Evaluation of dental material series from patients with dental prostheses and suspicion of delayed hypersensitivity.

BACKGROUND: Patients with oral sensitivity are common in our practice. Allergic contact dermatitis is one of the most frequent etiologies. OBJECTIVES: Evaluate oral contact dermatitis using the Brazilian standard series and complementary dental series in patients using dental prostheses, with or without oral complaints. Determine specific dental Brazilian series. METHODS: Patients using dental prostheses with or without oral complaints realized patch tests. Brazilian standard series and complementary dental series were used according to ICDRG recommendations. The results were analysed according to age, sex, race, atopic conditions and symptoms associated. RESULTS: From 54 patients tested, 34 (63%) were positive at least to one substance. Nineteen had oral complaints, such as burning mouth, itch or oral erythema. There was no association between atopic condition and tests results. Without the oral series, just 23(42,6%) patients had a positive result. Using the Brazilian standard series with the complementary dental series we improved the positivity of the patch test to 47%. CONCLUSION: In patients using prostheses and with oral complaints, patch tests with Brazilian standard series with complementary dental series improve the tests positivity.

Evaluation of dental material series from patients with dental prostheses and suspicion of delayed hypersensitivity

Abstract: BACKGROUND: Patients with oral sensitivity are common in our practice. Allergic contact dermatitis is one of the most frequent etiologies. OBJECTIVES: Evaluate oral contact dermatitis using the Brazilian standard series and complementary dental series in patients using dental prostheses, with or without oral complaints. Determine specific dental Brazilian series. METHODS: Patients using dental prostheses with or without oral complaints realized patch tests. Brazilian standard series and complementary dental series were used according to ICDRG recommendations. The results were analysed according to age, sex, race, atopic conditions and symptoms associated. RESULTS: From 54 patients tested, 34 (63%) were positive at least to one substance. Nineteen had oral complaints, such as burning mouth, itch or oral erythema. There was no association between atopic condition and tests results. Without the oral series, just 23(42,6%) patients had a positive result. Using the Brazilian standard series with the complementary dental series we improved the positivity of the patch test to 47%. CONCLUSION: In patients using prostheses and with oral complaints, patch tests with Brazilian standard series with complementary dental series improve the tests positivity.

Patch test results in children and adolescents. Study from the Santa Casa de Belo Horizonte Dermatology Clinic, Brazil, from 2003 to 2010.

BACKGROUND: Patch testing is an efficient method to identify the allergen responsible for allergic contact dermatitis. OBJECTIVE: To evaluate the results of patch tests in children and adolescents comparing these two age groups' results. METHODS: Cross-sectional study to assess patch test results of 125 children and adolescents aged 1-19 years, with suspected allergic contact dermatitis, in a dermatology clinic in Brazil. Two Brazilian standardized series were used. RESULTS: Seventy four (59.2%) patients had "at least one positive reaction" to the patch test. Among these positive tests, 77.0% were deemed relevant. The most frequent allergens were nickel (36.8%), thimerosal (18.4%), tosylamide formaldehyde resin (6.8%), neomycin (6.4%), cobalt (4.0%) and fragrance mix I (4.0%). The most frequent positive tests came from adolescents (p=0.0014) and females (p=0.0002). There was no relevant statistical difference concerning contact sensitizations among patients with or without atopic history. However, there were significant differences regarding sensitization to nickel (p=0.029) and thimerosal (p=0.042) between the two age groups under study, while adolescents were the most affected. CONCLUSION: Nickel and fragrances were the only positive (and relevant) allergens in children. Nickel and tosylamide formaldehyde resin were the most frequent and relevant allergens among adolescents.

Patch test results in children and adolescents. Study from the Santa Casa de Belo Horizonte Dermatology Clinic, Brazil, from 2003 to 2010

AbstractBACKGROUND:Patch testing is an efficient method to identify the allergen responsible for allergic contact dermatitis.OBJECTIVE:To evaluate the results of patch tests in children and adolescents comparing these two age groups' results.METHODS:Cross-sectional study to assess patch test results of 125 children and adolescents aged 1-19 years, with suspected allergic contact dermatitis, in a dermatology clinic in Brazil. Two Brazilian standardized series were used.RESULTS:Seventy four (59.2%) patients had "at least one positive reaction" to the patch test. Among these positive tests, 77.0% were deemed relevant. The most frequent allergens were nickel (36.8%), thimerosal (18.4%), tosylamide formaldehyde resin (6.8%), neomycin (6.4%), cobalt (4.0%) and fragrance mix I (4.0%). The most frequent positive tests came from adolescents (p=0.0014) and females (p=0.0002). There was no relevant statistical difference concerning contact sensitizations among patients with or without atopic history. However, there were significant differences regarding sensitization to nickel (p=0.029) and thimerosal (p=0.042) between the two age groups under study, while adolescents were the most affected.CONCLUSION:Nickel and fragrances were the only positive (and relevant) allergens in children. Nickel and tosylamide formaldehyde resin were the most frequent and relevant allergens among adolescents.

