DYNAMIC PATTERNS OF ALLERGIC PATCH TEST REACTIONS TO 10 EUROPEAN STANDARD ALLERGENS - AN ANALYSIS OF DATA RECORDED BY THE INFORMATION NETWORK OF DEPARTMENTS OF DERMATOLOGY (IVDK)

Insight into the dynamic time courses of patch test reactions may be u seful for patch test evaluation. To put this to the proof, we have ana lysed the time courses of allergic patch test reactions that were file d between 1990 and 1994 by the Information Network of Departments of D ermatology in Germany (IVDK). Based on reaction strength at days 1 to 3, each allergic patch test was assigned to 1 of 5 distinct dynamic re action patterns: crescendo, plateau, decrescendo, crescendo/decrescend o, or decrescendo/crescendo. The frequencies of these patterns were de termined for those 10 standard allergens yielding the highest numbers of allergic reactions (n between 180 and 1240), and dynamic patterns w ere classified as type 1 (crescendo or plateau patterns) or type 2 (ot her patterns). Influences of population characteristics upon the class ification of patterns were evaluated by logistic regression analyses. Different frequencies of reaction patterns were found for distinct all ergens. For all 10 allergens, type-1 patterns were significantly more often observed for allergic reactions assessed as clinically relevant. For 5 allergens, female sex of patients was associated with a lower f requency of type-2 patterns. A history of atopic dermatitis and the ag e of patients were only weakly associated with a certain classificatio n of reaction patterns in some of the allergens. In a comparison of re action patterns obtained with different allergens in the same populati on, we found that nickel sulfate elicited type 1 reaction patterns mor e often than fragrance mix. We conclude that the dynamic reaction patt erns should be taken into account in the evaluation of patch tests. Th e relation of type-1 patterns to clinical relevance of the reaction ne eds further attention.