Photopatch testing: Clinical characteristics, test results, and final diagnoses from the North American Contact Dermatitis Group, 2009-2020

Vincent A. DeLeo, Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Brandon L. Adler, Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Donald V. Belsito, Department of Dermatology, Columbia University Irving Medical School, New York, New York, USA.
Melanie D. Pratt, Division of Dermatology, University of Ottawa, Ottawa, Ontario, Canada.
Denis Sasseville, Division of Dermatology, McGill University Health Centre, Montreal, Québec, Canada.
Margo J. Reeder, Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
Erin M. Warshaw, Department of Dermatology, Park Nicollet/Health Partners Health Services, Minneapolis, Minnesota, USA.
Amber R. Atwater, Department of Dermatology, Duke University Medical Center, Durham, North Carolina, USA.
James S. Taylor, Department of Dermatology, Cleveland Clinic, Cleveland, Ohio, USA.
Frances Storrs, Department of Dermatology, Oregon Health Science University, Portland, Oregon, USA.
James G. Marks, Department of Dermatology, Pennsylvania State University, Hershey, Pennsylvania, USA.
Joel G. DeKoven, Division of Dermatology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
Jonathan Silverberg, Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA.
JiaDe Yu, Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Nina Botto, Department of Dermatology, University of California, San Francisco, San Francisco, California, USA.
Marie-Claude Houle, Division of Dermatology, Centre Hospitalier Universitaire Québec, Laval University, Quebec City, Québec, Canada.
Christen M. Mowad, Division of Dermatology, Geisinger Medical Center, Danville, Pennsylvania, USA.
Cory A. Dunnick, Department of Dermatology, University of Colorado, Aurora, Colorado, USA.

Document Type

Journal Article

Publication Date

8-21-2024

Journal

Contact dermatitis

DOI

10.1111/cod.14677

Keywords

North American Contact Dermatitis Group; allergic contact dermatitis; avobenzone; benzophenone; ketoprofen; octocrylene; patch testing; photoallergic contact dermatitis; photoallergy; photopatch test; photosensitivity

Abstract

BACKGROUND: Photoallergic contact dermatitis (PACD) is a delayed hypersensitivity reaction to allergens only in the presence of ultraviolet radiation in sunlight. Photopatch testing (PhotoPT) is necessary to confirm the diagnosis of PACD. There are few published studies of PhotoPT in North America. OBJECTIVE: To summarise the results of patients photopatch tested by members of the North American Contact Dermatitis Group (NACDG), 2009-2020. METHODS: Retrospective analysis of patient characteristics and PhotoPT results to 32 allergens on the NACDG Photopatch Test Series. RESULTS: Most of the 454 tested patients were female (70.3%), 21-60 years old (66.7%) and White (66.7%). There were a total of 119 positive photopatch tests. Sunscreen agents comprised 88.2% of those, with benzophenones responsible for over half of them. Final diagnoses included PACD in 17.2%, allergic contact dermatitis (ACD) in 44.5%, polymorphous light eruption (PMLE) in 18.9% and chronic actinic dermatitis (CAD) in 9.0% of patients. CONCLUSIONS: In 454 patients with suspected photosensitivity referred for photopatch testing in North America, approximately one-fifth had PACD. Sunscreen agents, especially benzophenones, were the most common photoallergens. Other common diagnoses included ACD, PMLE and CAD. Photopatch testing is an important tool for differentiating these conditions.

Department

Dermatology

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