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PATCH TESTING

WHAT IS PATCH TESTING?

Patch testing is a relatively painless skin test performed in our office. The goal of the test is to elucidate the allergen or inciting substance(s) which may be provoking your rash. 65 different substances are placed on the back as detailed below. We carry the North American Contact Dermatitis Series 65. A list of the allergens can be here.

WHAT IS ALLERGIC CONTACT DERMATITIS?

Allergic contact dermatitis is a condition in which you develop areas of inflammation on your skin as a result of your immune system fighting a substance (allergen) which came in contact with your skin. While these allergens do not commonly cause rashes in most people, others will manifest persistent eyelid, neck or hand rashes as a result of repeated contact. Common symptoms may include: scaly itchy rash, hives or blisters.

The only way to successfully treat allergic contact dermatitis is avoidance of the specific allergen. A patch test may help in identifying these agents you need to avoid in order to reduce your symptoms. Prescription medications and lifestyle changes may help reduce the severity of the symptoms.

IS PATCH TESTING PAINFUL?

Patch testing is a simple and painless process. It does not require the use of any needles or injections. A positive reaction may result in itching and mild irritation.

HOW LONG DOES A PATCH TESTING TAKE?

Patch testing is a week long process. On your first scheduled patch test visit, we will apply patches with various potential chemicals to the skin on your back. These chemicals will be left on for 48 hours. You need to avoid direct sun, excessive sweating and showering in the area during this time. After 48 hours, you will return to the office to remove the tape for an initial reading. The doctor will do a final interpretation of the results 120 hours after initial patch placement. A typical schedule for testing is to come in on a Monday (to apply patches), Wednesday (to remove patches), and Friday (to read results). There are even some late reactions on the following Monday which may be relevant.

WHAT TO DO BEFORE THE PATCH TEST

Before undergoing patch testing, you are recommended to stop using topical corticosteroids in the area to be tested, avoid oral antihistamines and steroids, and do not expose the test area to the sun for at least three weeks. These factors may invalidate test results. Your back should be clear and free of any rash or infection. Do not apply any lotions, creams or sunblock.

INTERPRETATION

When reading the results, each spot will be classified on a scale from negative (meaning no reaction) to extreme reaction (meaning positive results for substance). Strong results may cause blisters or ulcers on the skin, which can be treated once the test is complete.

Once the allergens or allergic substances have been elucidated, you will be provided with specific information on your individual triggers and how to prevent contact. You will be given education specifically on how to edit and review your everyday exposures in order to AVOID these offending substances and where to go to choose products which are void of these substances.

WHAT ARE THE CODES USED OR COSTS ASSOCIATED WITH PATCH TESTING?

99214, 95044 (x 65) are used to bill insurance. Rates and coverage depend on your unique plan. Call your insurance to verify coverage and costs. If your insurance does not cover the procedure or you do not have insurance, the cost is $650 which includes 3 visits. 

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PATCH TEST PRODUCTS

NORTH AMERICAN 65 EXTENDED SERIES

  1. Benzocaine

  2. 2-Mercaptobenzothiazole (MBT)

  3. COLOPHONIUM

  4. p-PHENYLENEDIAMINE (PPD)

  5. IMADAZOLIDINYL UREA

  6. CINNAMAL

  7. Amerchol L-101

  8. Carba mix

  9. Neomycin sulfate

  10. Thiuram mix

  11. FORMALDEHYDE

  12. Ethylenediamine dihydrochloride

  13. Epoxy resin, Bisphenol A

  14. QUATERNIUM-15

  15. 4-tert-Butylphenolformaldehyde resin (PTBP)

  16. Mercapto mix

  17. 1,3-Diphenylguanidine

  18. Potassium dichromate

  19. Peru balsam

  20. Nickel(II)sulfate hexahydrate

  21. DIAZOLIDINYL UREA

  22. DMDM HYDANTOIN

  23. Bacitracin

  24. Mixed dialkyl thiourea

  25. METHLISOTHIAZOLINONE + METHYLCHLOROISOTHIAZOLINONE

  26. Paraben mix

  27. METHYLDIBROMO GLUTARONITRILE

  28. Frangrance mix I

  29. GLUTARAL

  30. 2-BROMO-2-NITROPROPANE-1,3-DIOL

  31. Sesquiterpene lactone mix

  32. Fragrance mix II

  33. PROPYLENE GLYCOL

34. BENZOPHENON-3

35. CHLOROXYLENOL (PCMX)

36. Hydroperoxides of Limonene

37. IODOPROPYNYL BUTYLCARBAMATE

38. Disperse Blue mix 106/124

39. Ethyl acrylate

40. Hydroperoxides of Linalool

41. Toluenesulfonamide formaldehyde resin

42. Methyl methacrylate

43. Cobalt(II)chloride hexahydrate

44. Tixocortol-21-pivalate

45. Budesonide

46. Compositae mix II

47. Textile dye mix

48. OLEAMIDOPROPYL DIMETHYLAMINE

49. COCAMIDOPROPYL BETAINE

50. METHYLISOTHIAZOLINONE

51. Lidocaine

52. Dibucaine hydrochloride

53. DECYL GLUCOSIDE

54. Clobetasol-17-propionate

55. Amidoamine

56. 2-Hydroxyethyl methacrylate

57. Desoximetasone

58. HYDROXYISOHEXYL 3-CYCLOHEXENE 

      CARBOXALDEHYDE

59. BENZYL ALCOHOL

60. TOCOPHEROL

61. Propolis

62. Fusidic acid sodium salt

63. COCAMIDE DEA

64. Tea tree oil oxidized

65. Yland ylang oil

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