European Society of Contact Dermatitis, ESCD, Institute of Dermatology, instytut dermatologii, congress, Derk P. Bruynzeel, James Ferguson, Alastair Kerr, Cezary Kowalewski, Percy Lehmann, Joanna Narbutt, Radoslaw Spiewak, meeting, symposium, course, photobiology photodamage of the skin, skin barrier and the UV, sunscreens and skin protection, common and rare photodermatoses, photoallergy, phototherapy, diagnosis and treatment of photodermatoses, quality of life in photodermatoses, patient education  and public health issues related to photodermatoses, photopatch test, patch test, photoallergy, photocontact dermatitis, photo contact dermatitis, contact allergy, sun allergy, dermatology, allergology, skin diseases, allergy, conference, course, workshop, Krakow, Cracow, Cracovie, Poland, Europe, EU, meeting, course, conference, 18 september 2009, 19 september 2009 European Society of Contact Dermatitis, ESCD, Institute of Dermatology, instytut dermatologii, congress, Derk P. Bruynzeel, James Ferguson, Alastair Kerr, Cezary Kowalewski, Percy Lehmann, Joanna Narbutt, Radoslaw Spiewak, meeting, symposium, course, photobiology photodamage of the skin, skin barrier and the UV, sunscreens and skin protection, common and rare photodermatoses, photoallergy, phototherapy, diagnosis and treatment of photodermatoses, quality of life in photodermatoses, patient education  and public health issues related to photodermatoses, photopatch test, patch test, photoallergy, photocontact dermatitis, photo contact dermatitis, contact allergy, sun allergy, dermatology, allergology, skin diseases, allergy, conference, course, workshop, Krakow, Cracow, Cracovie, Poland, Europe, EU, meeting, course, conference, 18 september 2009, 19 september 2009 European Society of Contact Dermatitis, ESCD, Institute of Dermatology, instytut dermatologii, congress, Derk P. Bruynzeel, James Ferguson, Alastair Kerr, Cezary Kowalewski, Percy Lehmann, Joanna Narbutt, Radoslaw Spiewak, meeting, symposium, course, photobiology photodamage of the skin, skin barrier and the UV, sunscreens and skin protection, common and rare photodermatoses, photoallergy, phototherapy, diagnosis and treatment of photodermatoses, quality of life in photodermatoses, patient education  and public health issues related to photodermatoses, photopatch test, patch test, photoallergy, photocontact dermatitis, photo contact dermatitis, contact allergy, sun allergy, dermatology, allergology, skin diseases, allergy, conference, course, workshop, Krakow, Cracow, Cracovie, Poland, Europe, EU, meeting, course, conference, 18 september 2009, 19 september 2009

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photopatch.euPhotopatch Test Coursephotoallergic reaction

When to suspect a photoallergic reaction?

Alastair Kerr

Photobiology Unit, Ninewells Hospital, Dundee DD1 9SY, Scotland, UK

Photoallergic contact dermatitis is thought to occur when an exogenous agent combines with a carrier molecule within the skin in the presence of light, to create an antigenic complex. Currently, the best method of investigating photoallergy in humans is photopatch testing. Sunscreens and topical nonsteroidal anti-inflammatory drugs (NSAIDs) are currently the commonest photoallergens.

Indications for photopatch testing include:

  1. Any photo-exposed site dermatitis
  2. Precipitation or aggravation of a dermatosis by sunlight
  3. History of sunscreen reaction
  4. History of topical NSAID reaction
  5. Deterioration of photosensitivity in a pre-existing photodermatosis (e.g. Polmorphic Light Eruption - PLE, Chronic Actinic Dermatitis - CAD, lupus).

Contraindications include:

  1. Extreme photosensitivity
  2. Age less than 5 years
  3. History of anaphylaxis to agent
  4. Xeroderma pigmentosum.

Patients should be aware that there are benefits and disadvantages to having photopatch tests performed and it is their choice on whether to proceed with the investigation.

Benefits include:

  1. The patient becomes aware of contact and photocontact allergens they should avoid
  2. Testing is a relatively non-invasive procedure
  3. Negative results are still useful in the differential diagnosis
  4. Results aid research.

