Original articleRelationship between skin prick and atopic patch test reactivity to aeroallergens and disease severity in children with atopic dermatitis
Introduction
Atopic dermatitis (AD) affects children with a wide degree of severity. The immunological mechanism in aetiology of AD shows significant differences from other allergic diseases. Allergen exposure plays an important role in AD. Allergen inhalation exacerbates AD lesions and AD patients’ complaints decrease in house dust mite (HDM) low level environments, which reveals the importance of inhalant allergens in AD.1, 2
It was shown that HDM are capable of inducing the release of multiple chemokines and pro-inflammatory cytokines from epidermal keratinocytes and dermal fibroblasts.3
The basic role of T lymphocyte in the physiopathology of AD lesions and its importance in late reactions4, 5 brings forth the atopy patch test (APT) despite its controversial diagnostic value in clinical use.6
We evaluated the skin prick (SPT) and APT reactivity to aeroallergens and studied the relationship of test results to the clinical characteristics of children with AD.
Section snippets
Materials and methods
The study was approved by the local ethics committee, and written informed consent was given by the child's parents prior to enrolment.
Forty-five children aged 2–15 years with AD who applied to GATA Haydarpasa Teaching Hospital, Department of Allergy between May 2006 and 2007 were included in the study. All patients were tested using the prick test method with lancet. A standardised panel (ALK-Abello, Madrid, Spain) including HDM (Dermatophagoides pteronyssinus (Dp) and Dermatophagoides farinea
Results
45 patients, 21 (46.7%) male and 24 (53.3%) female, diagnosed with atopic dermatitis, were included in the study according to the Hanifin Rajka criteria. Mean age of the patients was 82.77 ± 43.76 (24–180) months. Average age of onset was 26.44 ± 28.8 (2–120) months. 25% of the patients were at or under the age of three. Mean duration of disease was 56 ± 41.1 (9–174) months.
SPT were positive in 68.9% of patients with aeroallergens. The HDM was the most common allergen (Fig. 1).
Highest positivity of
Discussion
Rapidly developing symptoms (type-1 reactions) caused by allergens in allergic diseases can be easily diagnosed with detailed anamnesis, skin tests and/or specific IgE level measurements. However, diagnostic approaches are rather complex in late onset reactions, such as AD. The role of pollutants and allergens of the indoor air in the pathogenesis and clinical features of AD have not been investigated in detail.
It is reported that APT has a higher specificity than SPT and sIgE in the evaluation
Protection of human subjects and animals in research
The authors declare that the procedures followed were in accordance with the regulations of the responsible Clinical Research Ethics Committee and in accordance with those of the World Medical Association and the Helsinki Declaration.
Confidentiality of data
The authors declare that they have followed the protocols of their work centre on the publication of patient data and that all the patients included in the study have received sufficient information and have given their informed consent in writing to participate in
Conflict of interest
The authors have no conflict of interests to declare.
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