Definition and research guide
This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.
Content available: 4 complete abstracts (721 words), 10 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.
Definition
Skin tests in which the sensitizer is applied to a patch of cotton cloth or gauze held in place for approximately 48-72 hours. It is used for the elicitation of a contact hypersensitivity reaction.
Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.
Also known as: Patch Test; Test, Patch; Tests, Patch; Patch Testing; Patch Testings; Testing, Patch; Testings, Patch.
Where it fits in the MeSH classification
- Broader topics
- Skin Tests
Research landscape
PubMed indexes 12,260 records tagged with the MeSH heading “Patch Tests” (counts retrieved 2026-11-04). 1,691 of them (13.8%) were published from 2020 onward, and the busiest period so far is through 1999 with 4,668 records.
Reviews account for 1,009 records (8.2%) and meta-analyses for 24. Randomized controlled trials number 201 (1.6%) as a share of all records on the topic. Randomized trials make up only a small share of this literature, so much of what is known comes from laboratory, observational or descriptive work.
Show the data
| Period | Records |
|---|---|
| through 1999 | 4,668 |
| 2000-2009 | 3,225 |
| 2010-2019 | 2,676 |
| 2020 onward | 1,691 |
Publication-type chart data
| Type | Records | Share |
|---|---|---|
| Reviews | 1,009 | 8.2% |
| Meta-analyses | 24 | 0.2% |
| Randomized controlled trials | 201 | 1.6% |
Method: PubMed query "Patch Tests"[MeSH Terms] with publication-type and date filters, retrieved 2026-11-04.
Reading the evidence in diagnostics and medical technology
A test or device is judged by how well it detects a condition, how often it gives false alarms or misses cases, and whether using it improves outcomes for people. Accuracy depends on who is tested and how common the condition is, so a test that performs well in a specialist hospital can perform differently in the community. Check the reference standard, the population studied, the sensitivity and specificity and whether results were confirmed in a separate group.
Evidence from open-access studies
These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.
| Study / authors | Year | Source label / design | Europe PMC citations | Licence / source |
|---|---|---|---|---|
| A retrospective study on titanium sensitivity: Patch test materials and manifestations | 2018 | Research article Design not recorded in structured metadata | 32 | cc by PMID 29797739 · DOI · PMC6099462 |
| Diagnosing lanolin contact allergy with lanolin alcohol and Amerchol L101 | 2019 | Research article Design not recorded in structured metadata | 27 | cc by PMID 30624788 · DOI · PMC6593808 |
| New positive patch test reactions on day 7-The additional value of the day 7 patch test reading | 2019 | Research article Design not recorded in structured metadata | 25 | cc by PMID 31116435 · DOI · PMC6771944 |
| European Society of Contact Dermatitis Guideline for Diagnostic Patch Testing-Recommendations on Best Practice (Update 2026) | 2026 | Research article Design not recorded in structured metadata | 4 | cc by PMID 42324086 · DOI · PMC13441402 |
A retrospective study on titanium sensitivity: Patch test materials and manifestations [1]
Abstract reading summary — source excerpts
- Opening excerpt
- BackgroundTitanium is being increasingly used.
