test reaction; and judging patch test relevance. In this chapter, frequent pitfalls and errors encountered in patch testing are described. With an up-to-date quality assurance system in the patch test unit, they can be prevented with a high probability.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 59.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 79.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Wilf-Miron R, Lewenhoff I, Benyamini Z, Aviram A. From aviation to medicine: applying concepts of aviation safety to risk management in ambulatory care. Qual Saf Health Care. 2003;12(1):35–9.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  2. Moshell AN, Parikh PD, Oetgen WJ. Characteristics of medical professional liability claims against dermatologists: data from 2704 closed claims in a voluntary registry. J Am Acad Dermatol. 2012;66(1):78–85.

    Article  PubMed  Google Scholar 

  3. Nethercott JR. Practical problems in the use of patch testing in the evaluation of patients with contact dermatitis. Curr Probl Dermatol. 1990;2(4):97–123.

    Article  Google Scholar 

  4. Lamb SR, Wilkinson SM. Audit of primary and secondary care as a source of patch test clinic referrals. Br J Dermatol. 2004;151(6):1258–60.

    Article  PubMed  CAS  Google Scholar 

  5. Corazza M, Borghi A, Mantovani L, Virgili A. Analysis of patch test referrals: influence of appropriateness of referrals on sensitization rate. Contact Dermatitis. 2012;66(2):95–100.

    Article  PubMed  Google Scholar 

  6. Devos SA, Van Der Valk PG. The risk of active sensitization to PPD. Contact Dermatitis. 2001;44(5):273–5.

    Article  PubMed  CAS  Google Scholar 

  7. Bruze M, Condé-Salazar L, Goossens A, Kanerva L, White IR. Thoughts on sensitizers in a standard patch test series. The European Society of Contact Dermatitis. Contact Dermatitis. 1999;41(5):241–50.

    Article  PubMed  CAS  Google Scholar 

  8. Mitchell J, Maibach HI. Managing the excited skin syndrome: patch testing hyperirritable skin. Contact Dermatitis. 1997;37(5):193–9.

    Article  PubMed  CAS  Google Scholar 

  9. Lindberg M, Matura M. Contact dermatitis. Heidelberg/New York: Springer; 2011.

    Google Scholar 

  10. Belsito DV. Patch testing with a standard allergen (“screening”) tray: rewards and risks. Dermatol Ther. 2004;17(3):231–9.

    Article  PubMed  Google Scholar 

  11. Sköld M, Hagvall L, Karlberg A-T. Autoxidation of linalyl acetate, the main component of lavender oil, creates potent contact allergens. Contact Dermatitis. 2008;58(1):9–14.

    Article  PubMed  Google Scholar 

  12. Frosch PJ, Geier J, Uter W, Goossens A. Patch testing with the patients’ own products. In: Contact dermatitis. Heidelberg/New York: Springer; 2011. p. 1107–19.

    Chapter  Google Scholar 

  13. Isaksson M, Gruvberger B, Frick-Engfeldt M, Bruze M. Which test chambers should be used for acetone, ethanol, and water solutions when patch testing? Contact Dermatitis. 2007;57(2):134–6.

    Article  PubMed  Google Scholar 

  14. Bruze M, Isaksson M, Gruvberger B, Frick-Engfeldt M. Recommendation of appropriate amounts of petrolatum preparation to be applied at patch testing. Contact Dermatitis. 2007;56(5):281–5.

    Article  PubMed  CAS  Google Scholar 

  15. Bruze M, Frick-Engfeldt M, Gruvberger B, Isaksson M. Variation in the amount of petrolatum preparation applied at patch testing. Contact Dermatitis. 2007;56(1):38–42.

    Article  PubMed  CAS  Google Scholar 

  16. Frick-Engfeldt M, Gruvberger B, Isaksson M, Hauksson I, Pontén A, Bruze M. Comparison of three different techniques for application of water solutions to Finn Chambers®. Contact Dermatitis. 2010;63(5):284–8.

    Article  PubMed  Google Scholar 

  17. Gilpin SJ, Hui X, Maibach HI. Volatility of fragrance chemicals: patch testing implications. Dermatitis. 2009;20(4):200–7.

