Norman B. Kanof

THE AMERICAN ACADEMY OF DERMATOLOGY PATCH TEST SERIES FOR CONTACT DERMATITIS

The patch test is essential for the definitive diagnosis and the competent management of allergic contact dermatitis. It can only be effectively studied by the accurate evaluation of this test. Despite the fact that the patch test does not duplicate the multiple applications, sweating and maceration of clinical exposure, it is safer and quicker for the identification of allergic contact dermatitis than trial and error or avoidance and re-exposure. Reliable in vitro tests may eventually be developed for this type of hypersitivity, but today the patch test is indispensable for proving the cause and directing the treatment of this frequently encountered clinical problem. The patch test is so well known that the term is widely used by the public. The basic principles on which the patch test are based are simple, and the execution of the test seems straightforward. Nonetheless, training and experience in the performance and interpretation of the test are necessary if the results obtained are to be valid. Patch tests have frequently been performed by persons lacking this necessary background, and the errors that have resulted have tarnished the image of the procedure, so that many dermatologists came to doubt the value of the patch test in their practices.

A Spray Surgical Dressing

Rezifilm, * a sterile spray of methacrylate resin in ethyl acetate, containing tetramethylthiuram disulfide (TMTD), and using dichlorodifluoromethane and trichloromonofluoromethane as propellants, was employed as a postoperative dressing following dermatologic surgical procedures on ambulatory office patients. Unsutured Sites.— Rezifilm was employed as a postoperative dressing on 216 unsutured surgical sites of basal-cell and prickle-cell epitheliomata, senile and seborrheic keratoses, soft fibromata, and nevi of various types. Following the removal of the lesion by excision, curettage, or electrosurgery, bleeding was controlled by chemical coagulants or electrocoagulation. Rezifilm was then sprayed in such a manner as to produce a uniform visible film over the wound and adjacent skin. No other surgical dressing was applied in most instances. Occasionally, a gauze and adhesive tape dressing was used for cosmetic reasons. Rezifilm did not produce any discomfort during the period of application. It dried quickly to form a soft, pliable, and visible but transparent film.