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To the Editor.—
Dr. Epstein has suggested that the data we presented are compatible with the conclusion that the patient's reactions to stearyl alcohol preparations represented irritant rather than allergic responses. Unfortunately, Dr. Epstein did not have either the advantage of viewing the patch test reactions directly or of following the patient before, during, and after the period of her contact dermatitis. Having had this opportunity, we were aware of several aspects that present strong evidence for the presence of contact allergy, and that may not have been sufficiently stressed in the original report.First, we agree that it may be extremely difficult to distinguish irritant from allergic patch test reactions in some situations. In the patient we observed, however, we found that patch testing with commercial stearyl alcohol in standard concentration (30% in petrolatum) produced an irregular, eczematous reaction characteristic of allergy. This was in sharp contrast to the
Shore RN, Shelley WB. Patch Test Reactions-Reply. Arch Dermatol. 1974;110(2):300. doi:10.1001/archderm.1974.01630080088043