{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T19:35:06Z","timestamp":1783020906853,"version":"3.54.6"},"reference-count":22,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T00:00:00Z","timestamp":1710374400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Dermatitis\u00ae"],"published-print":{"date-parts":[[2024,4,1]]},"abstract":"\n \n \n Abstract: Background:<\/jats:italic>\n <\/jats:bold>\n <\/jats:underline>\n Doubtful patch test reactions generally do not meet criterion for positivity in patch testing. However, the North American Contact Dermatitis Group (NACDG) allows for doubtful reactions to be coded with a final determination of \u201callergic\/positive\u201d based on the temporal pattern, appearance, known characteristics of the allergen, and\/or other supportive patch test reactions.\n <\/jats:p>\n \n \n \n Objectives:<\/jats:italic>\n <\/jats:bold>\n <\/jats:underline>\n To analyze NACDG data from the 2019\u20132020 patch test cycle to identify patterns in the interpretation and relevance of doubtful reactions.\n <\/jats:p>\n \n \n \n Methods:<\/jats:italic>\n <\/jats:bold>\n <\/jats:underline>\n The frequency and proportions of doubtful reactions were tabulated and analyzed for patterns. Statistical analyses were limited to allergens with \u226530 doubtful reactions to ensure adequate sample size.\n <\/jats:p>\n \n \n \n Results:<\/jats:italic>\n <\/jats:bold>\n <\/jats:underline>\n Of patch-tested patients, 31.9% (1315\/4121) had \u22651 doubtful reaction. Of 2538 total doubtful reactions, 46% (n\u2009=\u20091167) had a final interpretation of \u201callergic\/positive.\u201d The allergens with the highest proportion of doubtful reactions at the final visit were hydroperoxides of linalool 1% (4.5%), fragrance mix I 8.0% (3.9%), and cetrimonium chloride 0.5% (3.4%). Methylchloroisothiazolinone\/methylisothiazolinone (MCI\/MI) 0.02% (\n P<\/jats:italic>\n \u2009<\u20090.001), MI 0.2% (\n P<\/jats:italic>\n \u2009<\u20090.001), nickel sulfate hexahydrate 2.5% (\n P<\/jats:italic>\n \u2009=\u20090.001), and neomycin sulfate 20.0% (\n P<\/jats:italic>\n \u2009=\u20090.003) doubtful reactions were more likely to be interpreted as allergic than nonallergic. Methyldibromoglutaronitrile\/phenoxyethanol 0.2% (\n P<\/jats:italic>\n \u2009<\u20090.001), oleamidopropyl dimethylamine 0.1% (\n P<\/jats:italic>\n \u2009<\u20090.001), formaldehyde 2.0% (\n P<\/jats:italic>\n \u2009<\u20090.001), cetrimonium chloride 0.5% (\n P<\/jats:italic>\n \u2009<\u20090.001), benzophenone-4 (sulisobenzone) 10% (\n P<\/jats:italic>\n \u2009<\u20090.001), iodopropynyl butylcarbamate 0.5% (\n P<\/jats:italic>\n \u2009<\u20090.001), cocamidopropyl betaine 1.0% (\n P<\/jats:italic>\n \u2009=\u20090.002), and benzisothiazolinone 0.1% (\n P<\/jats:italic>\n \u2009=\u20090.012) doubtful reactions were less likely to be interpreted as allergic. Of the 1167 doubtful reactions interpreted as allergic, 84.9% had current relevance.\n <\/jats:p>\n \n \n \n Conclusions:<\/jats:italic>\n <\/jats:bold>\n <\/jats:underline>\n Doubtful reactions were common and approximately one half were coded with a final interpretation of \u201callergic\/positive.\u201d Of those, most were clinically relevant. MCI\/MI, MI, nickel, and neomycin were more likely to be interpreted as allergic.\n <\/jats:p>","DOI":"10.1089\/derm.2023.0285","type":"journal-article","created":{"date-parts":[[2024,2,6]],"date-time":"2024-02-06T16:24:13Z","timestamp":1707236653000},"page":"138-143","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Allergic or Not: Final Interpretation of Doubtful Patch Test Reactions from the North American Contact Dermatitis Group, 2019\u20132020"],"prefix":"10.1177","volume":"35","author":[{"given":"Margo J.","family":"Reeder","sequence":"first","affiliation":[{"name":"From the, Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9159-2608","authenticated-orcid":false,"given":"Aman","family":"Nihal","sequence":"additional","affiliation":[{"name":"University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srikanth R.","family":"Aravamuthan","sequence":"additional","affiliation":[{"name":"From the, Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin M.","family":"Warshaw","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Park Nicollet Health Services, Minneapolis, Minnesota, USA."},{"name":"Department of Dermatology, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota, USA."},{"name":"Department of Dermatology, University of Minnesota, Minneapolis, Minnesota, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel G.","family":"DeKoven","sequence":"additional","affiliation":[{"name":"Division of Dermatology, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7434-0014","authenticated-orcid":false,"given":"Amber R.","family":"Atwater","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Duke University Medical Center, Durham, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Claude","family":"Houle","sequence":"additional","affiliation":[{"name":"Division of Dermatology, CHU de Quebec, Laval University, Quebec City, Quebec, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6522-1483","authenticated-orcid":false,"given":"Brandon L.","family":"Adler","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3686-7805","authenticated-orcid":false,"given":"Jonathan I.","family":"Silverberg","sequence":"additional","affiliation":[{"name":"Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James S.","family":"Taylor","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Cleveland Clinic, Cleveland, Ohio, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie D.","family":"Pratt","sequence":"additional","affiliation":[{"name":"Division of Dermatology, University of Ottawa, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1229-6673","authenticated-orcid":false,"given":"Donald V.","family":"Belsito","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Columbia University Irving Medical School, New York, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiade","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina B.","family":"Botto","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of California, San Francisco, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris M.","family":"Mowad","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Geisinger Medical Center, Danville, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cory A.","family":"Dunnick","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA; 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