Background and Design: The nickel Accupatch (Dermx, Inc., Bethlehem, PA) is a patented ready-to-use patch testing device in which the antigen nickel sulfate is incorporated into the adhesive. In this investigation the performance of the Accupatch was compared with the Finn Chamber (Epitest Ltd., Oy, Hyryla, Finland) technique in detecting delayed-type hypersensitivity to nickel. In addition, the ability of subjects to interpret their own patch test reactions was studied. Women with a history of jewelry sensitivity were patch tested in a random, double-blinded, placebo-controlled procedure. Results: Ten subjects (31%) had positive reactions to both nickel-containing patches, whereas 10 subjects (31%) had negative reactions to both. The concordance between the two nickel patches was 75%. The comparison of Accupatch and Finn Chamber placebos showed 100% concordance with all negative reactions. The subjects' ability to correctly read patch test sites was good. When compared with the physician's reading of the nickel sites, concordance was 84% at the nickel Accupatch test site and 88% at the nickel Finn Chamber test site. Conclusion: We conclude the following: (1) Accupatch compares favorably with Finn Chamber in detecting sensitivity to nickel, (2) sensitivity to nickel cannot reliably be predicted by history alone, and (3) subjects can read their own patch test reactions.
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