Standard photopatch test battery? Proposal based on current epidemiology and experience in our Skin Allergy Unit

Photodermatol Photoimmunol Photomed. 2021 Sep;37(5):449-453. doi: 10.1111/phpp.12680. Epub 2021 May 8.

Abstract

Background: The diagnosis of photoallergic contact dermatitis (PACD) is confirmed by photopatch testing (PPT). In Spain, the latest recommendation on which allergens to test in PPT dates from 1995.

Methods: In the last 4 years, we studied 455 patients with epicutaneous tests and performed PPT on 33 of those patients (7.3%).

Results: The most prevalent allergens in PPT were as follows: non-steroidal anti-inflammatory drugs (NSAIDs) (46%), fragrances (21%), and solar filters (18%).

Discussion: In our country, the most common photoallergens continue to be NSAIDs (ketoprofen). The increasingly common use of sunscreens has led to a growing involvement of solar filters in PACD, which can be also contained in other cosmetics. In our experience, PACD due to fragrances is nonetheless at least similar in frequency.

Conclusions: The PPT battery must adapt to the prescription, use, and exposure habits of each country. We propose a diagnostic model to guide which allergens to test in PPT, which in our experience should also include fragrances.

Keywords: anti-inflammatory drugs; fragrances; photoallergy; photopatch test; solar filters; standard battery.

MeSH terms

  • Allergens
  • Dermatitis, Photoallergic* / diagnosis
  • Dermatitis, Photoallergic* / epidemiology
  • Dermatitis, Photoallergic* / etiology
  • Humans
  • Patch Tests
  • Sunscreening Agents
  • Ultraviolet Rays

Substances

  • Allergens
  • Sunscreening Agents