I am suffering from various types of allergic skin reactions since several years. Recently, I was told to get a skin allergy patch test done. Can you explain what this test is?

Skin allergic reactions pose a significant diagnostic challenge. This is because of the complex nature of allergy as a disorder and the complexity of the various immunological mechanisms involved in causing the allergy. An allergy patch test is mainly recommended for patients whose clinical features and blood investigations fail in helping physicians reach a conclusive diagnosis. The test patches are fixed on the sufferer’s upper back. However, in certain cases, if the upper back is clear of lesions, the test patches can be placed on upper arms. The inner surfaces of these patches contain several small chambers that have pre-filled allergens of most commonly suspected chemicals or metals. The patches are removed after 48-72 hours. The doctor then examines the tested areas of the skin and decides the positivity or negativity of the test based on the presence or absence of a reaction. The positive reactions produce redness under the chambers containing the most likely allergen, which is later correlated with the labels on top of these chambers to name the positive allergen. The degree of redness determines the severity grade of the reaction.

My daughter has red itchy blisters, which appear to be acne, on her face. What can be done?

Your daughter appears to be suffering from acne. However, the description of skin lesions as “itchy blisters” is somehow surprising as among the wide morphological range of acne lesions we don’t usually see blisters. They could be pustular pimples. Acne is the most common skin disorder affecting teenagers. The severity of acne is calculated based on the type of lesions, extent of the body area involved, its duration and response to the previous treatments. While face is the most common area involved, a large number of acne sufferers can also develop lesions on their chest, upper arms, upper back, lower back and even buttocks and upper thighs. Mostly, the acne lesions are non-itchy, however, severely inflamed lesions can become itchy. In your daughter’s case, we would recommend that she consult an experienced dermatologist for thorough clinical examination. Her dermatologist will design an appropriate treatment protocol, based on severity of her skin condition. She definitely needs to immediately stop scratching her acne lesions.