Patch tests / Testes de contato

Patch tests were introduced as a diagnostic tool in the late nineteenth century. Since then, they have improved considerably becoming what they are today. Patch tests are used in the diagnostic investigation of contact dermatitis worldwide. Batteries or series previously studied and standardized should be used in patch testing. The methodology is simple, but it requires adequate training for the results to be correctly interpreted and used. Despite having been used for over a century, it needs improvement like all other diagnostic techniques in the medical field.

Os testes de contato foram introduzidos, como ferramenta diagnóstica, no final do século XIX. Desde então passaram por diversos aprimoramentos tornando-os o que são hoje. Eles são utilizados na investigação diagnóstica das dermatites de contato em diferentes partes do mundo. Devem ser aplicados com a utilização de baterias ou séries previamente estudadas e padronizadas. A metodologia é simples, mas requer treinamento adequado para sua interpretação e bom aproveitamento dos resultados obtidos. Apesar de ser utilizado há mais de um século, necessita de aprimoramentos como todas as outras técnicas utilizadas para investigação diagnóstica na área médica.

Patch tests.

Patch tests were introduced as a diagnostic tool in the late nineteenth century. Since then, they have improved considerably becoming what they are today. Patch tests are used in the diagnostic investigation of contact dermatitis worldwide. Batteries or series previously studied and standardized should be used in patch testing. The methodology is simple, but it requires adequate training for the results to be correctly interpreted and used. Despite having been used for over a century, it needs improvement like all other diagnostic techniques in the medical field.

Patch test standard series recommended by the Brazilian Contact Dermatitis Study Group during the 2006-2011 period.

A retrospective study was carried out between 2006-2011. Six hundred and eighteen patients with suspected allergic contact dermatitis underwent the standard patch test series recommended by the Brazilian Contact Dermatitis Research Group. The aim of our study was to evaluate the variation of positive patch-test results from standard series year by year. The most frequently positive allergens were: nickel sulfate, thimerosal and potassium bichromate. Decrease of positive patch-test results over the years was statistically significant for: lanolin (p=0.01), neomycin (p=0.01) and anthraquinone (p=0.04). A follow-up study should be useful in determining which allergens could be excluded from standard series, as they may represent low sensitization risk.

Reproducibility of patch test results: a concurrent right-versus-left study using TRUE Test.

Wide variations in the reproducibility rate of positive patch test responses have been reported. We hypothesized that a major source of non-reproducibility resides in the methodological pitfalls of routine patch testing. Simultaneous duplicate patch testing on opposite sides of the upper back was performed on 500 consecutive patients, using the TRUE Test system consisting of 2 panels, each one containing 12 standard allergens. A rigorous methodological design was applied and relevance was assessed for all discordant patch test reactions. A total of 435 positive patch test reactions were observed either on one or both sides in 289 patients (58.8%). Of these, 22 (5%) were discordant, i.e. interpreted as positive allergic on one side whilst negative or doubtful on the opposite side. The allergens responsible for discordant reactions were nickel sulfate (4 patients), cobalt chloride (3), lanolin alcohol (3), fragrance mix (2), carba mix (2), thiuram mix (2), colophonium (1), potassium dichromate (1), p-phenylenediamine (1), formaldehyde (1), balsam of Peru (Myroxylon pereirae resin) (1) and thimerosal (1). Of the 19 (4%) patients with discordant patch test reactions, the allergen was deemed to be of definite present or past relevance in 9 patients (1.8% of the total and 3.1% of all patients with positive patch test reactions) and of possible relevance in a further 2 patients. These data suggest that patch testing is a reasonably reproducible procedure as long as methodological error is minimized.

The atopy patch tests for detection of cow's milk allergy with digestive symptoms.

Infants (n = 35) with digestive symptom were investigated for diagnosis of cow's milk allergy (CMA). Milk atopy patch tests (APTs) were positive in 19 of 24 CMA versus 1 of 11 in non-CMA patients (P <.001). This sensitivity (79%) and specificity (91%) suggest that the APT could improve the detection of conditions related to CMA.

Excited skin syndrome: study of 39 patients.

BACKGROUND: Excited skin syndrome (ESS) is an adverse reaction obtained when carrying out epicutaneous patch tests, characterized by multiple positive test results, associated with one or more strongly positive tests, which are not all reproduced when the patient is tested afterward. OBJECTIVE: The aim of this study was (1) to determine the frequency of ESS in patients submitted to patch testing, (2) to confirm the influence of the evolution time of the primary dermatosis with ESS induction, (3) to determine differences among patients according the rate of positive test loss, and (4) to compare the number of positive tests for each substance between the first test, when all allergens in the test battery were applied, and the second test, when only the allergens with positive tests on the first occasion were applied at a greater distance from one another. METHODS: Epicutaneous tests were carried out in 630 patients with a suspected diagnosis of allergic contact dermatitis. Patients presenting 2 or more positive test results were considered to have ESS and were submitted to a second patch test. RESULTS AND CONCLUSIONS: ESS developed in 39 of the 630 patients tested, corresponding to a frequency of 6.2%. Analysis of data found a longer duration of the primary dermatitis in patients who in whom ESS developed compared with those who did not. Parabens, fragrance mix, and thimerosal had more positive patch test reactions using standard application techniques relative to the retest procedure, which placed the substances at a greater distance from one another, suggesting that, in addition to the factors previously reported to influence the reduction of ESS, the position of the allergens in the testing procedure also should be considered.