Patients with negative patch tests

Retrospective analysis of North American Contact Dermatitis Group (NACDG) data 2001-2016

Erin M. Warshaw, Amy J. Zhang, Donald V. Belsito, Joseph F. Fowler, James S. Taylor, Howard I. Maibach, Toby Mathias, Denis Sasseville, James Marks, Vincent A. DeLeo, Anthony F. Fransway, Kathryn A. Zug, Melanie D. Pratt, Matthew J. Zirwas, Joel G. DeKoven

Research output: Contribution to journalArticle

Abstract

Background: Little is known regarding the characteristics of patients with negative patch test (NPT) results. Objective: To characterize patients with NPT results. Methods: Retrospective cross-sectional analysis of 34,822 patch tested patients. NPT results were defined as negative or irritant final interpretations of all North American Contact Dermatitis Group screening allergens and no relevant allergens on supplemental series. Results: Almost one-third of patients (n = 10,888 [31.3%]) had NPT results. Patients with NPT results were significantly more likely to be male (P < .0001), be age 40 years or younger (P = .0054), be nonwhite (P = .0005), and have dermatitis primarily having a scattered generalized distribution (P = .0007) or primarily located on the lips (P = .0214) or eyelids (P = .0364). However, the absolute differences in age, race, and site were small and may not be clinically meaningful. Patients with NPT results were significantly less likely to have occupationally related skin disease (P < .0001). Overall, 8.3% of patients with NPT results had occupationally related skin disease, with precision production worker/machine operator (28.5%), health care worker (17.0%), and mechanic/repairer (7.5%) being the most commonly related occupations. In all, 22.9% of patients with NPT results had relevant irritants and 41.6% of irritants were occupationally related; cosmetics/health care products and soaps were common sources for both occupationally related and non–occupationally related irritants. Limitations: Retrospective cross-sectional study of tertiary referral population. Conclusions: Patients with NPT results have distinct characteristics.

Original languageEnglish (US)
Pages (from-to)1618-1629
Number of pages12
JournalJournal of the American Academy of Dermatology
Volume80
Issue number6
DOIs
StatePublished - Jun 1 2019

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Patch Tests
Contact Dermatitis
Irritants
Skin Diseases
Allergens
Cross-Sectional Studies
Delivery of Health Care
Soaps
Dermatitis
Eyelids
Lip
Occupations
Cosmetics
Referral and Consultation

All Science Journal Classification (ASJC) codes

  • Dermatology

Cite this

Warshaw, Erin M. ; Zhang, Amy J. ; Belsito, Donald V. ; Fowler, Joseph F. ; Taylor, James S. ; Maibach, Howard I. ; Mathias, Toby ; Sasseville, Denis ; Marks, James ; DeLeo, Vincent A. ; Fransway, Anthony F. ; Zug, Kathryn A. ; Pratt, Melanie D. ; Zirwas, Matthew J. ; DeKoven, Joel G. / Patients with negative patch tests : Retrospective analysis of North American Contact Dermatitis Group (NACDG) data 2001-2016. In: Journal of the American Academy of Dermatology. 2019 ; Vol. 80, No. 6. pp. 1618-1629.
@article{156b86b9a1b5432ea11ab50d7a5fd4d1,
title = "Patients with negative patch tests: Retrospective analysis of North American Contact Dermatitis Group (NACDG) data 2001-2016",
abstract = "Background: Little is known regarding the characteristics of patients with negative patch test (NPT) results. Objective: To characterize patients with NPT results. Methods: Retrospective cross-sectional analysis of 34,822 patch tested patients. NPT results were defined as negative or irritant final interpretations of all North American Contact Dermatitis Group screening allergens and no relevant allergens on supplemental series. Results: Almost one-third of patients (n = 10,888 [31.3{\%}]) had NPT results. Patients with NPT results were significantly more likely to be male (P < .0001), be age 40 years or younger (P = .0054), be nonwhite (P = .0005), and have dermatitis primarily having a scattered generalized distribution (P = .0007) or primarily located on the lips (P = .0214) or eyelids (P = .0364). However, the absolute differences in age, race, and site were small and may not be clinically meaningful. Patients with NPT results were significantly less likely to have occupationally related skin disease (P < .0001). Overall, 8.3{\%} of patients with NPT results had occupationally related skin disease, with precision production worker/machine operator (28.5{\%}), health care worker (17.0{\%}), and mechanic/repairer (7.5{\%}) being the most commonly related occupations. In all, 22.9{\%} of patients with NPT results had relevant irritants and 41.6{\%} of irritants were occupationally related; cosmetics/health care products and soaps were common sources for both occupationally related and non–occupationally related irritants. Limitations: Retrospective cross-sectional study of tertiary referral population. Conclusions: Patients with NPT results have distinct characteristics.",
author = "Warshaw, {Erin M.} and Zhang, {Amy J.} and Belsito, {Donald V.} and Fowler, {Joseph F.} and Taylor, {James S.} and Maibach, {Howard I.} and Toby Mathias and Denis Sasseville and James Marks and DeLeo, {Vincent A.} and Fransway, {Anthony F.} and Zug, {Kathryn A.} and Pratt, {Melanie D.} and Zirwas, {Matthew J.} and DeKoven, {Joel G.}",
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Warshaw, EM, Zhang, AJ, Belsito, DV, Fowler, JF, Taylor, JS, Maibach, HI, Mathias, T, Sasseville, D, Marks, J, DeLeo, VA, Fransway, AF, Zug, KA, Pratt, MD, Zirwas, MJ & DeKoven, JG 2019, 'Patients with negative patch tests: Retrospective analysis of North American Contact Dermatitis Group (NACDG) data 2001-2016', Journal of the American Academy of Dermatology, vol. 80, no. 6, pp. 1618-1629. https://doi.org/10.1016/j.jaad.2018.12.062

