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Excipient and Dose per Unit Area Affect Sensitivity When Patch Testing with Gold Sodium Thiosulfate

Hamann, Dathan; Bruze, Magnus LU ; Fowler, Joseph F.; Hamann, Carsten R.; Andersen, Klaus E. and Hamann, C P (2018) In Dermatitis 29(5). p.258-263
Abstract

Background Dose/area and reading paradigms for gold patch testing are controversial and not standardized worldwide. Objectives The aims of this study were to determine the optimum patch test dose of gold sodium thiosulfate (GST) in a hydrogel (HYD) and to establish GST HYD safety/efficacy and further characterize normal morphology and time course of GST reactions. Methods Twenty gold-allergic patients were patch tested with a dilution series of GST HYD and with GST 2% petrolatum (pet). Furthermore, this previously determined optimal dose was compared with GST 0.5% pet in 19 known-allergic and 216 consecutive subjects. Results The optimal GST HYD dose was 0.075 mg/cm2, not statistically different from GST 2% pet (P = 0.4795).... (More)

Background Dose/area and reading paradigms for gold patch testing are controversial and not standardized worldwide. Objectives The aims of this study were to determine the optimum patch test dose of gold sodium thiosulfate (GST) in a hydrogel (HYD) and to establish GST HYD safety/efficacy and further characterize normal morphology and time course of GST reactions. Methods Twenty gold-allergic patients were patch tested with a dilution series of GST HYD and with GST 2% petrolatum (pet). Furthermore, this previously determined optimal dose was compared with GST 0.5% pet in 19 known-allergic and 216 consecutive subjects. Results The optimal GST HYD dose was 0.075 mg/cm2, not statistically different from GST 2% pet (P = 0.4795). Gold sodium thiosulfate HYD outperformed GST 0.5% pet in both known-allergic subjects (79% vs 63%, P = 0.2482) and consecutive subjects (30% vs 9%, P < 0.0001). Late reactions were common in consecutive patients with both HYD and pet. Significantly more persistent reactions were associated with GST HYD than with GST 0.5% pet. Conclusions Gold sodium thiosulfate HYD 0.075 mg/cm2 is the optimal dose for diagnosis of gold contact allergy with GST. Gold sodium thiosulfate 0.5% pet yielded false-negatives in some patients, suggesting inadequate dose per centimeter squared. Late reads are normal, expected, and necessary for diagnosis of gold contact allergy in this cohort.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Dermatitis
volume
29
issue
5
pages
6 pages
publisher
BC Decker
external identifiers
  • scopus:85053669509
ISSN
1710-3568
DOI
10.1097/DER.0000000000000395
language
English
LU publication?
yes
id
196a332b-eedd-4c78-8f45-0b26f43e99c9
date added to LUP
2018-10-12 12:54:36
date last changed
2019-10-15 06:47:55
@article{196a332b-eedd-4c78-8f45-0b26f43e99c9,
  abstract     = {<p>Background Dose/area and reading paradigms for gold patch testing are controversial and not standardized worldwide. Objectives The aims of this study were to determine the optimum patch test dose of gold sodium thiosulfate (GST) in a hydrogel (HYD) and to establish GST HYD safety/efficacy and further characterize normal morphology and time course of GST reactions. Methods Twenty gold-allergic patients were patch tested with a dilution series of GST HYD and with GST 2% petrolatum (pet). Furthermore, this previously determined optimal dose was compared with GST 0.5% pet in 19 known-allergic and 216 consecutive subjects. Results The optimal GST HYD dose was 0.075 mg/cm<sup>2</sup>, not statistically different from GST 2% pet (P = 0.4795). Gold sodium thiosulfate HYD outperformed GST 0.5% pet in both known-allergic subjects (79% vs 63%, P = 0.2482) and consecutive subjects (30% vs 9%, P &lt; 0.0001). Late reactions were common in consecutive patients with both HYD and pet. Significantly more persistent reactions were associated with GST HYD than with GST 0.5% pet. Conclusions Gold sodium thiosulfate HYD 0.075 mg/cm<sup>2</sup> is the optimal dose for diagnosis of gold contact allergy with GST. Gold sodium thiosulfate 0.5% pet yielded false-negatives in some patients, suggesting inadequate dose per centimeter squared. Late reads are normal, expected, and necessary for diagnosis of gold contact allergy in this cohort.</p>},
  author       = {Hamann, Dathan and Bruze, Magnus and Fowler, Joseph F. and Hamann, Carsten R. and Andersen, Klaus E. and Hamann, C P},
  issn         = {1710-3568},
  language     = {eng},
  number       = {5},
  pages        = {258--263},
  publisher    = {BC Decker},
  series       = {Dermatitis},
  title        = {Excipient and Dose per Unit Area Affect Sensitivity When Patch Testing with Gold Sodium Thiosulfate},
  url          = {http://dx.doi.org/10.1097/DER.0000000000000395},
  volume       = {29},
  year         = {2018},
}