    PubMed  CAS  Google Scholar 

  18. Uter W, Hegewald J, Kränke B, Schnuch A, Gefeller O, Pfahlberg A. The impact of meteorological conditions on patch test results with 12 standard series allergens (fragrances, biocides, topical ingredients). Br J Dermatol. 2008;158(4):734–9.

    Article  PubMed  CAS  Google Scholar 

  19. Brasch J, Geier J, Henseler T. Evaluation of patch test results by use of the reaction index. An analysis of data recorded by the Information Network of Departments of Dermatology (IVDK). Contact Dermatitis. 1995;33(6):375–80.

    Article  PubMed  CAS  Google Scholar 

  20. Maibach HI, Fregert S. Manual of contact dermatitis. Contact Dermatitis. 1980;6(7):430–4.

    Article  PubMed  Google Scholar 

  21. Fregert S. Manual of contact dermatitis: on behalf of the International Contact Dermatitis Research Group. Copenhagen: Munksgaard; 1974.

    Google Scholar 

  22. Svedman C, Isaksson M, Björk J, Mowitz M, Bruze M. ‘Calibration’ of our patch test reading technique is necessary. Contact Dermatitis. 2012;66(4):180–7.

    Article  PubMed  Google Scholar 

  23. Becker D. Allergic contact dermatitis. J Dtsch Dermatol Ges. 2013;11(7):607–21.

    PubMed  Google Scholar 

  24. Löffler H, Becker D, Brasch J, Geier J, German Contact Dermatitis Research Group (DKG). Simultaneous sodium lauryl sulphate testing improves the diagnostic validity of allergic patch tests. Results from a prospective multicentre study of the German Contact Dermatitis Research Group (Deutsche Kontaktallergie-Gruppe, DKG). Br J Dermatol. 2005;152(4):709–19.

    Article  PubMed  Google Scholar 

  25. Schuster C, Mofarrah R, Aberer W, Kränke B. Pitfalls of patch testing with dental materials. Br J Dermatol. 2012;166(3):674–5.

    Article  PubMed  CAS  Google Scholar 

  26. Maurice PD, Rivers JK, Jones C, Cronin E. Dermatitis artefacta with artefact of patch tests. Clin Exp Dermatol. 1987;12(3):204–6.

    Article  PubMed  CAS  Google Scholar 

  27. Mowad CM. Patch testing: pitfalls and performance. Curr Opin Allergy Clin Immunol. 2006;6(5):340–4.

    Article  PubMed  Google Scholar 

  28. Davis MDP, Bhate K, Rohlinger AL, Farmer SA, Richardson DM, Weaver AL. Delayed patch test reading after 5 days: the Mayo Clinic experience. J Am Acad Dermatol. 2008;59(2):225–33.

    Article  PubMed  Google Scholar 

  29. Jonker MJ, Bruynzeel DP. The outcome of an additional patch-test reading on days 6 or 7. Contact Dermatitis. 2000;42(6):330–5.

    Article  PubMed  CAS  Google Scholar 

  30. Lachapelle JM. A proposed relevance scoring system for positive allergic patch test reactions: practical implications and limitations. Contact Dermatitis. 1997;36(1):39–43.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Dermatology, University Hospital Jena, Erfurter Str. 35, Jena, 07743, Germany

    Peter U. Elsner MD, PhD & Sibylle Schliemann MD

Authors
  1. Peter U. Elsner MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sibylle Schliemann MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Peter U. Elsner MD, PhD .

Editor information

Editors and Affiliations

  1. Department of Dermatology, Cliniques Universitaires Saint-Luc, Catholic University of Louvain, Brussels, Belgium

    Jean-Marie Lachapelle

  2. Dept. of Occup. a. Environmental Dermatology, Lund University, Malmö, Sweden

    Magnus Bruze

  3. Department of Dermatology, University Hospital Jena, Jena, Germany

    Peter U. Elsner

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Elsner, P.U., Schliemann, S. (2014). Pitfalls and Errors in Patch Testing: Suggestions for Quality Assurance. In: Lachapelle, JM., Bruze, M., Elsner, P. (eds) Patch Testing Tips. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-45395-3_3

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-45395-3_3

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-45394-6

  • Online ISBN: 978-3-642-45395-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation