Basics in Diagnostic Work Up and Assessment of Clinical Relevance

  • Jeanne D. JohansenEmail author
  • Ulrik Fischer Friis
  • Jacob P. Thyssen


Advice is given about diagnostic work-up in patients with suspected contact dermatitis. Advice on exposure assessment, use of ingredient labelling, and pitfalls in safety data sheets are outlined. How to reach a decision on clinical relevance is described. The European, Chinese and North American baseline series are given as examples of basic investigations. A flow-diagram gives easy guidance to process of diagnostic work-up and final diagnosis.


Medical history Diagnostic work-up Baseline series Exposure assessment Ingredient labelling Safety data sheets Spot tests Clinical relevance Diagnosis 


  1. 1.
    Chemotechnique Diagnostics. Last accessed 31 Jan 2015.
  2. 2.
    Johansen JD, Aalto-Korte K, Agner T, Andersen KE, Bircher A, Bruze M, Cannavó A, Giménez Arnau A, Gonçalo M, Goossens A, John SM, Lidén C, Lindberg M, Mahler V, Matura M, Rustemeyer T, Serup J, Spiewak R, Thyssen JP, Vigan M, White I, Wilkinson M, Uter W. European Society of Contact Dermatitis guideline for diagnostic patch testing. Recommendations of best practice. Contact Dermatitis. 2015. doi:  10.1111/cod.12432. [Epub ahead of print]Google Scholar
  3. 3.
    Bruze M, Condé-Salazar L, Goossens A, Kanerva L, White IR. Thoughts on sensitizers in a standard patch test series. The European Society of Contact Dermatitis. Contact Dermatitis. 1999;41(5):241–50.CrossRefPubMedGoogle Scholar
  4. 4.
    Fischer LA, Voelund A, Andersen KE, Menné T, Johansen JD. The dose-response relationship between the patch test and ROAT and the potential use for regulatory purposes. Contact Dermatitis. 2009;61(4):201–8.CrossRefPubMedGoogle Scholar
  5. 5.
    Friis UF, Menné T, Thyssen JP, Johansen JD. A patient’s drawing helped the physician to make the correct diagnosis: occupational contact allergy to isothiazolinone. Contact Dermatitis. 2012;67(3):174–6.CrossRefPubMedGoogle Scholar
  6. 6.
    Friis UF, Menné T, Flyvholm MA, Bonde JP, Johansen JD. Difficulties in using Material Safety Data Sheets to analyse occupational exposures to contact allergens. Contact Dermatitis. 2015;72(3):147–53.CrossRefPubMedGoogle Scholar
  7. 7.
    Thyssen JP, Skare L, Lundgren L, Menné T, Johansen JD, Maibach HI, Lidén C. Sensitivity and specificity of the nickel spot (dimethylglyoxime) test. Contact Dermatitis. 2010;62(5):279–88.CrossRefPubMedGoogle Scholar
  8. 8.
    Julander A, Skare L, Vahter M, Lidén C. Nickel deposited on the skin-visualization by DMG test. Contact Dermatitis. 2011;64(3):151–7. Erratum in: Contact Dermatitis. 2012;66(1):53.CrossRefPubMedGoogle Scholar
  9. 9.
    Bruze M. What is a relevant contact allergy? Contact Dermatitis. 1990;23:224–5.CrossRefPubMedGoogle Scholar
  10. 10.
    Friis UF, Menné T, Flyvholm MA, Bonde JP, Johansen JD. Occupational allergic contact dermatitis diagnosed by a systematic stepwise exposure assessment of allergens in the work environment. Contact Dermatitis. 2013;69(3):153–63.CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Jeanne D. Johansen
    • 1
    Email author
  • Ulrik Fischer Friis
    • 1
  • Jacob P. Thyssen
    • 1
  1. 1.National Allergy Research Centre, Department of Dermato-AllergologyCopenhagen University Hospital GentofteHellerupDenmark

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