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Contact Dermatitis

Get to the Bottom of Your Skin Allergy

Treatment for Contact Dermatitis in Pittsburgh

If you have moderate to severe eczema or atopic dermatitis that developed as an adult, or an itchy rash localized to the hands, face, or eyelids, you may benefit from patch testing. Allegheny Health Network offers expanded patch testing in the evaluation of allergic contact dermatitis at Allegheny General Hospital in Pittsburgh.

What is allergic contact dermatitis?

Allergic contact dermatitis is a form of eczematous (eczema-like) dermatitis. It is the result of chronic exposure and stimulation of the body’s immune system to foreign substances over time. These substances are often chemicals and compounds found in everyday items in our environment and household products. Nickel allergy is an example of allergic contact dermatitis and is the most common contact allergen in humans.

Patients often try to discover which new products or agents may be causing their potentially allergic rash, but it is actually compounds or ingredients in products they have used for many years that are often the culprit. Formaldehydes that keep our clothing wrinkle free, preservative compounds in our lotions and cosmetics, and topical medicines including antibiotics are some of the most common contact allergens. These are also extremely prevalent in our modern day environment, increasing the possibility that a growing number of individuals will become allergic at some point in their lives.

How is allergic contact dermatitis diagnosed?

  • You first will meet with our dermatologist to undergo a complete history and physical to determine if your condition is concerning for allergic contact dermatitis and warrants patch testing.
  • If your condition is consistent with or concerning for contact allergy our practice will arrange patch testing to further evaluate any potential allergic component.

 

How is patch testing performed?

  • You will be scheduled for 3 appointments within a single week on a Monday, Wednesday, and Friday.
  • On Monday’s appointment you will have 3-8 paper panels applied to your back which will stay attached in place via hypoallergenic adhesive for 48 hours until your Wednesday appointment.
  • You will be prohibited from showering, bathing, significant sweating (from physical activity such as fitness training, etc) for the 48 hours while the panels are in place to prevent detachment of the panels and dilution or contamination of the allergens.
  • On Wednesday’s appointment the panels will be removed after which you will be able to shower, bathe, and exercise. The areas where the panels were attached will be remarked for later identification.
  • On Friday’s appointment the various allergen chambers within the panels will be inspected and your potential allergies determined by our staff. We will go over potential sources of contact with any allergens revealed by your testing and provide educational material to help you avoid future contact with them.
  • You will need to avoid any oral steroids for a minimum 2 weeks and intramuscular steroids for 4 weeks prior to your Monday patch application appointment. You will also need to avoid oral antihistamines such as Benadryl, Claritin, Zyrtec, Allegra for 3 days prior and during your patch testing. You will need to avoid topical steroids on your back for 1 week prior to testing, but you will be allowed to use them on other areas of your body as needed.

 

I have already had allergy testing by a dermatologist or an allergist. Why would I need expanded patch testing?

For patch testing most dermatologists and allergists utilize a commercially available patch testing kit product that is easy to apply and read, but only tests for 35 common allergens. While this product is easy to use it lacks many potential allergens that have been discovered over the last several years during our advancement in understanding contact dermatitis. Also, many leaders in contact dermatitis feel the concentrations used in this product are not adequate and may actually miss relevant allergies in some patients. Blood testing and a “prick” allergy testing that is done by allergists do not adequately assess for contact dermatitis of the skin. These methods are more appropriate for assessing inhaled and ingested allergies such as mold, dander, pollen, and food allergies.