The detection of clinically relevant contact allergens with a standard screening tray of 28 allergens

摘要

Background. A standard method for diagnosing allergic contact dermatitis in the United States is the Thin-layer Rapid Use Epicutaneous (TRUE) test (TRUE Test?), which consists of three panels containing 20 individual allergens and eight allergen mixes. Previous studies had raised concern regarding the adequacy of the initial two-panel TRUE Test? system (16 individual allergens and seven allergen mixes) in fully assessing patients with possible allergic contact dermatitis. Objectives. We sought to investigate the effectiveness of the current three-panel TRUE Test? as the sole diagnostic tool for detecting allergic contact dermatitis. Patients/materials/methods. This study was a retrospective analysis of 2088 patients who underwent patch testing between 1995 and 2010. Study groups were analysed to determine whether positive reactions were to allergens and/or mixes present in the TRUE Test? panels. Results. Of the 2088 patch-tested patients, 1385 had at least one positive reaction. Among these 1385 patients, 27.6% were fully evaluated by use of only the TRUE Test? series, 49.9% were partially evaluated, and 22.5% did not have any of their allergens detected. On assessment for clinical relevance, similar percentages were observed. Conclusion. In our study, the current TRUE Test? series of 28 allergens would have completely identified allergens in only 27.6% of patients. Broadening the standard panel to include common allergens causing >50% of allergic contact dermatitis cases in a given geographical location and aim testing allergens on the basis of the patient's history will increase the test's sensitivity.