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Thermography: High sensitivity and specificity diagnosing contact dermatitis in patch testing


Anzengruber, Florian; Alotaibi, Fayez; Kaufmann, Lilian S; Ghosh, Adhideb; Oswald, Martin R; Maul, Julia-Tatjana; Meier, Barbara; French, Lars E; Bonmarin, Mathias; Navarini, Alexander A (2019). Thermography: High sensitivity and specificity diagnosing contact dermatitis in patch testing. Allergology International, 68(2):254-258.

Abstract

Background Patch testing of contact allergens to diagnose allergic contact dermatitis (ACD) is a traditional, useful tool. The most important decision is the distinction between allergic and irritant reactions, as this has direct implications on diagnosis and management. Our objective was to evaluate a new method of non-contact infrared reading of patch tests. Secondary objectives included a possible correlation between the intensity of the patch test reaction and temperature change. Methods 420 positive reactions from patients were included in our study. An independent patch test reader assessed the positive reactions and classified them as allergic (of intensity + to +++) or irritant (IR). At the same time, a forward-looking infrared (FLIR) camera attachment for an iPhone was used to acquire infrared thermal images of the patch tests, and images were analyzed using the FLIR ONE app. Results Allergic patch test reactions were characterized by temperature increases of 0.72 ± 0.67 °C compared to surrounding skin. Irritant reactions only resulted in 0.17 ± 0.31 °C temperature increase. The mean temperature difference between the two groups was highly significant (p < 0.0001) and therefore was used to predict the type of contact dermatitis. Conclusions Thermography is a reliable and effective way to distinguish between allergic and irritant contact dermatitis. Keywords Allergic contact dermatitis Contact allergy Infrared Irritant contact dermatitis Patch testing

Abstract

Background Patch testing of contact allergens to diagnose allergic contact dermatitis (ACD) is a traditional, useful tool. The most important decision is the distinction between allergic and irritant reactions, as this has direct implications on diagnosis and management. Our objective was to evaluate a new method of non-contact infrared reading of patch tests. Secondary objectives included a possible correlation between the intensity of the patch test reaction and temperature change. Methods 420 positive reactions from patients were included in our study. An independent patch test reader assessed the positive reactions and classified them as allergic (of intensity + to +++) or irritant (IR). At the same time, a forward-looking infrared (FLIR) camera attachment for an iPhone was used to acquire infrared thermal images of the patch tests, and images were analyzed using the FLIR ONE app. Results Allergic patch test reactions were characterized by temperature increases of 0.72 ± 0.67 °C compared to surrounding skin. Irritant reactions only resulted in 0.17 ± 0.31 °C temperature increase. The mean temperature difference between the two groups was highly significant (p < 0.0001) and therefore was used to predict the type of contact dermatitis. Conclusions Thermography is a reliable and effective way to distinguish between allergic and irritant contact dermatitis. Keywords Allergic contact dermatitis Contact allergy Infrared Irritant contact dermatitis Patch testing

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Dermatology Clinic
Dewey Decimal Classification:610 Medicine & health
Uncontrolled Keywords:Immunology and Allergy, General Medicine
Language:English
Date:1 April 2019
Deposited On:12 Feb 2019 14:44
Last Modified:29 Mar 2019 02:04
Publisher:Japanese Society of Allergology
ISSN:1323-8930
OA Status:Gold
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1016/j.alit.2018.12.001
PubMed ID:30598404

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