Author(s): Sharon E. Jacob and Shehla Admani
Patch testing is the gold standard for diagnosis of allergic contact dermatitis, though irritant reactions may be seen as well. ‘Doubtful’ reactions showing only macular erythema can at times be difficult to distinguish between irritant from allergic reactions, especially in patients with impaired skin barriers. We use the ‘pull test’ technique to help delineate irritant reactions.