Dermatologist Mamta Jhaveri describes contact dermatitis and the process of patch testing. Jhaveri discusses how patch testing impacts treatment options and how this diagnostic option had evolved in recent years.
Yeah. Contact dermatitis is a specific type of eczema which is due to a delay type for hypersensitivity. So the most common cause of this is poison ivy, but other common causes are nickel fragrances and other preservatives. Internet car care products. So it is diagnosed by patch testing. Which is a treatment or diagnostic option that we use here in the office where we do use hypoallergenic tape to tell Tape on the most common allergens in North America. That can be about 80-120 allergies. Um and this is placed on the back for 48 hours. The patient then returns to the office to how the patch is removed and then two days later they return for their delayed reading. This helps identify if there's any contact dermatitis that is leading to the flair of their. Excellent. No. Yeah. So packs testing is a process to help diagnose contact dermatitis. Um So what we would do is we would initially do a consultation with the patient to help go over the history and what products they are using on their skin commonly. We will then perform passed testing in the office and that is a week long process which includes having the patch is placed Returning to the Office two days later to have the patch is removed and then a delayed reading on day 5-6 where we would identify if there's any contact allergens. After that. We do help provide the patient with information to help avoid the contact allergies and other products as it is really hard to identify some of these long chemical names. Um and we do provide them with an app that helps them identify safe products. Yeah, some packs, testing helps us identify contact dermatitis and eczema. And so we often utilize that in patients who have new or worsening eczema or also eczema that isn't responding to our conventional eczema treatments. So passed testing helps us identify a contact allergen and by admitting that from the personal care products by the patient or exposures to it. Thanks Emma becomes a lot more controllable so I can give you an example from clinic. So we had a patient with new onset worsening island eczema. She did have a history of childhood eczema but this was new and worse for her. Um and we did patch testing. We identified a landfill in allergy and we did identify that she was using an eczema product that had landed on her eyelids every time her skin became dry on her eyelids which is propagating and making her eczema worse there. So by emitting lanolin from her Chair Products, we were able to better control our eczema. And she didn't require as many eczema treatments because her eczema is better controlled. So patch testing is ever evolving as we know, a lot of the cosmos articles in our industry are also ever evolving. So we do have to keep up with the new chemical ingredients that are placed into our products. Um And so one unique thing about johns Hopkins patch testing is we can do personalized patch testing to what patients are using um and we use the expanded series so that we can actually select which antigens were testing for on the day of service. Um and we can also test for personal care products. So one example of evolving things is there's more essential oils and natural ingredients being used in our products. So sometimes we do know those can lead to irritant contact allergens, as many of the plants and botanicals are actually the most common cause of contact dermatitis. Um And also we are able to keep up with the evolving trends. So for example, propylene glycol is being less commonly used as a preservative in our products and it's being replaced by formaldehyde formaldehyde release ear's metal Clara is a diocese alone and mental ISIS areas alone. And so that was leading to an increase in contact dermatitis. Um and so Pakistan was able to help identify that. And through that we were actually able to fight for those product concentrations to be lowered to decrease the incidence of contact dermatitis in some of our patients leave on and rinse off products. So in summary, were able to evolve with the products because we can personalize the patch testing to what's being used. Yeah.