A Pragmatic Approach to Patch Testing Atopic Dermatitis Patients: Clinical Recommendations Based on Expert Consensus Opinion

TY - JOUR

T1 - A Pragmatic Approach to Patch Testing Atopic Dermatitis Patients

T2 - Clinical Recommendations Based on Expert Consensus Opinion

AU - Chen, Jennifer K

AU - Jacob, Sharon E

AU - Nedorost, Susan T

AU - Hanifin, Jon M

AU - Simpson, Eric L

AU - Boguniewicz, Mark

AU - Watsky, Kalman L

AU - Lugo-Somolinos, Aida

AU - Hamann, Carsten R

AU - Eberting, Cheryl Lee

AU - Silverberg, Jonathan I

AU - Thyssen, Jacob Pontoppidan

PY - 2016/7/1

Y1 - 2016/7/1

N2 - Allergic contact dermatitis (ACD) may complicate the clinical course of atopic dermatitis (AD), and patch testing remains the criterion standard for diagnosing ACD. To date, there have been no guidelines or consensus recommendations on when and how to patch test individuals with AD. Failure to patch test when appropriate may result in overlooking an important and potentially curable complicating comorbidity. In this article, we present consensus recommendations regarding when to perform patch testing in the AD patient, best practices, and common pitfalls. Patch testing should be considered in AD patients with dermatitis that fails to improve with topical therapy; with atypical/changing distribution of dermatitis, or pattern suggestive of ACD; with therapy-resistant hand eczema in the working population; with adult- or adolescent-onset AD; and/or before initiating systemic immunosuppressants for the treatment of dermatitis. A suggested patch testing algorithm for AD patients is provided.

AB - Allergic contact dermatitis (ACD) may complicate the clinical course of atopic dermatitis (AD), and patch testing remains the criterion standard for diagnosing ACD. To date, there have been no guidelines or consensus recommendations on when and how to patch test individuals with AD. Failure to patch test when appropriate may result in overlooking an important and potentially curable complicating comorbidity. In this article, we present consensus recommendations regarding when to perform patch testing in the AD patient, best practices, and common pitfalls. Patch testing should be considered in AD patients with dermatitis that fails to improve with topical therapy; with atypical/changing distribution of dermatitis, or pattern suggestive of ACD; with therapy-resistant hand eczema in the working population; with adult- or adolescent-onset AD; and/or before initiating systemic immunosuppressants for the treatment of dermatitis. A suggested patch testing algorithm for AD patients is provided.

KW - Journal Article

U2 - 10.1097/DER.0000000000000208

DO - 10.1097/DER.0000000000000208

M3 - Journal article

C2 - 27427820

SN - 1710-3568

VL - 27

SP - 186

EP - 192

JO - Dermatitis

JF - Dermatitis

IS - 4

ER -