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Patch testing: Facts and controversies

机译：补丁测试：事实和争议

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The German dermatologist, Josef Jadassohn (1863-1936), first presented the results of his innovative patch-testing technique in 1895. The safety and efficacy of this diagnostic tool has stood the test of time and is still the gold standard for the diagnosis of allergic contact dermatitis (ACD).Since its discovery, much effort has been put into standardization and optimization of allergens, vehicles, and concentrations of patch-test materials; in procedures of its application; and in reading and scoring of test reactions-all contributing to the development of an accurate, reliable, and safe test with a high reproducibility of its results. Even this seemingly carved-in-stone practice, which has been used for nearly 120 years, has been questioned and challenged, engendering debates, disagreements, and controversies, which show no signs of coming to an end. Almost every step of the procedure has provoked discussions and controversies:. ?Who should be patch-tested??What should be the criteria for referral of patients to a patch-test clinic??What are the criteria for including an allergen in the standard patch-test series??Which chambers should be used in terms of size, material, and shape??What is the optimal occlusion time??What is the optimal test-reading time??What is the best way of scoring patch-test reactions??How should the relevance of positive patch tests be classified? (This latter issue, which is the crucial and most complex and tricky phase of the process, has paradoxically not created more controversies than other apparently less problematic parts of the procedure.).
机译：德国皮肤科医生Josef Jadassohn（1863-1936）于1895年首次展示了他创新的斑贴测试技术的结果。该诊断工具的安全性和有效性经受了时间的考验，仍然是诊断皮肤癌的金标准。自发现以来，已在标准化和优化变应原，赋形剂和斑贴试验材料的浓度方面投入了大量精力;在其应用程序中;以及对测试反应的阅读和评分-所有这些都有助于开发准确，可靠和安全的测试，并具有高度可重复的结果。甚至这种已经使用了近120年的看似刻板的做法也受到了质疑和挑战，引发了辩论，分歧和争议，这些迹象都没有结束的迹象。该过程的几乎每一步都引发了讨论和争议：谁应该进行斑块测试？将患者转诊至斑块测试诊所的标准是什么？在标准斑块测试系列中包括过敏原的标准是什么？应使用哪个隔室大小，材料和形状？最佳封堵时间是多少？最佳试读时间是多少？对斑贴试验反应进行评分的最佳方法是什么？如何对阳性斑贴试验的相关性进行分类？ （后一问题是该过程的关键，最复杂和棘手的阶段，自相矛盾的是，没有比该过程中其他看起来问题少的部分引起更多争议。）

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