A 30-year Patch Testing Experience at Siriraj Dermatology

Silada  Kanokrungsee; Pichanee  Chaweekulrat; Chayada  Chaiyabutr; Suthasanee  Prasertsook; Chudapa  Sereeaphinan; Monthathip  Bunyavaree; Titinun  Kumpangsin; Janista  Thumrongtharadol; Waranya   Boonchai

doi:10.33192/smj.v75i2.260755

Authors

Silada Kanokrungsee Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok
Pichanee Chaweekulrat Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok
Chayada Chaiyabutr Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok
Suthasanee Prasertsook Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok
Chudapa Sereeaphinan Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok
Monthathip Bunyavaree Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok
Titinun Kumpangsin Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok
Janista Thumrongtharadol Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok
Waranya Boonchai Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok

DOI:

https://doi.org/10.33192/smj.v75i2.260755

Keywords:

Patch test, contact dermatitis, Siriraj, contact allergens, skin allergy, Thailand

Abstract

Objective: To identify trends of contact allergy and patch testing amendments at the Contact Dermatitis Clinic, Department of Dermatology, Siriraj Hospital.

Materials and Methods: Medical records of 6,862 patients referred to our clinic between January 1992 and December 2021for patch testing were reviewed.

Results: The number of patients patch tested increased and reached a peak of 600 patients/year in 2019 before the COVID-19 pandemic. The most frequently used series was baseline, while the most used specific series was cosmetics. The overall positivity rate was 69%. The highest positivity rate was in the cosmetics series (70.2%). Nickel sulfate was the most common contact allergen found (24.2%).

Conclusion: Our patch test service has been growing in the last 30 years. The series of allergens used for patch testing has been amended every few years to be up-to-date with current global trends of contact allergies. Continual surveillance of contact prevalence and periodic updating of those series are necessary to enhance our ability to detect culprit contact allergens, which could help us improve care of our patients.

References

Nelson JL, Mowad CM. Allergic Contact Dermatitis: Patch Testing Beyond the TRUE Test. J Clin Aesthet Dermatol. 2010;3(10):36-41.

Davis MD, Scalf LA, Yiannias JA, Cheng JF, El-Azhary RA, Rohlinger AL, et al. Changing trends and allergens in the patch test standard series: a mayo clinic 5-year retrospective review, January 1, 2001, through December 31, 2005. Arch Dermatol. 2008;144(1):67-72.

Zug KA, Warshaw EM, Fowler JF, Jr., Maibach HI, Belsito DL, Pratt MD, et al. Patch-test results of the North American Contact Dermatitis Group 2005-2006. Dermatitis. 2009;20(3):149-60.

Lachapelle JM. Patch testing: historical aspects. Ann Dermatol Venereol. 2009;136(8-9):575-7.

Boonchai W, Maneeprasopchoke P, Suiwongsa B, Kasemsarn P. Assessment of nickel and cobalt release from jewelry from a non-nickel directive country. Dermatitis. 2015;26(1):44-8.

Bunyavaree M, Limphoka P, Kumpangsin T, Boonchai W. Contact Allergen Avoidance Program (CAAP). Thai Journal of Dermatology. 2018;34(3):183-91.

Boonchai W, Kasemsarn P. Suitability of patch test allergens for standard series in Thai patients: ten-year retrospective review of patch test results. J Dermatol. 2013;40(1):65-7.

Pongpairoj K, Ale I, Andersen KE, Bruze M, Diepgen TL, Elsner PU, et al. Proposed ICDRG Classification of the Clinical Presentation of Contact Allergy. Dermatitis®. 2016;27(5):248-58.

Boonchai W, Iamtharachai P. Risk factors for common contact allergens and patch test results using a modified European baseline series in patients tested during between 2000 and 2009 at Siriraj Hospital. Asian Pac J Allergy Immunol. 2014;32(1):60-5.

Gisondi P, Piaserico S, Conti A, Naldi L. Dermatologists and SARS-CoV-2: the impact of the pandemic on daily practice. J Eur Acad Dermatol Venereol. 2020;34(6):1196-201.

DeKoven JG, Silverberg JI, Warshaw EM, Atwater AR, Reeder MJ, Sasseville D, et al. North American Contact Dermatitis Group Patch Test Results: 2017-2018. Dermatitis. 2021;32(2):111-23.

Wentworth AB, Yiannias JA, Keeling JH, Hall MR, Camilleri MJ, Drage LA, et al. Trends in patch-test results and allergen changes in the standard series: a Mayo Clinic 5-year retrospective review (January 1, 2006, to December 31, 2010). J Am Acad Dermatol. 2014;70(2):269-75.e4.

El-Rab M, Al-Sheikh O. Is the European standard series suitable for patch testing in Riyadh, Saudi Arabia? Contact Dermatitis. 1995;33(5):310-4.

Boyvat A, Kalay-Yildizhan I. Patch test results of the European baseline series among 1309 patients in Turkey between 2013 and 2019. Contact Dermatitis. 2021;84(1):15-23.

