WITH DR. TAMARA LAZIC STRUGAR
Dr. Lazic’s passion for diagnosing and treating skin allergies is inspired by her mentor and role model, the contact dermatitis guru, Dr. Vincent DeLeo. He is an author of the renowned textbook “Contact and Occupational Dermatology”, and the Founder and Chairman Emeritus of the Department of Dermatology and Residency training program at Mount Sinai St Luke’s- Roosevelt Hospital Center, as well as co-founder of the Skin of Color Center and the Skin of Color Society. Dr. DeLeo and Dr. Lazic met in 2012, when he hired her to join the Department; she has continued to learn about the field of dermatology and contact dermatitis from him ever since.
Contact dermatitis is a rash that occurs when your skin comes into contact with a substance that causes a reaction by your immune system. There are two types of contact dermatitis: irritant and allergic. contactdermatitisinstitute.com
Allergic contact dermatitis is a rash caused by an allergic reaction to a chemical that touches your skin. The rash typically develops days after contact with an allergen, not immediately, which makes it difficult to trace the source. Common contact allergens include ingredients in cosmetics (e.g. fragrances, preservatives), rubber, metals (most commonly nickel), plants, dyes and formaldehyde from clothing.
Once a diagnosis of allergic contact dermatitis is made, Dr. Lazic will provide a personalized consultation, and schedule your patch test. With this type of allergy testing, Dr. Lazic can help determine what you are allergic to, so that you know what ingredients to avoid in products.
Patch testing is used to assess your skin’s reaction to a variety of substances with which you come in contact at home, at work, or during recreational activities. It involves applying a purified allergen to your skin to see if it causes an allergic reaction. Typically, 8 to 10 hypoallergenic stickers are placed on the back for about 48 hours, at which point they are removed and the back is marked with a surgical pen. Around 72-96 hours, results are analyzed. The back must remain dry throughout the testing process. There are no needles or “pricking” used in this form of allergy testing (note that patch testing is not the same as prick testing, which is a different type of allergy test used to diagnose hay fever or food allergies).
Once we’ve identified the cause of the allergic reaction, we provide you with the name of the ingredient, as well as any aliases that may be used by various manufacturers, so you know what to look for when shopping for new products. We also provide a customized list of products that are safe to use via the CAMP Program. www.contactdermatitisinstitute.com
After the initial consultation, the patch testing process consists of 3 visits:
Typically done on a Monday, we place the adhesive patches on your back. Please shower on Monday morning prior to your visit, but do NOT apply any lotions/ perfume/ medicated creams or any other products on your back.
After the patches are placed, please DO NOT GET YOUR BACK WET until (ideally) Thursday evening, after the last visit.
If you need to take a shower on Wednesday evening, please do not scrub the back, in order to preserve the pen markings. Sponge baths are preferable at this point. Furthermore, the patches must remain firmly adherent to your skin; exercise and other activities which may loosen the patches are discouraged.
Typically, on a Wednesday, we remove the adhesive patches from your back, and mark your back with a surgical marker.
Since your back will be somewhat sticky and marked, you may wish to BRING AN OLD T-SHIRT, as the ink can rub off on clothing. These pen markings must remain dry until Thursday’s final visit.
Typically, on a Thursday afternoon, Dr. Lazic will interpret and discuss your results. You can resume all your normal activities after this visit.
1. Should the patch/adhesive tape become loose, apply additional tape to reattach the edges to the original area.
2. Avoid scratching the areas as this may interfere with the results. If you feel itchy, you may take an antihistamine (Allegra/Zyrtec/Claritin during the day, Benadryl at night). Do not apply any creams/medications to your back.
3. Do not expose the area to the sun/UV light during the testing or a week prior, as this may interfere with the results.
4. In order to obtain accurate patch test results, please avoid the following medications:
• oral (Prednisone) or injectable steroids 4 weeks prior to patch testing
• medicated creams/ointments on your back for 7 days prior to patch testing (may be used on other affected areas of the body, but not the back)
• if you are on any oral immunosuppressive medications, please notify us
5. Occasionally, some patients may have vigorous local reactions to some substances. This may result in itchy discomfort, which can be treated at the final follow-up appointment, after the patch test. In addition, some of the chemicals (allergens) can temporarily stain the skin; this will fade with time.
6. Rarely, you may observe a reaction at the test site as late as 2-3 weeks after your visit. If this happens, please report it to us (take photos and email to us), as it may be an important result.
“Dermatology, like a photograph, is an open secret. The lesions present on the surface, the diagnoses, however, can lead to the most remote of etiologies, making the clinical work a daily discovery.”
“Skin may seem like a border between individuals and their environment, but really it is a window to the diseases experienced by the body.”
“By practising Dermatology, I crossed over yet another border as a physician who understands that what matters most about what one sees is its link to what lies beneath.”
“In my quest to shed boundaries that are either trivial or artificial, I have chosen a profession in which I will cross daily the very boundary whose integrity is the sine qua non of our existence: the skin.”
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