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We have surveyed Scottish dermatologists to establish the extent of patch testing, to assess the reasons for referral and to document resources and methods used by dermatologists. 104 questionnaires were sent to members of the Scottish Dermatological Society. 82 questionnaires (79%) were returned. 50% of respondents were consultants, 27% were trainees and 23% held staff grade or clinical assistant positions. The mean waiting time for a patch test appointment was 4.5 months. The most frequent reasons for patch testing were localized eczema, eczema not responding to conventional treatment, occupational eczema, history of contact sensitivity and eczema of uncertain cause. 17 of 82 respondents (21%) were the principal clinicians supervising patch testing in their hospitals. 11 of 17 read reactions at 2 and 4 days. Mean time spent on advising patients was 13 min per patients. 7 of 17 were dissatisfied with resources available for patient education and 16 of 17 felt they would benefit from a central source for patient information. Only 4 of 17 centres recorded patch test results on a database and 3 centres regularly reviewed their patch test results. In conclusion, we have identified areas of patch testing that require further improvement. [ABSTRACT FROM AUTHOR]

The results of patch testing with a series containing components of cigarettes and matches were reviewed. 2 years were reviewed, 1987 and 1997. 314 patients were patch tested to this series, 203 in 1987 and 111 in 1997. 31 patients had clinically relevant positive reactions to the series, 25 in 1987 and 6 in 1997. 26 patients had relevant positive tests to cigarette components in the series. There were 14 relevant positive reactions to phosphorus sesquisulfide in 1987 and one in 1997. All patients with relevant positive reactions to red match tips also had reactions to phosphorus sesquisulfide. There was a significant association between cigarette and fragrance hypersensitivity. The eczema in 3 of 4 patients who stopped smoking improved. A series containing match heads, smoked cigarette filters and remnants of tobacco from smoked cigarettes may be useful in smokers with eczema of the lace, neck or hands. [ABSTRACT FROM AUTHOR]

1203 patients attending for routine patch testing at 3 hospitals and 105 volunteers were tested with 0.5% and 0.05% gold sodium thiosulfate (GST). 38 patients (3.2%) and 5 volunteers (4.8%) had positive patch tests to GST There were no significant differences between volunteers and patients with respect to age, sex, atopy or exposure to gold in dental restorations, jewellery or through occupation. There were no significant differences in prevalence of GST hypersensitivity in the 3 hospitals, or between patients and controls. This is the 1st controlled study of hypersensitivity to GST, and suggests that routine patch testing to gold is of limited clinical benefit. [ABSTRACT FROM AUTHOR]

It has been suggested that allergic contact dermatitis (ACD) is uncommon in psoriasis, but associated with flexural and palmoplantar involvement. Previous studies have suggested an association between site and morphology of psoriasis and allergic contact sensitivity but it was found that a similar proportion of patients with and without positive patch test reactions had flexural, palmoplantar and chronic plaque psoriasis. Contact allergy to medicaments including dithranol has been recorded in psoriatics.

Lymphomatoid allergic contact dermatitis from gold is a rare entity characterized by nodules at sites of piercing with gold jewellery, and histological features resembling lymphocytoma cutis. A 34-year old woman described painful nodules of both earlobes for 2 years. Her ears had been pierced when she was 13 years of age and she had since worn gold and platinum earrings with occasional mild dermatitis around sites of ear piercing. She did not have gold dental filling, and had no known therapeutic or occupational exposure to gold salts. There was no history of dermatitis on contact with jewellery at other body sites, and she was not atopic.