- Closing excerpt
- The patient's medical history and clinical picture remain crucial in the diagnostic work-up.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (200 words)
BackgroundTitanium is being increasingly used. Although it is considered to be a non-allergenic material, allergic reactions to it have been reported. Titanium dioxide has been found to be an unreliable patch test material. Few studies to date have profiled titanium allergy, and it therefore remains difficult to distinguish its manifestations.ObjectivesTo evaluate alternatives for titanium dioxide as a patch test preparation, and to profile titanium reactions and manifestations.MethodsA retrospective chart review was conducted with 458 patients who underwent patch testing with at least 1 of 5 different titanium salts.ResultsAt least 1 positive result was noted in 5.7% of the patients. The frequency of positive results for the tested salts ranged from 0.9% to 7.9%. Titanium(IV) oxalate hydrate had the highest yield and titanium dioxide the lowest. Erythema, dermatitis and local swelling were the most common objective complaints. In 16 (61.5%) patients, the test result had partial or full clinical relevance.ConclusionsNo titanium-specific risk factors and clinical picture could be identified. Titanium dioxide is not adequately sensitive for identifying titanium allergy. The titanium salts seem to be possible superior patch test preparations, but appear to be unsuitable if used singly. The patient's medical history and clinical picture remain crucial in the diagnostic work-up.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 29797739 · DOI · PMC6099462
Diagnosing lanolin contact allergy with lanolin alcohol and Amerchol L101 [2]
Abstract reading summary — source excerpts
- Opening excerpt
- BackgroundThe prevalence of lanolin contact allergy in dermatitis patients varies from 1.
- Closing excerpt
- Routinely testing with other lanolin derivatives may not be worthwhile, as it detects only a few additional patients.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (175 words)
BackgroundThe prevalence of lanolin contact allergy in dermatitis patients varies from 1.2% to 6.9%. Different lanolin derivatives are used in patch testing.ObjectivesTo determine which combination of lanolin derivatives is most effective in patch testing for the diagnosis of lanolin contact allergy.MethodsA retrospective analysis of patients patch tested between 2016 and 2017 was performed. Patients were eligible if they had been tested with lanolin alcohol 30% pet., Amerchol L101 50% pet., and a supplementary series containing other lanolin derivatives. Lanolin alcohol and Amerchol L101 were tested in duplicate.ResultsOf 594 patients, 28.6% (95% confidence interval [CI]: 25.1%-32.3%) had a positive patch test reaction to at least one lanolin derivative. Reactions to lanolin alcohol (14.7%, 95%CI: 11.3%-18.2%) and Amerchol L101 (15.0%, 95%CI: 11.5%-18.5%) were common in the routinely tested series. Reactions to other test preparations were significantly less frequent (P ConclusionsThe combination of lanolin alcohol and Amerchol L101 is effective in patch testing for the diagnosis of lanolin contact allergy. Routinely testing with other lanolin derivatives may not be worthwhile, as it detects only a few additional patients.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 30624788 · DOI · PMC6593808
New positive patch test reactions on day 7-The additional value of the day 7 patch test reading [3]
Abstract reading summary — source excerpts
- Opening excerpt
- BackgroundNot performing a day (D) 7 patch test reading might result in positive patch test reactions being missed.
- Closing excerpt
- ConclusionA D7 reading to identify new positive patch test reactions is of added value, especially for topicals and corticosteroids.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (196 words)
BackgroundNot performing a day (D) 7 patch test reading might result in positive patch test reactions being missed.ObjectivesTo investigate the added value of the D7 patch test reading for individual allergens, and to identify patient characteristics and allergen groups associated with new positive D7 reactions.MethodsData from patients patch tested between 2008 and 2018 with the extended European baseline series were analysed. Patch test readings were performed on D3 and D7. Positive reactions were categorized into positive on D3 or new positive on D7.ResultsA total of 3292 patients were consecutively patch tested with at least 43 allergens of the TRUE Test panels 1 and 2 supplemented with investigator-loaded allergens. In total, 447 (13.6%) patients showed new positive D7 reactions. In univariable regression analysis, age between 18 and 30 years showed a negative association with new positive D7 reactions. Significantly more D7 positive reactions were seen for topicals (odds ratio [OR] 2.60, 95% confidence interval [CI]: 1.92-3.51) and corticosteroids (OR 1.87, 95%CI: 1.09-3.21). No associations were found between sex, atopic dermatitis and occupational dermatitis and a new positive D7 reaction.ConclusionA D7 reading to identify new positive patch test reactions is of added value, especially for topicals and corticosteroids.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 31116435 · DOI · PMC6771944
European Society of Contact Dermatitis Guideline for Diagnostic Patch Testing-Recommendations on Best Practice (Update 2026) [4]
Abstract reading summary — source excerpts
- Opening excerpt
- 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.
