European Society of Contact Dermatitis Guideline for Diagnostic Patch Testing—Recommendations on Best Practice (Update 2026)
ESCD · 2026 · Europe
Source and licence
- Authors
- Wolfgang Uter, Olivier Aerts, Tove Agner et al.
- Title
- European Society of Contact Dermatitis Guideline for Diagnostic Patch Testing—Recommendations on Best Practice (Update 2026)
- Journal
- Contact Dermatitis, 2026
- Licence
- CC BY 4.0
- Changes
- Verbatim excerpts; formatting adapted
Full text retrieved 2026-10-27 from Europe PMC · PMC13441402
Licence statement of the original publication
This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
This page reproduces excerpts of the original publication; the original is authoritative. It has not been reviewed by a physician, does not state a recommendation of Medelix and does not replace medical advice. The guideline may have been updated since.
Open the original publication →Full text on Europe PMC
Recommendations
We found no explicitly labelled recommendations in this publication; its recommendations are in the running text of the original.
Abstract
The present guideline updates the initial ESCD patch testing guideline, summarizing all aspects of patch testing for the diagnosis of contact allergy in patients suspected of suffering, or having been suffering, from allergic contact dermatitis or other delayed‐type hypersensitivity skin and mucosal conditions. Sections with brief descriptions and discussions of different pertinent topics are followed by highlighted short practical recommendations, which have been consensualized in a Delphi process. Topics comprise, after an introduction with important definitions, materials, technique, modifications of epicutaneous testing, individual factors influencing the patch test outcome or necessitating special considerations, children, patients with occupational contact dermatitis and drug eruptions as special groups, patch testing of materials brought in by the patient, adverse effects of patch testing and the final evaluation and patient counselling based on this judgement. Finally, short reference is made to aspects of (continuing) medical education and to electronic collection of data for epidemiological surveillance.
Contents of the original publication
The section headings of the original.
- Overall Objective and Methods
- Introduction
- Definitions
- Indications
- Materials
- Test Systems
- Selection of Patch Test Materials
- Vehicles and Concentrations
- Storage and Stability
- Technique
- Dosing of Chambers
- Anatomical Site of Patch Test Application
- Occlusion Time
- Reading Times
- Morphology
- Other Techniques
- Semi‐Open Test
- Open Test
- Strip and Scratch Patch Tests
- Repeated Open Application Test
- Photopatch Testing
- Patch Testing of Patients' Own Materials
- Patch Test Concentrations
- Vehicle
- Extracts and Chromatograms
- Preparation of the Test Material
- Final Evaluation: Clinical Relevance and Diagnosis
- The Concept of Clinical Relevance
- Current Clinical Relevance
- Unknown Relevance
- Past Relevance
- Interpretation of Doubtful Patch Test Reactions
- Final Diagnosis
- Influence of Individual and Exogenous Factors
- Medication
- Immunosuppressive Diseases
- Atopic Dermatitis and Concomitant Active Eczematous Disease
- UV Radiation/Sun Exposure
- Temperature and Ambient Air Humidity
- Special Groups
- Children
- Occupational Contact Dermatitis
- Testing in Drug Reactions
- Patch Testing in Eruptions Related to Drugs
- Potential Adverse Effects of Patch Testing
- Unexpected Irritant Reactions
- Active Sensitization
- Persisting/Long‐Lasting Reactions
- Flare‐Up Reactions
- Pigmentation Changes
- Immediate Type Reactions
- Other Adverse Effects
- Subjective Complaints
- Patient Counselling on Allergen Avoidance
- Counselling Patients on Allergen Avoidance
- Challenges in Patient Counselling
- Professional Training in Cutaneous Allergy
- Physicians With an Interest in Cutaneous Allergy
- Maintenance of Expertise
- Databases and Surveillance
- Information Sources
- Software for Documentation of Patch Test Results
- Contact Allergy Networks and Surveillance
- Cosmetovigilance/Pharmacovigilance
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