Allergy Patch Testing Wizard Name Step 1: Enter patient details Step 2: Select all positive reactions and their respective severity in the form below Step 3: Submit the form to view your summary First name Last name Date of birth Panel 1 Nickel Sulphate Balsam of Peru Colophony Diazolidinylurea (Germal II) 4-Phenylenediamine Base 2-Mercaptobenzothiazole (MBT) Formaldehyde Potassium Dichromate Wool Alcohols Epoxy Resins (Araldite) Panel 2 Methyldibromoglutaronitrile (MDBGN) Neomycin sulphate Cobalt chloride Imidazolidinylurea (Germal115) Paraben Mix Thiuram Mix Mercapto Mix Fragrance Mix Black Rubber Mix Cl+Me-isothiazolinone (Kathon GC) Panel 3 Euxyl K 400 Sesquiterpene lactone Mix Fragrance Mix II 4-tert-Butylphenol formaldehyde resin Toluene sulphonamide formaldehyde resin Quaternium 15 (Dowicil 200) Tixocortol-21-pivalate Benzocaine Budesonide Propylene glycol Panel 4 Benzyl alcohol Tea Tree Oil Cetyl steryl alcohol Compositae Mix 4-Chloro-3-cresol (PCMC) Basic Red 46 Chloroacetamide Methylprednisolone Dialkyl Thiourea Mix Coconut diethanolamide Panel 5 DMDN Hydantoin Carba Mix dl-Limonene (Dipentene) Oxybenzone (Benz3) Sulisobenzone (Benz4) Benzalkonium chloride Lyral Disperse Blue 106 + 124 Mix Amerchol L 101 Diprosone Ointment (21 dipropionate) Panel 6 Bufexamac Parson MCX, Escalol 557 4-Chloro-3-xylenol (PCMX) Triethanolamiine Betamethasone 17 valerate Cinchocaine hydrochloride dibucaine Triamcinolone acetonide Lidocaine Iodopropinyl butyl carbamate Methylisothiazolinone Summary