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  • 1
    Electronic Resource
    Electronic Resource
    The association between size of test chamber and patch test reaction: a statistical reanalysis (1999)
    Oxford, UK : Blackwell Publishing Ltd
    Contact dermatitis 40 (1999), S. 0 
    Details
    ISSN: 1600-0536
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: A recent study by Brasch and co-workers reported on the association between size of test chamber and patch test reaction. The investigators interpreted their data on 495 patients as having conclusively shown that standard preparations of fragrance mix, wool wax alcohols, Kathon CG and formaldehyde led to more positive test reactions when large Finn Chambers were used for patch testing. We have scrutinized the statistical aspects of this study and conclude that the authors should have adopted a statistical approach suitable to analyse dependent samples. After explaining the correct methodological way of dealing with quadratic contingency tables formed by 2 dependent samples, we reanalyze the data accordingly and compare the results to those of the original paper. Based on this reanalysis, the conclusions are more complex: the reaction pattern for the fragrance mix and wool wax alcohols is significantly different between small and large test chambers; however, this discrepancy arises primarily from changing weak positive reactions with small chambers to strong positive reactions with large chambers. For formaldehyde, no relationship between chamber size and patch test reaction was found in the data, while for Kathon CG, statistical evidence is borderline that more positive test reactions are yielded by large test chambers than by small ones.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1600-0536.1999.tb05970.x
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  • 2
    Electronic Resource
    Electronic Resource
    Guidelines for the descriptive presentation and statistical analysis of contact allergy data (2004)
    Oxford, UK; Malden, USA : Munksgaard International Publishers
    Contact dermatitis 51 (2004), S. 0 
    Details
    ISSN: 1600-0536
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The present guidelines aim to support clinical researchers in adequately presenting data on contact allergy, and to use statistical tests appropriate for their data. A description of the mode of selection of patients, and of their relevant demographic details, is an essential prerequisite for the correct interpretation of study results. Proportions and rates, if regarded as estimate of these parameters of a target populations, should normally be supplemented with confidence intervals to address precision. Concordance, i.e., agreement between two ratings in a dependent sample, must be quantified with a chance-corrected measure such as Cohen's kappa coefficient. If the diagnostic quality of an outcome is being assessed, standard measures like sensitivity and specificity, as well as the prevalence-dependent positive and negative predictive values should be calculated. Often, contact allergy to a certain substance depends on several factors. In this situation, depending on the research question, techniques like stratification, standardization or multifactorial analysis should be employed. With increasing complexity of statistical description and analysis, consulting with a biostatistician is often mandatory.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.0105-1873.2004.00406.x
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  • 3
    Electronic Resource
    Electronic Resource
    Patch tests with thiurams at 0.25% pet. and 1% pet. are of equal diagnostic value (2002)
    Oxford, UK : Munksgaard International Publishers
    Contact dermatitis 46 (2002), S. 0 
    Details
    ISSN: 1600-0536
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Thiuram mix is tested in the standard series at a test concentration of 1% pet. The single thiurams (DPTD, TMTD, TMTM, TETD), however, are usually tested at 0.25% pet. in Germany. In other countries, the individual components of thiuram mix are tested at 1% pet. The German Contact Dermatitis Research Group (DKG) compared both patch test concentrations in 530 patients in order to find out if (i) a significant number of positive patch tests are missed by testing at the lower concentration, (ii) problems with irritant test reactions occur by increasing the test concentration to 1%, and (iii) the sensitivity of the thiuram mix rises when the breakdown test is done with the higher concentration. Slightly more positive reactions were seen with the higher concentration, but this increase did not reach statistical significance. The reaction index, as a measure for the relation of positive to irritant and/or questionable reactions, remained unchanged for the individual thiurams. The sensitivity of the mix also did not change when the breakdown test was performed with 1% pet. instead of 0.25% pet. Thus, we conclude that both concentrations are of equal diagnostic value in patch testing.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1034/j.1600-0536.2002.460502.x
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  • 4
    Electronic Resource
    Electronic Resource
    Dynamic patterns of allergic patch test reactions to 10 European standard allergens (1996)
    Oxford, UK : Blackwell Publishing Ltd
    Contact dermatitis 35 (1996), S. 0 
    Details
    ISSN: 1600-0536