- Closing excerpt
- Finally, short reference is made to aspects of (continuing) medical education and to electronic collection of data for epidemiological surveillance.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (150 words)
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.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 42324086 · DOI · PMC13441402
Key reviews and meta-analyses
The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.
- Research article European Society of Contact Dermatitis guideline for diagnostic patch testing - recommendations on best practice [5]
- Research article Guidelines for measurement of skin colour and erythema. A report from the Standardization Group of the European Society of Contact Dermatitis [6]
- Research article Contact and photocontact sensitivity to sunscreens. Review of a 15-year experience and of the literature [7]
- Research article The European baseline series and recommended additions: 2019 [8]
- Research article Italian Guidelines in Patch Testing - adapted from the European Society of Contact Dermatitis (ESCD) [9]
- Research article Allergic Contact Dermatitis [10]
References
- de Graaf NPJ, Feilzer AJ, Kleverlaan CJ, Bontkes H, Gibbs S, Rustemeyer T. A retrospective study on titanium sensitivity: Patch test materials and manifestations. . 2018. PMID 29797739 · DOI · PMC6099462
- Knijp J, Bruynzeel DP, Rustemeyer T. Diagnosing lanolin contact allergy with lanolin alcohol and Amerchol L101. . 2019. PMID 30624788 · DOI · PMC6593808
- van Amerongen CCA, Ofenloch R, Dittmar D, Schuttelaar MLA. New positive patch test reactions on day 7-The additional value of the day 7 patch test reading. . 2019. PMID 31116435 · DOI · PMC6771944
- Uter W, Aerts O, Agner T, Brans R, Bruze M, Cannavó A, et al.. European Society of Contact Dermatitis Guideline for Diagnostic Patch Testing-Recommendations on Best Practice (Update 2026). . 2026. PMID 42324086 · DOI · PMC13441402
- Johansen JD, Aalto-Korte K, Agner T, Andersen KE, Bircher A, Bruze M, et al.. European Society of Contact Dermatitis guideline for diagnostic patch testing - recommendations on best practice. Contact Dermatitis. 2015. PMID 26179009 · DOI
- Fullerton A, Fischer T, Lahti A, Wilhelm KP, Takiwaki H, Serup J. Guidelines for measurement of skin colour and erythema. A report from the Standardization Group of the European Society of Contact Dermatitis. Contact Dermatitis. 1996. PMID 8896947 · DOI
- Schauder S, Ippen H. Contact and photocontact sensitivity to sunscreens. Review of a 15-year experience and of the literature. Contact Dermatitis. 1997. PMID 9412750 · DOI
- Wilkinson M, Gonçalo M, Aerts O, Badulici S, Bennike NH, Bruynzeel D, et al.. The European baseline series and recommended additions: 2019. Contact Dermatitis. 2019. PMID 30421432 · DOI
- Stingeni L, Bianchi L, Hansel K, Corazza M, Gallo R, Guarneri F, et al.. Italian Guidelines in Patch Testing - adapted from the European Society of Contact Dermatitis (ESCD). G Ital Dermatol Venereol. 2019. PMID 30717577 · DOI
- Nassau S, Fonacier L. Allergic Contact Dermatitis. Med Clin North Am. 2020. PMID 31757238 · DOI
About this article
- Sources
- NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
- Verification
- Every reference was resolved against PubMed on 2026-11-04; title, year and DOI matched.
- Review state
- automated source verified; no human expert review has been recorded yet.
- Version
- 1, last updated 2026-11-04.
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Evidence strength
EvidenceHelix's computed view of the study designs behind this topic: how common meta-analyses, randomized trials and reviews are, how recent the literature is, and a plain-language reading. It describes the design mix of the literature. It is not a quality appraisal of any study, and it is not medical advice.