Contact Dermatitis – Patch Testing Clinic
Allergic contact dermatitis is inflammation of the skin caused by substances, such as preservatives, fragrances, dyes and metals. We call these substances allergens. Even small amounts of allergens can result in itching, redness, soreness and cracked skin that sometimes bleeds, and small blisters. Most of the time, patients are not exposed to the pure allergen, but products which have the allergen as an ingredient. For example, the allergen may be an ingredient in soap, cream, shampoo, medication, clothing, or jewelry. Some patients react to allergens found in cleaning supplies, construction materials, rubber gloves or ink. The allergic contact dermatitis reaction usually occurs 1-7 days after exposure to the allergen, and often lasts for a few weeks. What appears to be a chronic rash may be allergic contact dermatitis that can be cured if the patient can avoid the allergens causing it. The key is to identify what allergens are causing the contact dermatitis, and our tool for this is patch testing.
What is allergic contact dermatitis?
What is patch testing?
Patch testing is the standard method to diagnose allergic contact dermatitis. The goal of the patch test is to help you identify what substances are causing your skin to rash and itch.
Who can provide patch testing services?
Many Dermatologists and Allergists perform basic patch testing services. However, most of them use what is called the TRUE Test, which tests only the most common allergens. There are a few specialists in Contact Dermatitis who have a full range of allergens, not just the most common ones. This is important since there may be several allergens causing your skin rash and a limited patch test may not find all of the allergens. At the Kuchnir Contact Dermatitis Clinic we offer a full range of allergens and select those that are relevant to each individual patient. Dr. Peter Schalock, who performs the patch testing in our clinic, has over 10 years of experience conducting patch testing. This expertise is highly beneficial when selecting allergens to test, interpreting the results and providing advice on products that are safe to use.
Where is the Kuchnir Contact Dermatitis Clinic located?
We perform patch testing services in our Framingham office, located at 125 Newbury St, Suite 400 in Framingham, MA.
How do I get an appointment at the Kuchnir Contact Dermatitis Clinic?
Call our office at (508) 872-2230 or email us at firstname.lastname@example.org to make an appointment for a patch test. We do not require a referral from another physician.
How long is the patch test?
A patch test consists of 3 appointments during one week. Each appointment will take 15-30 minutes.
How is the patch test performed?
In short, we tape about 120 different allergens (chemicals) onto your back and leave them there for 2 days to determine if and to what you are allergic. Yes, it may itch but the goal is to find out what allergens are causing the itch so you can avoid them in the future. In fact, itching during the test is a positive sign since it may indicate that we have found something that is causing your rash! During the patch test week your activities may be limited and you cannot shower as usual.
Visit 1 - As part of your evaluation in our Contact Dermatitis Clinic, you will be interviewed and a complete skin exam will be performed. Information that we collect in this interview/exam, together with the suspect agents you bring, will help us select the appropriate allergens for the test. Patch testing involves taping many small chambers filled with allergens onto your upper back using strips of hypoallergenic tape. You may experience some itching, but most people have little difficulty. There is an extremely rare possibility that the testing itself may make you allergic to a chemical. Please wear loose-fitting clothes.
Between visits - Benadryl (diphenhydramine) and all other antihistamines (Claritin, Zyrtec, Allegra, Hydroxyzine) are OK to take as necessary for itching. Please do not scratch the patch test area since it can irritate the skin.
Visit 2 - We will remove the tests during your second visit and mark each allergen on your back with a purple marker. Bring dark colored, washable, underclothes (for example - t-shirt and bra) to this visit! The marker used will partially rub off, though it should wash out.
Visit 3 - The final reading and discussion of the results will occur on your third visit. You will receive written information about each positive allergen and a list of products which are safe to use. We will also discuss any necessary changes in the management of your condition at that time.
Afterwards - In general, you will return to your referring provider for further care. Your referring physician will also get a report with the findings and recommendations.
What do I need to do to PREPARE for my patch test?
There are several things to remember to do and NOT do to prior to and during your visits.
Restrictions prior to testing
If you are currently being treated with phototherapy, please stop at least 2 weeks before your appointment. Please do not suntan "naturally" either.
It is important that you not be taking any cortisone derivative (Prednisone, Cyclosporine, Mycophenolate, Azathioprine) by mouth for 7 days prior to your visit with us. You should not have received a cortisone injection within 1 month prior to your visit. Medicines for psoriasis such as Humira or Enbrel are OK to continue.
Do not apply any creams or lotions including those containing cortisone to your back for 24 hours prior to your appointment.
Patch testing should not be performed if you are pregnant or breastfeeding.
Additional restrictions during testing
Do not apply anything to the test area until testing is completed
Please avoid exercising, swimming or strenuous work
Avoid heavy lifting or significant bending/stretching
NO SHOWER. Do not get your back wet IN ANY WAY during the entire testing time (96 hours). You may get the rest of your body wet as you desire – sponge bath, washing hair in the sink etc.
To do before first visit
If your insurance is a HMO you will need to get a referral from your PCP. If there is a copay with your insurance it will be expected at each appointment.
For your first visit, we would like you to bring any items of clothing, medication or cosmetics, that you believe may be causing your dermatitis. We would also like you to bring any creams or lotions, in their original containers, which you are applying to the area of skin that is broken out. These may be creams that your doctor has prescribed or creams that you have purchased over the counter to treat your dermatitis.
If you suspect any items with which you come into contact at work, please bring a Material Safety Data Sheet (M.S.D.S.) for each of the chemicals. These sheets should be available through your supervisor at work.
You will also need to fill out the Contact Dermatitis Evaluation Form and bring to your first appointment. This form is mailed to you once an appointment is made.
This information is also summarized in our checklist.
Where do I find more information?
This video provides information on patch testing.
If you have any further questions, please feel free to contact our office at (508) 872-2230 or (508) 872-2220. We look forward to caring for you here at Kuchnir Dermatology & Dermatologic Surgery.
Patches are taped to the back.
We put on about 100 different allergens.
During the second visit we remove the patches and mark the allergens.
Final reading and discussion of the results.