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Insight into the dynamic time courses of patch test reactions may be useful for patch test evaluation. To put this to the proof, we have analysed the time courses of allergic patch test reactions that were filed between 1990 and 1994 by the Information Network of Departments of Dermatology in Germany (IVDK). Based on reaction strength at days 1 to 3, each allergic patch test was assigned to 1 of 5 distinct dynamic reaction patterns: crescendo, plateau, decrescendo, crescendo/decrescendo, or decrescendo/crescendo. The frequencies of these patterns were determined for those 10 standard allergens yielding the highest numbers of allergic reactions (n between 180 and 1240), and dynamic patterns were classified as type 1 (crescendo or plateau patterns) or type 2 (other patterns). Influences of population characteristics upon the classification of patterns were evaluated by logistic regression analyses. Different frequencies of reaction patterns were found for distinct allergens. For all 10 allergens, type-1 patterns were significantly more often observed for allergic reactions assessed as clinically relevant. For 5 allergens, female sex of patients was associated with a lower frequency of type-2 patterns. A history of atopic dermatitis and the age of patients were only weakly associated with a certain classification of reaction patterns in some of the allergens. In a comparison of reaction patterns obtained with different allergens in the same population, we found that nickel sulfate elicited type 1 reaction patterns more often than fragrance mix. We conclude that the dynamic reaction patterns should be taken into account in the evaluation of patch tests. The relation of type-1 patterns to clinical relevance of the reaction needs further attention.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1600-0536.1996.tb02260.x
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  • 5
    Electronic Resource
    Electronic Resource
    Reproducibility of patch tests (2004)
    Oxford, UK; Malden, USA : Munksgaard International Publishers
    Contact dermatitis 51 (2004), S. 0 
    Details
    ISSN: 1600-0536
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.0105-1873.2004.00393.x
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  • 6
    Electronic Resource
    Electronic Resource
    Hand dermatitis in a prospectively-followed cohort of hairdressing apprentices:nal results of the POSH study (1999)
    Oxford, UK : Blackwell Publishing Ltd
    Contact dermatitis 41 (1999), S. 0 
    Details
    ISSN: 1600-0536
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The incidence of hand dermatitis is high in the hairdressing trade; the individual disease burden is substantial, as are the costs of treatment, workers compensation and retraining programs. To evaluate the risk of developing occupational irritant hand dermatitis associated with several potential risk factors, namely constitution (atopy) and occupational exposure, an observational prospective population-based cohort study set in vocational training schools in northwest Germany, recruiting 2352 hairdressing apprentices, was performed. Unprotected wet work of more than 2 h per day is the major signicant risk factor; low ambient absolute humidity is equally associated with a signicantly increased risk. Compared to the youngest age group, risk diminishes with increasing age. Constitutional risk factors are difcult to evaluate because of selective dropout of atopic participants. For primary prevention, a population approach, improving working conditions and skin protection for all exposed, appears to be the most beneficial.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1600-0536.1999.tb06162.x
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  • 7
    Electronic Resource
    Electronic Resource
    Patch test reactions at D4, D5 and D6 (1999)
    Oxford, UK : Blackwell Publishing Ltd
    Contact dermatitis 40 (1999), S. 0 
    Details
    ISSN: 1600-0536
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: In this retrospective study, patch test reactions in 3 groups of patients were analysed, in order to obtain information on the best day for the 2nd patch-test reading after day 2 (D2), on the usefulness of additional readings after D3, and on the dependence of patch-test reactions at D4, D5, or D6 on allergen and/or patient characteristics. In the years 1990 to 1995, patch tests were routinely read at D3 and D4 in 1096 patients, at D3 and D5 in 1243 patients, and at D3 and D6 in 1136 patients. In all of the 3 groups, significantly more positive reactions diminished than appeared de novo from D3 to the later reading. Virtually identical results were observed in subgroups of patients formed by sex, age or atopy. However, men might possibly react more slowly than women on patch testing, showing more increasing than diminishing reactions in the D3/D4- and the D3/ D5-comparison. Reactions to individual allergens showed wide differences in this connection. Neo-mycin sulfate, cobalt salts, and p-phenylenediamine can be characterized as slow allergens, with more reactions increasing than diminishing from D3 to the later readings. With fragrance mix and balsam of Peru, the opposite pattern occurred. In all subgroups of patients, and with most allergens, the gain in positive reactions was biggest when an additional reading was performed at D5. We conclude that for a single 2nd patch test reading after D2, D3 is the best day, and especially better than D4. If a 3rd reading is performed, it should be done at D5 to get the maximum information out of patch testing. However, this extends the test procedure to at least 1 day of the weekend.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1600-0536.1999.tb06008.x
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  • 8
    Electronic Resource
    Electronic Resource
    The association between ambient air conditions (temperature and absolute humidity), irritant sodium lauryl sulfate patch test reactions and patch test reactivity to standard allergens (2003)
    Oxford, UK : Munksgaard International Publishers
    Contact dermatitis 49 (2003), S. 0 
    Details
    ISSN: 1600-0536
