The SLS provocative patch test in allergic contact sensitization.

1. In the increasingly chemical environment of modern life, there are individuals whose marginal state of contact sensitization may not be revealed by standard methods of patch test- ing. The substances are often comparatively weak allergens with extremely limited capacity to penetrate normal skin. 2. Provocative patch tests magnify the manifestations of allergic contact dermatitis. Threshold states of contact sensitization are brought to light. Provocative testing is indispensable in screening new substances for allergenic potentiality. 3. Physical and chemical insults which mildly damage the skin may act as provocative agents. Physical injuries such as sandpapering and ultraviolet radiation are inferior to chemical insults. 4. The promoting effect of provocative tests is mediated by assuring penetration into the immunologic target tissue by damaging the horny layer barrier and by initiating a mild inflammatory response which conditions the tissue to react in an exaggerated but specific way to allergens. 5. Sodium lauryl sulfate (SLS) was the most effective provocative agent. The SLS provocative test is performed by pre-treating the skin for one hour with a 10% aqueous solution of SLS.