Objective Assessment of Allergic Patch Test Reactions: Evaluation of a 3D Imaging System Versus Standard iPad Imaging for Patch Test Reactions

Abstract: Background: Patch testing is the gold standard for diagnosing contact allergies, but its diagnostic accuracy can be influenced by subjective visual assessment and variability in measurement using 2D imaging systems. Objective: This study evaluated the accuracy of the Iko Derma Monitor 3D imaging system in comparison to a standard clinic iPad for patch test reaction evaluation. Methods: Forty-two patients undergoing patch testing were included, yielding 293 evaluated reactions. Reactions were imaged on day 2 and day 4 using the Iko Derma Monitor, an iPad, and a handheld dermatoscope. Measurements of lesion area were compared across imaging modalities, and statistical tests were conducted to assess changes over time and accuracy differences between the Iko Derma Monitor and iPad. Results: The 3D imaging device demonstrated significantly higher accuracy than the iPad when compared to the dermatoscope as the reference standard ( P < 0.001). Both devices detected significant changes in lesion area over time, but the 3D device provided more consistent and sensitive measurements. Conclusion: The Iko Derma Monitor 3D camera offers superior accuracy and sensitivity compared to iPad-based imaging for patch test reactions. Its ability to standardize documentation may improve diagnostic precision and expand access to remote or underserved populations.