Improving Patch Test Interpretation in Skin of Color: Development and Evaluation of an Asynchronous Educational Module.

BACKGROUND

Patch testing is the gold standard for diagnosing allergic contact dermatitis, yet interpretation in patients with skin of color (SOC) can be challenging, as positive reactions may appear differently. Limited SOC-specific training may further contribute to diagnostic gaps.

OBJECTIVE

To develop and evaluate an asynchronous, web-based module to improve health care provider recognition and interpretation of patch test reactions in SOC.

METHODS

Clinical photographs across Fitzpatrick skin types I-VI were used to create a handout and PowerPoint covering reaction grading, features more common in SOC, interpretation strategies, and population-specific allergens. Forty health care providers completed pre- and post-intervention surveys on confidence, knowledge, and perceptions of the materials.

RESULTS

Overall confidence in patch test interpretation increased significantly, including confidence specific to patients with SOC. Recognition of SOC-specific erythema characteristics and positive reaction patterns improved by more than 20 percentage points, and knowledge of population-specific allergens improved substantially. Participants rated the materials as highly helpful.

CONCLUSIONS

This asynchronous, SOC-focused educational intervention improved health care provider confidence and accuracy in interpreting patch tests, supporting the value of targeted training to reduce diagnostic disparities and enhance care.