Notice the array of erythema in each skin tone. In the lighter spectrum, the positive patch test is pink to red. As the skin tone darkens, the results become slightly more hyperpigmented. When interpreting patch tests, the value of palpation should not be underestimated. Side lighting is a helpful tool to identify the elevation of a positive patch test. Note, if a brisk positive reaction occurs in a darker skin tone, the risk of hyperpigmentation increases.

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