Publication date: Available online 11 January 2019
Source: Journal of the American Academy of Dermatology
Author(s): Erin M. Warshaw, Amy J. Zhang, Donald V. Belsito, Joseph F. Fowler, James S. Taylor, Howard I. Maibach, Toby Mathias, Denis Sasseville, James G. Marks, Vincent A. DeLeo, Anthony F. Fransway, Kathryn A. Zug, Melanie D. Pratt, Matthew J. Zirwas, Joel G. DeKoven
Abstract
Background
Little is known regarding characteristics of patients with negative patch tests (NPTs).
Objective
To characterize patients with NPTs.
Methods
Retrospective cross-sectional analysis of 34,822 patch tested patients. NPTs were defined as negative or irritant final interpretations of all North American Contact Dermatitis Group (NACDG) screening allergens and no relevant allergens on supplemental series.
Results
Almost one-third (n=10,888, 31.3%) of patients had negative results. NPT patients were significantly more likely to be male (p<0.0001), aged ≤40 years (p=0.0054), non-Caucasian (p=0.0005), and have dermatitis primarily involving the following body sites: scattered generalized (p=0.0007), lips (p=0.0214), or eyelids (p=0.0364). However, absolute differences in age, race, and site were small and may not be clinically meaningful. NPT patients were significantly less likely to have occupationally related skin disease (p<0.0001). Overall, 8.3% of NPT patients had occupationally related skin disease with precision production workers/machine operators (28.5%), healthcare workers (17.0%), and mechanics/repairers (7.5%) being the most commonly related occupations. 22.9% of NPT patients had relevant irritants and 41.6% of irritants were occupationally related; cosmetics/health care products and soaps were common sources for both occupationally related and non-occupationally related irritants.
Limitations
Retrospective cross-sectional study of tertiary referral population.
Conclusions
Patients with NPTs have distinct characteristics.
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