Allergy Patch Testing

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What is AllergEAZE?

AllergEAZE is a reliable, easy to use diagnostic test that we offer to our patients who have or are suspected of having chronic cutaneous contact dermatitis or skin allergies. We test for 70 of the most common skin allergens in North America with a state-of-the-art comprehensive panel. This extensive list of allergens has not been previously available outside of large institutions like the University of Oregon. Some of the allergens we test for are ones that people commonly encounter in their environment, such as Neomycin, nickel, and formaldehyde releasing agents. The extended panel also includes more than usual allergens including budesonide for diagnosing an allergy to topical steroids. Our service includes post-test counseling to educate you on products that contain the allergens that cause you problems and alternative products without them.

People who would benefit most from the testing are patients who are suspected of environmental exposure on their skin to contact allergens. These may include patients with atopic dermatitis that do not respond to standard treatments, undiagnosed chronic eczematous dermatitis, and environmental exposure to allergens. The patch testing is not helpful in the diagnosis of the inhaled allergens (hay fever) or food allergies that are commonly tested for using a prick test or a scratch test methods. These patients would be better served by an allergy doctor.

Here’s a list of the allergens we test for (and links to PDF files with further info on each):

• NA72 (2-hydroxyethyl)-methacrylate
• NA01 2,5-diazolidinyl urea (Germall® II)
• NA03 2-bromo-2-nitropropane-1,3-diol (Bronopol)
• NA85 2-hydroxy-4-methoxy-benzophenone
• NA05 2-mercaptobenzothiazole
• NA06 4-chloro-3,5-xylenol (PCMX)
• NA07 4-phenylenediamine base
• NA08 4-tert-butylphenol formaldehyde resin
• NA10 amidoamine (stearamidopropyl dimethylamine)
• NA11 bacitracin
• NA12 balsam of peru (myroxylon pereirae resin)
• NA13 benzocaine
• NA67 benzyl alcohol
• NA33 bisphenol A epoxy resin
• NA15 black rubber mix – IPPD [B]
• NA16 budesonide
• NA65 cananga odorata (ylang ylang)
• NA18 carba mix
• NA73 carvone
• NA19 cinnamic aldehyde
• NA20 clobetasol-17-propionate
• NA21 cobalt (II) chloride hexahydrate
• NA22 cocamidopropyl betaine
• NA23 coconut diethanolamide (cocamide DEA)
• NA24 colophony
• NA25 compositae mix
• NA74 decyl glucoside
• NA68 desoximetasone
• NA26 dibucaine (cinchocaine-HCl)
• NA75 dimethylaminopropylamine (DMAPA)
• NA27 dimethylol dihydroxyethyleneurea
• NA83 disperse blue mix (124/106)
• NA87 dl alpha tocopherol
• NA79 d-limonene
• NA31 DMDM hydantoin
• NA34 ethyl acrylate
• NA35 ethylenediamine dihydrochloride
• NA37 formaldehyde
• NA38 fragrance mix
• NA70 fragrance mix II
• NA39 glutaraldehyde
• NA40 glyceryl monothioglycolate
• NA69 hydrocortisone-17-butyrate
• NA43 imidazolidinyl urea (Germall® 115)
• NA44 iodopropynyl butylcarbamate
• NA76 jasminum officinale oil (jasminum grandiflorum)
• NA64 lanolin alcohol
• NA81 lavandula angustifolia oil (lavender oil)
• NA47 lidocaine-HCl
• NA77 majantol
• NA82 mentha piperita oil (peppermint oil)
• NA48 mercapto mix [A]
• NA49 methyl methacrylate
• NA09 methylchloroisothiazinolone / methyliisothiazinolone
• NA50 methyldibromo glutaronitrile/phenoxyethanol (MDBGN/PE)-Euxyl K 400
• NA88 mixed dialkyl thioureas
• NA51 neomycin sulphate
• NA52 nickel sulfate hexahydrate
• NA80 oleoamidopropyl dimethylamine
• NA53 paraben mix [B]
• NA54 potassium dichromate
• NA71 propolis
• NA55 propylene glycol
• NA56 quaternium 15
• NA57 sesquiterpenelactone mix (2ml)
• NA78 shellac
• NA58 tea tree oil, oxidized
• NA60 thiuram mix [A]
• NA61 tixocortol-21-pivalate
• NA62 tosylamide/formaldehyde resin

Is anyone eligible to have the patch testing?

No. Patients must have a contact dermatitis diagnosis.

Do I have to be seen in this office prior to the testing?

