What questions should be asked during patch testing intake?

Essential Questions for Patch Testing Intake

A comprehensive patch testing intake should include detailed questions about medical history, symptom patterns, potential allergen exposures, and medication use to optimize diagnostic accuracy and patient outcomes.

Medical History and Symptom Assessment

• Ask about the onset, duration, and pattern of skin symptoms (intermittent vs. continuous) 1
• Document the specific anatomical distribution of dermatitis (hands, face, flexural areas, etc.) 1
• Inquire about any relationship between symptoms and specific activities, environments, or exposures 1
• Ask about previous treatments attempted and their effectiveness 1
• Document any history of atopic conditions (eczema, asthma, allergic rhinitis) 1, 2
• Ask about any previous patch testing and results 1

Potential Allergen Exposures

• Obtain detailed occupational history, including specific job duties and materials handled 1
• Document all personal care products used (cosmetics, soaps, moisturizers, deodorants) 3, 4
• Ask about household cleaning products and chemicals 1
• Inquire about hobbies and recreational activities that may involve allergen exposure 1
• Document any suspected food triggers, especially for perioral or hand dermatitis 1
• Ask about jewelry, clothing, and footwear that may cause reactions 1, 2

Food-Related Questions (when relevant)

• Ask about any suspected food triggers and the timing of reactions after consumption 1
• Document any systemic symptoms associated with food consumption (fever, headache, GI complaints) 1
• Inquire about resolution of symptoms during periods of food avoidance 1
• Ask about reactions to specific food categories known to contain common allergens:
  • Metals in foods (nickel, cobalt, chromium) 1
  • Spices and flavorings 1
  • Fragrances in foods (Balsam of Peru components) 1, 3

Medication and Treatment History

• Document all current medications, including topical treatments 1
• Ask about any previous adverse reactions to medications, especially topical ones 1
• Document use of systemic corticosteroids or immunosuppressants within the past 3 months 1
• Ask about recent use of antihistamines 1
• Document any UV light therapy or significant sun exposure in the past 6 weeks 1
• Ask about use of biological agents within the past 6 months 1

Special Considerations

• For women, document pregnancy status or if breastfeeding 1
• Ask about any history of severe allergic reactions to suspected allergens 5
• Document any extensive active dermatitis that might interfere with testing 5
• Ask about ability to avoid bathing the test area and strenuous exercise during the testing period 1
• Inquire about availability for multiple follow-up visits for patch test readings (typically days 2,4, and potentially day 7) 1, 6

Patient Expectations and Consent

• Explain the testing procedure, including potential for skin reactions and discomfort 1
• Discuss the need to keep the back dry and avoid exercise during testing 1
• Explain the time commitment required for multiple readings 1
• Document informed consent after discussing potential adverse effects 1

Documentation of Suspected Allergens

• Ask patients to bring in suspected products for potential testing 1, 3
• Document any known allergens from previous testing 1
• Ask about specific occupational exposures that may require specialized testing panels 1
• Inquire about metal exposures that may require extended reading schedules (day 7 or beyond) 6