Nonanoic acid irritation ‐ A positive control at routine patch testing?

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Abstract
A false negative patch test can be related to errors in the testing procedure, or to a defect in the eliciting (efferent) phase of the immune response. To define this phase the application of a topical irritant (a “positive control”) is suggested. Various concentrations of non‐anoic acid in 1‐propanol were applied to 116 healthy volunteers and to 75 dermatitis patients. Dose‐response curves were obtained (concentrations 5, 10, 20 and 39.9 %). Twenty percent nonanoic acid produced skin reactions in 90.1–93.9 % of the subjects. The lesions consisted mainly of erythema at 48 h and pigmentation at 96 h. We suggest that the most interesting patients are those negative to this primary irritant and that they should be further evaluated.

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