What’s needed in a Patch Test clinic?
- A table or a counter area for Patch Test preparation
- Refrigerator for Hapten (and Skin Marker) storage
- Non-refrigerated storage area for:
Patch Test Units Application Device(s) Reading Plate(s) Ethanol
Cotton swab(s)
Optionally: Hair trimmer (or single-use razors), Reinforcing tape, micropipette, UV- lamp and Chemo Nickel Test™ (for educational purposes).
A week of Patch Testing
Patch testing involves a number of scheduled patient appointments within a one-week time-frame.
After the test application on Day 0, two to three appointments are needed for patch test removal and for readings.
Day 0 (Monday) – Patch test application
Determine which haptens to test for based on a prior patient questionnaire and a same day patient investigation. Patients should always be screened with a standard Baseline series but additional specific Screening Series might be relevant depending on patient occupation and exposure.
Day 0 (Monday) – Patch test application
To facilitate patient interaction and to ensure maximum patient compliance, consider producing a leaflet (handout) outlining the patch test procedure to be handed out prior to the patch testing.
You are being Patch Tested to see if your eczema could be caused by an allergy to any chemicals to which you may be exposed. This will involve three visits to our clinic in one week.
Monday:
You will have a set of chemicals (haptens) placed on special adhesive tapes (Patch Tests) on your back. This may cause discomfort, but should not be painful. We ask that you do not wash your back and refrain from exercise until after your visit on Wednesday (unless given special permission and instructions by your physician). Your back will be drawn on by a special skin marker indicating the test site.
Wednesday
The Patch Tests will be removed.
Friday
The test site will be examined and the test result will be explained to you by your physician
Clothing
Please wear clothing that will not be ruined if discolored during the patch test process as dye haptens and skin markers may stain clothing.
Itching
Itching and irritation is to be expected during the test period. Remove the tests should they cause unbearable itching or burning. In such case: immediately notify your physician.
Avoid exercise, perspiration and showers
Showers and exercise that involves a lot of movement (or excessive perspiration) should be avoided to ensure that the tests stay in place.
Wear a T-shirt in bed
This will help prevent the Patch Test from peeling off in bed.
Should the tests begin to peel off – reinforce them with hypoallergenic tape.
Patient Information
Positive - ACD avoidance
Take home messages for patients with positive patch test results:
After having determined which hapten(s) is/are causing the eczema, avoidance is key for patient well-being. Consider directing patients diagnosed with Contact Allergy to the hapten database at www.chemotechnique.se website for detailed hapten information and (if you are a member of the ACDS) introduce patients to the CAMP iPhone app for hapten information and hapten free product lists.
Printer friendly Hapten Information sheets for each hapten can be extracted from the Chemotechnique website and handed out to patients.
Positive – ACD avoidance
For patients with a diagnosed clinically relevant Nickel or Cobalt Allergy:
Introduce patient to the Chemo Nickel Test™ and Chemo Cobalt Test™. By testing metal objects before use or purchase the patient can avoid exposure
Negative – ACD prevention
Take home messages for patients with negative patch test results: Has the patient disclosed all possible sources of exposure?
Remind all patients to be wary of their surroundings. Is there any source of exposure that they have forgot to mention (skin product, clothing etc)?
Consider additional patch testing should new information arise.
Remind patients that Contact Allergy can be prevented but not cured
Inform patients of the importance of protecting their skin when in contact with sensitizing haptens. Special attention should be given to patients working with at risk occupations (hair dressers, beauty practitioners, factory workers) with negative patch test results.
Patch Test Instructions
(step-by-step)
Patch Test Instructions
Break the perforation of a preferred corner by folding the corner downwards and upwards.
Grip the tape by the detached corner and pull back gently until all chambers are revealed.
Do not completely remove the tape from the rotective cover
How much is 25 μl?
25 μl equals approximately to a 5 mm string of petrolatum or a single drop of liquid.
Depress the clip and carefully detach the Patch Test Unit. Remove the Patch Test Unit from the Application Device.
Depress the clip and carefully detach the Patch Test Unit. Remove the Patch Test Unit from the Application Device
Preloading
Patch testing can be facilitated by preloading.
Non-volatile Patch Test Haptens may be preloaded onto IQ Ultra™ or
IQ Ultimate™ Patch Test Units and stored for up to two weeks before test application if stored refrigerated, with sealed covers, and kept in air tight bags.
Patch Test Instructions
Put haptens (and Patch Test Units if preloading) back in fridge
Patch Test Instruction
Position the Patch Test Unit by holding it by its protective cover facing upwards and apply the tape onto the patient. Press your palm on the tape for 5 seconds to enhance adhesion.
Detach the cover and remove the plastic corner.
Position the Patch Test Unit by holding it by its protective cover facing upwards and apply the tape onto the patient. Press your palm on the tape for 5 seconds to enhance adhesion.
Detach the cover and remove the plastic corner.
Patch Test site preparation
Wiping the test site with ethanol before application is important and will improve adhesion of the Patch Test Unit on patients with oily skin. For patients with very dry or oily skin, additional reinforcing tape might be required.
Consider trimming the hair on the test site before patch test application on hairy patients
Position the Patch Test Unit by holding it by its protective cover facing upwards and apply the tape onto the patient. Press your palm on the tape for 5 seconds to enhance adhesion.
Detach the cover and remove the plastic corner.
Patch Test placement
Use the upper part of the patients back if possible. Avoid applying Patch Test Units to the midline and the scapula. Do not put any Patch Test Units under a brassiere which can dislocate the test units.
IQ Ultimate™ only:
When all test units have been applied, remove the top-liners with a gentle diagonal motion
After 48 hours:
Remove the Patch Tests with a gentle diagonal motion to minimize patient discomfort
www.chemotechnique.se
- Patient information sheets for haptens in English, French, Spanish and Swedish
- Patch test record forms for all Chemotechnique Hapten Series
- Safety Data Sheets (SDS)
- Video instructions
Mobile platform adapted website
Chemotechnique
The trusted name in Patch Testing
Serving dermatology since 1981 Chemotechnique is proud to be recognized as the trusted name in Patch Testing.
Quick facts:
- Founded in 1981
- 23 employees
- Pharmaceutical company, working under GMP
- ISO 13485 & 9001 certification
- Global distribution in around 100 countries
- Focus on R&D
- Long term cooperation with international and domestic contact dermatitis research groups
- ICDRG
- EECDRG
- NACDG
- 36 years of continuous growth