Patients with negative patch tests : Retrospective analysis of North American Contact Dermatitis Group (NACDG) data 2001-2016. / Warshaw, Erin M.; Zhang, Amy J.; Belsito, Donald V.; Fowler, Joseph F.; Taylor, James S.; Maibach, Howard I.; Mathias, Toby; Sasseville, Denis; Marks, James; DeLeo, Vincent A.; Fransway, Anthony F.; Zug, Kathryn A.; Pratt, Melanie D.; Zirwas, Matthew J.; DeKoven, Joel G.

In: Journal of the American Academy of Dermatology, Vol. 80, No. 6, 01.06.2019, p. 1618-1629.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Patients with negative patch tests

T2 - Retrospective analysis of North American Contact Dermatitis Group (NACDG) data 2001-2016

AU - Warshaw, Erin M.

AU - Zhang, Amy J.

AU - Belsito, Donald V.

AU - Fowler, Joseph F.

AU - Taylor, James S.

AU - Maibach, Howard I.

AU - Mathias, Toby

AU - Sasseville, Denis

AU - Marks, James

AU - DeLeo, Vincent A.

AU - Fransway, Anthony F.

AU - Zug, Kathryn A.

AU - Pratt, Melanie D.

AU - Zirwas, Matthew J.

AU - DeKoven, Joel G.

PY - 2019/6/1

Y1 - 2019/6/1

N2 - Background: Little is known regarding the characteristics of patients with negative patch test (NPT) results. Objective: To characterize patients with NPT results. Methods: Retrospective cross-sectional analysis of 34,822 patch tested patients. NPT results were defined as negative or irritant final interpretations of all North American Contact Dermatitis Group screening allergens and no relevant allergens on supplemental series. Results: Almost one-third of patients (n = 10,888 [31.3%]) had NPT results. Patients with NPT results were significantly more likely to be male (P < .0001), be age 40 years or younger (P = .0054), be nonwhite (P = .0005), and have dermatitis primarily having a scattered generalized distribution (P = .0007) or primarily located on the lips (P = .0214) or eyelids (P = .0364). However, the absolute differences in age, race, and site were small and may not be clinically meaningful. Patients with NPT results were significantly less likely to have occupationally related skin disease (P < .0001). Overall, 8.3% of patients with NPT results had occupationally related skin disease, with precision production worker/machine operator (28.5%), health care worker (17.0%), and mechanic/repairer (7.5%) being the most commonly related occupations. In all, 22.9% of patients with NPT results had relevant irritants and 41.6% of irritants were occupationally related; cosmetics/health care products and soaps were common sources for both occupationally related and non–occupationally related irritants. Limitations: Retrospective cross-sectional study of tertiary referral population. Conclusions: Patients with NPT results have distinct characteristics.

AB - Background: Little is known regarding the characteristics of patients with negative patch test (NPT) results. Objective: To characterize patients with NPT results. Methods: Retrospective cross-sectional analysis of 34,822 patch tested patients. NPT results were defined as negative or irritant final interpretations of all North American Contact Dermatitis Group screening allergens and no relevant allergens on supplemental series. Results: Almost one-third of patients (n = 10,888 [31.3%]) had NPT results. Patients with NPT results were significantly more likely to be male (P < .0001), be age 40 years or younger (P = .0054), be nonwhite (P = .0005), and have dermatitis primarily having a scattered generalized distribution (P = .0007) or primarily located on the lips (P = .0214) or eyelids (P = .0364). However, the absolute differences in age, race, and site were small and may not be clinically meaningful. Patients with NPT results were significantly less likely to have occupationally related skin disease (P < .0001). Overall, 8.3% of patients with NPT results had occupationally related skin disease, with precision production worker/machine operator (28.5%), health care worker (17.0%), and mechanic/repairer (7.5%) being the most commonly related occupations. In all, 22.9% of patients with NPT results had relevant irritants and 41.6% of irritants were occupationally related; cosmetics/health care products and soaps were common sources for both occupationally related and non–occupationally related irritants. Limitations: Retrospective cross-sectional study of tertiary referral population. Conclusions: Patients with NPT results have distinct characteristics.

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DO - 10.1016/j.jaad.2018.12.062

M3 - Article

VL - 80

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JO - Journal of the American Academy of Dermatology

JF - Journal of the American Academy of Dermatology

SN - 0190-9622

IS - 6

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