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
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Benzocaine
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2-Mercaptobenzothiazole (MBT)
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COLOPHONIUM
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p-PHENYLENEDIAMINE (PPD)
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IMADAZOLIDINYL UREA
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CINNAMAL
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Amerchol L-101
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Carba mix
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Neomycin sulfate
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Thiuram mix
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FORMALDEHYDE
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Ethylenediamine dihydrochloride
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Epoxy resin, Bisphenol A
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QUATERNIUM-15
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4-tert-Butylphenolformaldehyde resin (PTBP)
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Mercapto mix
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1,3-Diphenylguanidine
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Potassium dichromate
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Peru balsam
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Nickel(II)sulfate hexahydrate
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DIAZOLIDINYL UREA
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DMDM HYDANTOIN
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Bacitracin
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Mixed dialkyl thiourea
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METHLISOTHIAZOLINONE + METHYLCHLOROISOTHIAZOLINONE
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Paraben mix
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METHYLDIBROMO GLUTARONITRILE
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Frangrance mix I
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GLUTARAL
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2-BROMO-2-NITROPROPANE-1,3-DIOL
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Sesquiterpene lactone mix
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Fragrance mix II
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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