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: To support the decision as to whether erythematous patch test reactions to allergens are irritant or allergic, sodium lauryl sulfate (SLS, 0·5% in water) has been added to the standard patch tests since July 1996 in the Dortmund Department of Dermatology. Data on 1600 patients patch tested up until June 2001, as well as standardized data on ambient temperature and humidity obtained by the German Meteorological Service, were included in a logistic regression analysis taking age, sex and atopy as potential confounders into account. The pattern of association was heterogeneous: while doubtful reactions to nickel sulfate were significantly associated with dry/cold weather conditions, but not with SLS reactivity, the opposite was observed for lanolin alcohol, benzocaine and Myroxylon pereirae resin (balsam of Peru). Doubtful reactions to other allergens, namely formaldehyde, fragrance mix or p-phenylenediamine, were associated with both factors. For several other allergens of the standard series, no distinct, significant pattern could be discerned. In conclusion, meteorological conditions and SLS reactivity independently contribute information on individual irritability at the time of patch testing, and both should be considered.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.0105-1873.2003.00178.x
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  • 9
    Electronic Resource
    Electronic Resource
    Positive nickel patch tests do not intensify positive reactions to adjacent patch tests with dichromate (2000)
    Copenhagen : Munksgaard International Publishers
    Contact dermatitis 43 (2000), S. 0 
    Details
    ISSN: 1600-0536
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The possible interference of neighbouring allergic patch-test reactions is still an open question. In this study, we investigated whether there is a distance-related mutual modification of neighbouring allergic patch-test reactions to nickel sulfate and potassium dichromate. We used a double-blind multicentre study design with randomized attachment of special TRUE Tests with 1, 3 and 7 cm distance between nickel sulfate and potassium dichromate patches. 589 patients with a history of nickel allergy (523 female, 66 male) were tested, with a mean age of 35 years. A log-linear modelling approach was used for statistical assessment of the relation between the distance separating neighbouring patch tests with nickel and dichromate and the reactions to the allergens. Non-reproducibility coefficients were compared by the generalized version of Fisher's exact test for arbitrary 2-dimensional contingency tables. For the left side of the back, virtually no differences (p=0.70) were found in the reaction patterns obtained for the 3 distances separating nickel and dichromate patch tests. On the right side of the back, the number of reactions to dichromate patches with only 1 cm distance from moderate/strong nickel reactions was lower than the number of positive dichromate tests at larger distances from nickel tests (on the border of statistical significance: p=0.05). Corresponding side-related results were obtained for subgroups of patients with and without a history of atopic dermatitis. The non-reproducibility of reactions to dichromate was not significantly related to the distance between neighbouring tests. Our data argue against a “spillover“ effect of strong/moderate nickel reactions, but indicate that such reactions may, under certain conditions, attenuate adjacent reactions to an unrelated allergen. In the case of future verification, this will have implications for the interpretation of patch tests.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1034/j.1600-0536.2000.043003144.x
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  • 10
    Electronic Resource
    Electronic Resource
    Frühe irritative Hautschäden bei Friseurlehrlingen (1995)
    Springer
    Der Hautarzt 46 (1995), S. 771-778 
    Details
    ISSN: 1432-1173
    Keywords: Schlüsselwörter Friseurhandwerk ; Feuchtarbeit ; Atopie ; Irritatives Handekzem ; Querschnittserhebung ; Key words Hairdressing ; Wet work ; Atopy ; Irritant hand eczema ; Cross-sectional analysis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary In the course of a cohort study addressing the importance of constitutional and occupational risk factors for the development of irritant hand eczema, 859 hairdressing apprentices were examined in 14 vocational training schools in autumn 1993, after an average of 8 weeks of professional exposure. In this cross-sectional survey at the start of training, 38.2% were suffering from skin damage, in most cases mild to moderate and only rarely severe; we observed almost exclusively irritant skin damage, mostly localized interdigitally. Logistic regression analysis revealed previous hand eczema, an elevated “atopy score” (Diepgen) and, particularly, unprotected work for several hours daily with wet hands as significant risk factors for this early onset irritant damage/eczema. The high wet workload is mainly caused by very frequent shampooing and by permanent waving without wearing gloves; however, other tasks are also often performed without appropriate protective gloves. The implications of the considerable inter-observer variability are described and discussed.
    Notes: Zusammenfassung Im Rahmen einer ausbildungsbegleitenden Kohortenstudie zur Bedeutung konstitutioneller und expositionsbezogener (beruflicher) Risikofaktoren für die Entstehung eines irritativen Handekzems wurden im Herbst 1993 insgesamt 859 Friseurlehrlinge an 14 Berufsschulen erstuntersucht, im Mittel 8 Wochen nach Beginn der Berufstätigkeit. Bei dieser Querschnittserhebung zu Beginn der Ausbildung waren bei 38,2% leichtere bis mäßige, selten stärkere irritative Hautschäden festzustellen, welche hauptsächlich im Interdigitalraum lokalisiert waren. Hinsichtlich dieser frühen Hautschäden konnten in einer logistischen Regressionsmodellierung ein früheres Handekzem, ein höherer Atopie-Score (nach Diepgen) und v.a. eine tägliche ungeschützte Feuchtarbeitsdauer von mehreren Stunden als signifikante Risikofaktoren ermittelt werden. Die Feuchtarbeit wird hauptsächlich von sehr häufig durchgeführten Haarwäschen und Dauerwellen bestimmt. Auch bei den meisten anderen Tätigkeiten werden überwiegend keine adäquaten Schutzhandschuhe gemäß der Technischen Regel Gefahrstoffe (TRGS) 530 verwendet. Darüber hinaus wird die erhebliche Inter-Untersucher-Variabilität dargestellt und diskutiert.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001050050337
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