Disadvantages include:

  1. Time needed (3-5 days)
  2. Expenses/travel involved
  3. No washing of test area
  4. Keeping the test area out of the sun
  5. Angry back / worsening of pre-existing dermatitis
  6. Florid positive reactions
  7. Exposure and sensitisation to agents to which they may not otherwise have come into contact with.

To perform photopatch testing, the clinician should have as a minimum, a radiation source, test agent(s) and a method of recording results. Due to the multiple steps involved in photopatch testing, there have been differing methodologies over recent years. However, a European consensus methodology now exists to allow better comparison between centres. For photopatch testing photosensitive patients, a dose 50% that of the UVA MED or the dose below the MED has been suggested.

Reference

Bruynzeel DP, Ferguson J, Andersen K et al. Photopatch testing: a consensus methodology for Europe. J Eur Acad Dermatol Venereol 2004; 18: 679-682.

photopatch.euPhotopatch Test Coursephotoallergic reaction

European Society of Contact Dermatitis, ESCD, Institute of Dermatology, instytut dermatologii, congress, Derk P. Bruynzeel, James Ferguson, Alastair Kerr, Cezary Kowalewski, Percy Lehmann, Joanna Narbutt, Radoslaw Spiewak, meeting, symposium, course, photobiology photodamage of the skin, skin barrier and the UV, sunscreens and skin protection, common and rare photodermatoses, photoallergy, phototherapy, diagnosis and treatment of photodermatoses, quality of life in photodermatoses, patient education  and public health issues related to photodermatoses, photopatch test, patch test, photoallergy, photocontact dermatitis, photo contact dermatitis, contact allergy, sun allergy, dermatology, allergology, skin diseases, allergy, conference, course, workshop, Krakow, Cracow, Cracovie, Poland, Europe, EU, meeting, course, conference, 18 september 2009, 19 september 2009 Krakow (Cracow)

European Society of Contact Dermatitis, ESCD, Institute of Dermatology, instytut dermatologii, congress, Derk P. Bruynzeel, James Ferguson, Alastair Kerr, Cezary Kowalewski, Percy Lehmann, Joanna Narbutt, Radoslaw Spiewak, meeting, symposium, course, photobiology photodamage of the skin, skin barrier and the UV, sunscreens and skin protection, common and rare photodermatoses, photoallergy, phototherapy, diagnosis and treatment of photodermatoses, quality of life in photodermatoses, patient education  and public health issues related to photodermatoses, photopatch test, patch test, photoallergy, photocontact dermatitis, photo contact dermatitis, contact allergy, sun allergy, dermatology, allergology, skin diseases, allergy, conference, course, workshop, Krakow, Cracow, Cracovie, Poland, Europe, EU, meeting, course, conference, 18 september 2009, 19 september 2009 Krakow (Cracow)

European Society of Contact Dermatitis, ESCD, Institute of Dermatology, instytut dermatologii, congress, Derk P. Bruynzeel, James Ferguson, Alastair Kerr, Cezary Kowalewski, Percy Lehmann, Joanna Narbutt, Radoslaw Spiewak, meeting, symposium, course, photobiology photodamage of the skin, skin barrier and the UV, sunscreens and skin protection, common and rare photodermatoses, photoallergy, phototherapy, diagnosis and treatment of photodermatoses, quality of life in photodermatoses, patient education  and public health issues related to photodermatoses, photopatch test, patch test, photoallergy, photocontact dermatitis, photo contact dermatitis, contact allergy, sun allergy, dermatology, allergology, skin diseases, allergy, conference, course, workshop, Krakow, Cracow, Cracovie, Poland, Europe, EU, meeting, course, conference, 18 september 2009, 19 september 2009 Krakow (Cracow)

European Society of Contact Dermatitis

ESCD - GERDA Strasbourg 2010

Institute of Dermatology, Krakow

dermatoses.eu

© Alastair Kerr (text) and Radoslaw Spiewak (source code).
This page is part of the website photopatch.eu (contact).
Document created: 30 August 2009, last updated: 7 September 2009.