Abstract
ABSTRACT: Allergic contact dermatitis has been increasing in prevalence with the growing complexity of the ingredients in commercial products. The gold standard for the diagnosis of allergic contact dermatitis is patch testing. Patch testing allows for identification of relevant allergens that can then guide treatment with targeted avoidance. Although patch testing initially required clinicians to handpick suspected allergens, the development of a standard allergen panel in 1995 called the Thin-Layer Rapid Epicutaneous Test transformed the way patch testing is performed. In recent years, more comprehensive series have been developed, including the American Contact Dermatitis Society (ACDS) Core Allergen Series, which tests for 80 allergens rather than 36 allergens. The benefits of using the ACDS Series include (a) a greater likelihood of detecting relevant allergen(s), (b) a decreased need for repeat testing and subsequently fewer clinic appointments and less patient travel, and (c) an ability to update and modify the series of allergens based on consumer trends and patient data. Important/relevant allergens found in the ACDS Series but not the Thin-Layer Rapid Epicutaneous Test include many preservatives, adhesives, fragrances, and propylene glycol. We propose that patch testing with extended series of allergens be considered for first-line use when evaluating patients with suspected allergic contact dermatitis.