No. As long as you can provide documentation from another physician’s office that reflects a “contact dermatitis” diagnosis, you may schedule the patch testing with our office. The actual testing will be performed once a prior-authorization has been submitted and approved by your insurance company.

Does insurance cover the testing?

Most insurance companies require pre-approval for the testing to be covered. The only insurance company that does not require pre-approval is Medicare as long as the patient has been diagnosed with contact dermatitis and that is noted in their chart.

Can I have the patch testing even if I don’t have insurance?

Yes. Please contact our office for what the private pay cost of the patch testing panels and office visits run.

Is there anything else I need to do in preparation for the testing?

It is very important to stop taking any allergy medications (antihistamines) and steroids (topical and oral) for at least two weeks prior to the patches being applied and to not resume until the final evaluation is done a week later.

When do I come in for the patch testing?

The patches will be placed, usually on your back, on a Friday, left on for the entire weekend and removed on the following Monday, with two follow-up appointments on the Wednesday and Friday of that week. During these follow-up appointments, the skin will be examined for signs of redness and inflammation. These signs of reaction determine which of the chemicals you are allergic to.

There will be a total of five appointments needed for the patch testing:

1. Friday: Patches will be applied.
2. Monday: Patches will be removed and the first reading will take place.
3. Wednesday: The second reading will take place.
4. Friday: Last reading. After this appointment, you can go back to taking any of your usual allergy medications and steroids and you can go back to showering or bathing as usual.
5. We will then set up an appointment with your provider and Dr. Hopp to review all results.

What activities should I avoid while wearing the patches

During this week-long process, it is very important that your back doesn’t get wet. You will have to keep your back completely dry for the entire week-long process, even after the panels are removed since the panels are outlined and numbered with colored markers to identify the location of each allergen. Getting these markings wet will wash them away, and we would have to start the process all over again. So you cannot take any showers for one week. You can, however, take a sponge bath or take a very shallow bath during this time, as long as you make sure not to get your back wet. Likewise, you’ll need to avoid any strenuous activities that would either pull the panels off or make you perspire enough to loosen the tape or wash off the markings.

What should I do if my skin itches or burns while wearing the patch panels?

Itching and burning sensations are common side effects.Try not to scratch the patch test area. Scratching can irritate your skin and may make the itching worse. It also can affect your doctor’s ability to interpret your skin’s reaction. If the itching or burning becomes severe, you should contact us during office hours at 509-735-1100 and ask for Carrie Tilley or Tonya Brucell.

What are you looking for?

At each skin reading, the test area will be carefully examined for signs of allergic reaction. It may look like a small skin rash with swelling, redness, and tiny blisters.

IT IS VERY IMPORTANT TO KEEP ALL APPOINTMENTS.

Your skin needs to be checked for signs of allergic reaction in the test area at specific intervals after the test.

When will the test results be known?

Some reactions to the substances in AllergEAZE appear within a few days, while others can take as long as a week to appear, this is why we require 3 follow-up evaluation appointments. Your doctor will discuss your results with you during your last appointment.

If I am allergic to a substance in AllergEAZE, what should I do?

If you test positive, your doctor will explain which substance you are allergic to and talk to you about how to avoid contact. Your medical provider will provide information about:

• Where the substance can be found at work and at home.
• Which products are likely to contain this substance.
• Steps you can take to avoid this substance, and
• Alternative products you can use that don’t contain this substance.

What does a negative result mean?

Negative results are very common. If you test negative, you will not have to avoid products that contain the allergens. Some patients need additional tests to determine if they are allergic to less common allergens.

Customize the test

You can also bring in items from home to be tested, i.e. moisturizers, topical medications, hairspray, makeup, ect., as long as they are safe to put on the skin to test. These can be used in addition to the standard tray of antigens.

Other resources

Here are some websites we’ve found useful in researching different contact dermatitis allergens:

• New Zealand Dermatological Society has a large list of allergens, along with info about each.
• The Contact Allergen Database also has a large list of allergens, along with info about each.
• chemicalland21.com although this site is primarily for people looking to purchase chemicals, it also has extensive info on many of the chemicals that are contact dermatitis allergens.
• wikipedia.org the amount of information that can be found on each allergen varies, and is sometimes absent completely, but is often surprisingly comprehensive.
• Household Products Database This government database links over 8,000 consumer brands to health effects from Material Safety Data Sheets (MSDS) provided by manufacturers and allows scientists and consumers to research products based on chemical ingredients.
• Environmental Working Group’s Skin Deep Cosmetic Safety Database This product safety database currently has 42,846 products with 8,376 ingredients. If you want to find out what’s in a particular product and if it’s toxic or not, this is a good resource.