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g. an antibiotic.) The classical type IV allergic CD is a T-cell mediated reaction against small molecular weight substances (diglyceride to the GP. Allergic CD is frequent in people treated for atopic dermatitis due to the impairment of the skin barrier and the frequent use of different external emollients [49]. The diagnosis of CD is limited to the use of a skin patch test. This test uses a wide battery of contact allergens, normally diluted in petroleum. The test is applied to the back for 48?h and read twice after 48 and 72?h. The time-course may vary: reaction to corticosteroids have a slower time course and the test needs to be read at 96?h or even later. The most frequent contact allergens are combined in European or national standard series, however, the skill in diagnosis is detecting the more rare allergens. In selected occupational settings, it is crucial to have the relevant allergens available for testing. The patch test can be performed with the patient's own products with previous dilution. The major difficulty in reading the patch test is due to the irritant nature of contact allergens per se. The skin patch test needs to be postponed if very severe and acute reactions are present, because a patch test might provoke a flare of an already active eczema If the patch test is performed too early false positive reactions due to the activated skin immune system (��angry learn more back��) may hamper the diagnosis. An ��angry back�� should be suspected if more than seven nonrelated contact allergic reactions appear in a patch test. UV light reduces the skin immune functions so after tanning of the skin patch testing should thus be postponed for 4�C6?weeks. While a more sophisticated testing for contact allergic reactions need a referral to a dermatologist, already at the GPs office a good workup can be ensured by checking closely the patient's history S3I-201 price or already asking the patient to start writing a diary on when these reactions happen, reminding the patient that contact allergic reactions are delayed, usually at 12�C72?h after the application of the possible ingredient. The diagnosis of allergic diseases involves a thorough clinical history, further supported by in vivo or in vitro testing. Additional procedures such as challenge tests are needed to establish the correct diagnosis (Table?4). In accordance with the significant workload in a PC setting, simplified pathways for recognition and diagnosis of allergic diseases are proposed, that should be further adapted to local (national) conditions. The authors declare no conflicts of interest.