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Year : 2002  |  Volume : 68  |  Issue : 5  |  Page : 281-282

Patch testing with Indian standard series

Department of Dermatology and Venereology, PSG Institute of Medical Science & Research, Peelamedu Coimbatore-641 004, India

Correspondence Address:
Department of Dermatology and Venereology, PSG Institute of Medical Science & Research, Peelamedu Coimbatore-641 004, India


Hundred patients (61 males, 39 females) suspected to have allergic contact dermatitis were patch tested with Indian standard series (ISS). Forty four showed one or more positive reactions. The frequent sensitizers observed were nickel sulphate-12 (15%), potassium dichromate-11 (13.75%), cobalt chloride and colophony-7 (8.75%) each, fragrance mix and thiuram mix-6 (7.5%) each. The ISS differs from the European Standard Series by inclusion of propylene glycol, nitrofurazone, gentamicin, chlorocresol, PEG-400 and ethylenediamine chloride where assesquiterpene lactone mix and primin allergens are excluded.

How to cite this article:
Narendra G, Srinivas C R. Patch testing with Indian standard series. Indian J Dermatol Venereol Leprol 2002;68:281-2

How to cite this URL:
Narendra G, Srinivas C R. Patch testing with Indian standard series. Indian J Dermatol Venereol Leprol [serial online] 2002 [cited 2020 Jul 6];68:281-2. Available from:

   Introduction Top

Until recently there was no standard patch test series for the Indian subcontinent. The Contact and Occupational Contact Dermatoses Forum of India has recommended the Indian Standard Series (ISS). The purpose of this study wss to find the frequency of sensitivity to its allergens and to recommend alterations if required.

   Materials and Methods Top

Hundred patients (61 males, 39 females), between 1 to 70 years with suspected allergic contact dermatitis were patch tested with ISS [Table - 1]. The allergens were obtained from Systopic Pharmaceuticals (P) Ltd., New Delhi. The standard patch testing technique using aluminium chambers was done and reactions were interpreted as recommended by ICDRG.

   Results Top

Details of the 28 allergens and the number of patients with positive reactions are shown in [Table - 1]. The most frequent sensitizers observed were nickel sulphate-12 (15%), potassium dichromate-11(13.75%), neomycin sulphate-10 (12.5%), cobalt chloride and colophony-7(8.75%) each while benzocaine, formaldehyde, PEG-400, wool alcohol, ethylenediamine chloride, black rubber mix, 4TBPF resin and quarternium 15 showed reactions.

   Discussion Top

Nickel was the most frequent sensitizer as reported by others.[1],[2],[3] Potassium dichromate was the next commonest sensitizer-11 (13.75%). Though its prevalence is decreasing, in developed countries,[4] it is still common in India as the construction industry is flourishing. Fragrance mix allergy formed a significant cause of contact dermatitis 6 (7.5%) in our study and may increase in the near future as more people are using perfumes and cosmetics.
Topical antibiotics and preservatives together accounted for 22 cases of contact dermatitis (27.5%) and is a major cause of iatrogenically induced dermatitis. In India many combination preparations such as a steroid with antibiotic, steroid with antifungal and even the combination of all the above three are available. These preparations are used for prolonged periods. A combination of antibiotic and steroid is used well after the infection has subsided or even on many an occasion when there is no bacterial infection to start with. This prolonged needless usage is possibly responsible for numerous cases of antibiotic sensitivity.[5],[6] Chlorocresol is included in ISS. This is the most commonest preservative used and we feel that it should be a part of any standard series.
Although parthenium sensitivity is quite rampant in India sesquiterpene lactone has not been included since
i) the diagnosis can most often be clinically made
ii) the reaction in the presence of sensitivity is at times severe enough to cause irritable back syndrome
iii) it must possible that the testing may precipitate the dermatitis in a person with subclinical sensitivity. ISS however can be extended with a plant series which is used whenever contact dermatitis to plants or parthenium is suspected. 

   References Top

1.Mohammed Osman Gad EI-Rod, OmarAbdulazizAl-Sheikh. Is the European stantard series suitable for patch testing in Riyadh, Saudi Arabia? Contact Dermatitis 1995;33: 310-314.  Back to cited text no. 1    
2.Castiglioni G, Carosso A, Manzon S, et al. Result of routine patch testing of 834 patients in Turin. Contact Dermatitis 1999;27: 182-185.  Back to cited text no. 2    
3.Hogan DJ, Hill M, Lane PR. Result of routine patch testing of 542 patients in Saskatoon, Canada. Contact Dermatitis 1988;19: 120-124.  Back to cited text no. 3    
4.J TE Lim, CL Goh SK. NG, et al. Changing trends in the epidermiology of contact dermatitis in Singapore. Contact Dermatitis 1992;26: 321-326.  Back to cited text no. 4    
5.George ND, Srinivas CR, Balachandran C, et al. Short communications. Sensitivity to various ingredients of topical preparations following prolonged use. Contact Dermatitis 1990;23:367-368.  Back to cited text no. 5    
6.Pasricha JS, Bharati Guru. Contact hypersensitivity to local antibacterial agents. Indian J Dermatol Venereal Lepr 1981;47: 27-30.  Back to cited text no. 6    


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