Keragala BSDP, Herath HMMTB, Keragala TS, Malavi MAMH, Rodrigo C, Gunasekera CN. A seven-year retrospective analysis of patch test data in a cohort of patients with contact dermatitis in Sri Lanka. BMC Dermatol. 2019;19(1):10.

Bilcha KD, Ayele A, Shibeshi D, Lovell C. Patch testing and contact allergens in Ethiopia--results of 514 contact dermatitis patients using the European baseline series. Contact Dermatitis. 2010;63(3):140-5.

Schnuch A, Geier J, Uter W, Frosch PJ, Lehmacher W, Aberer W, et al. National rates and regional differences in sensitization to allergens of the standard series. Population-adjusted frequencies of sensitization (PAFS) in 40,000 patients from a multicenter study (IVDK). Contact Dermatitis. 1997;37(5):200-9.

Sukakul T, Pruksaeakanan C, Bunyavaree M, Boonchai W. Contact allergens in natural cosmetics-A market survey. J Cosmet Dermatol. 2021.

Warshaw EM, Buonomo M, DeKoven JG, Pratt MD, Reeder MJ, Silverberg JI, et al. Importance of Supplemental Patch Testing Beyond a Screening Series for Patients With Dermatitis: The North American Contact Dermatitis Group Experience. JAMA Dermatol. 2021;157(12):1456-65.

Boonchai W, Iamtharachai P, Sunthonpalin P. Prevalence of allergic contact dermatitis in Thailand. Dermatitis. 2008;19(3):142-5.

Sukakul T, Chaweekulrat P, Limphoka P, Boonchai W. Changing trends of contact allergens in Thailand: A 12-year retrospective study. Contact Dermatitis. 2019;81(2):124-9.

Beliauskiene A, Valiukeviciene S, Uter W, Schnuch A. The European baseline series in Lithuania: results of patch testing in consecutive adult patients. J Eur Acad Dermatol Venereol. 2011;25(1):59-63.

Uter W, Bauer A, Belloni Fortina A, Bircher AJ, Brans R, Buhl T, et al. Patch test results with the European baseline series and additions thereof in the ESSCA network, 2015-2018. Contact Dermatitis. 2021;84(2):109-20.

Ahlström MG, Thyssen JP, Menné T, Johansen JD. Prevalence of nickel allergy in Europe following the EU Nickel Directive - a review. Contact Dermatitis. 2017;77(4):193-200.

Sukakul T, Bruze M, Mowitz M, Antelmi A, Bergendorff O, Björk J, et al. Contact allergy to oxidized linalool and oxidized limonene: Patch testing in consecutive patients with dermatitis. Contact Dermatitis. 2022;86(1):15-24.

Nath NS, Liu B, Green C, Atwater AR. Contact Allergy to Hydroperoxides of Linalool and D-Limonene in a US Population. Dermatitis. 2017;28(5):313-6.

Bråred Christensson J, Andersen KE, Bruze M, Johansen JD, Garcia-Bravo B, Giménez-Arnau A, et al. An international multicentre study on the allergenic activity of air-oxidized R-limonene. Contact Dermatitis. 2013;68(4):214-23.

Madsen JT, Andersen KE. Further evidence of the methylisothiazolinone epidemic. Contact Dermatitis. 2014;70(4):246-7.

Mahler V, Geier J, Schnuch A. Current trends in patch testing - new data from the German Contact Dermatitis Research Group (DKG) and the Information Network of Departments of Dermatology (IVDK). J Dtsch Dermatol Ges. 2014;12(7):583-92.

Uter W, Aalto-Korte K, Agner T, Andersen KE, Bircher AJ, Brans R, et al. The epidemic of methylisothiazolinone contact allergy in Europe: follow-up on changing exposures. J Eur Acad Dermatol Venereol. 2020;34(2):333-9.

The European Union Commission. Commission Regulation (EU) No 1003/2014 of 18 September 2014 amending Annex V to Regulation (EC) No 1223/2009 of the European Parliament and of the Council on cosmetic products. 2014 [Available from: https://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:32014R1003&from=FR.

The European Union Commission. Commission Regulation (EU) 2016/1198 of 22 July 2016 amending Annex V to Regulation (EC) No 1223/2009 of the European Parliament and of the Council on cosmetic products. 2016 [Available from: https://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:32016R1198&from=FR.

The European Union Commission. Commission Regulation (EU) 2017/1224 of 6 July 2017 amending Annex V to Regulation (EC) No 1223/2009 of the European Parliament and of the Council on cosmetic products. 2017 [Available from: https://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:32017R1224&from=EN.

Sukakul T, Limphoka P, Boonchai W. Methylchloroisothiazolinone and/or Methylisothiazolinone Contact Allergies in Thailand. Dermatitis. 2021;32(6):375-80.

Sukakul T, Kanchanapenkul D, Bunyavaree M, Limphoka P, Kumpangsin T, Boonchai W. Methylchloroisothiazolinone and/or methylisothiazolinone in cosmetic products-A market survey. Contact Dermatitis. 2019;80(2):110-3.