H. Rajgopal Bala, A. Lee, A.M. Palmer, R.L. Nixon
Patch-testing is the gold standard for accurate diagnosis of allergic contact dermatitis (ACD) (1). The Australian Base- line Series (ABS) was formulated to include the 60 most common and relevant allergens in our patient population (2). Internationally, multiple baseline series have been for- mulated to aid patch-testing; these reﬂect the diverse aller- gens found in different patient populations, and include the European Baseline Series and North American Contact Dermatitis Group Series (2). Patients are generally patch- tested to a baseline series, and extra series, individual allergens and own contactants depending on clinical his- tory.
We reviewed the effectiveness of the ABS in diagnosing ACD in patients patch-tested in the Occupational Derma- tology and Contact Dermatitis clinics at the Skin and Cancer Foundation from 1 January 2012 to 31 December 2014. Data from each clinic were examined separately, and 583 patients were diagnosed with ACD over this per- iod. Overall, testing with the ABS successfully diagnosed 63% of cases of ACD; including 71% in Occupational Der- matology clinic patients and 58% in Contact Dermatitis clinic patients. The most common ABS allergens detected were methylisothiazolinone/methylchloroisothiazolinone.
Many patients are referred to Contact Dermatitis clinic with cheilitis and intra-oral problems. These conditions are often caused by allergens not found in the ABS, eg amalgam, mercury, gold and palladium. Fragrances such as lavender were also not detected by the ABS. Patients with oral mucosal problems or fragrance allergy may therefore require testing with additional series. Allergens occurring more frequently may also be considered for inclusion into the ABS at a later date