Differences in skin‐prick and patch‐test reactivity are related to the heterogeneity of atopic eczema in infants

Kekki, Outi-Maria; Turjanmaa, K.; Isolauri, Erika

doi:10.1111/j.1398-9995.1997.tb01234.x

Cited by 72 publications

(59 citation statements)

References 15 publications

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“…This result is important because it suggests that the E-patch \ would probably not promote systemic delivery of intact proteins, thereby reducing the possibility of systemic anaphylactic shocks. This is in agreement with the fact that no incident of anaphylactic shock has been described during clinical trials of APT (1,5,15,31).…”

Section: Discussionsupporting

confidence: 90%

“…It has been described that this type of reaction, accompanied by occasional palpable infiltration or eczema, tends to grow stronger between 48 and 72 h (1,12,15,16). This inflammatory reaction on the skin is mainly caused by the liberation of histamine.…”

Section: Introductionmentioning

confidence: 97%

“…This occlusive delivery system is intended to be prepared and secured on the skin of children by the medical practitioner. The occlusion time is 48 h and the results are read 24 h later (1,5,15). However, these tests suffer from many drawbacks including the absence of standardization (13,15Y17).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Skin Localization of Cow’s Milk Proteins Delivered by a New Ready-to-Use Atopy Patch Test

et al. 2005

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The E-patch system allows native beta-lactoglobulin to concentrate in the stratum corneum, in the vicinity of immunological cells, but does not lead to its systemic delivery. Therefore, it is suggested that this delivery system creates ideal conditions for promoting a positive topical response with reduced risk of systemic anaphylactic reactions caused by the native form of the beta-lactoglobulin A.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 97%

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Skin Localization of Cow’s Milk Proteins Delivered by a New Ready-to-Use Atopy Patch Test

et al. 2005

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“…Evidence for a good predictive value of the APT for late-onset reactions comes from Finland; the APT was positive in 89% of patients with delayed reactions in food challenge tests. Twenty-six percent of cow's milk-allergic children were detectable by APT only [37,38].…”

Section: Sensitivity Specificity and Reproducibilitymentioning

confidence: 98%

Lessons from atopy patch testing in Atopic Dermatitis

Kerschenlohr

Darsow

Burgdorf

et al. 2004

Curr Allergy Asthma Rep

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The exposure of atopic eczema (AE) patients to their relevant protein allergens (eg, from house dust mite, cat dander, grass pollen, or food allergens) can trigger an exacerbation or maintain the disease. Diagnostic procedures are needed to specify allergen avoidance recommendations for the individual patient. Skin prick tests and specific serum IgE tests might be helpful in pointing out potential trigger factors, but relevance needs to be confirmed (eg, with food provocation tests). The atopy patch test (APT) involves the epicutaneous application of intact protein allergens in a diagnostic patch test setting with an evaluation of the induced eczematous skin lesions after 24 to 72 hours. The APT targets the cellular component of AE and helps round out the AE test spectrum. As a number of apparently minor test modifications greatly influence the sensitivity, specificity, and reproducibility of the APT, the European Task Force on Atopic Dermatitis (ETFAD) has developed a standardized APT technique. It consists of purified allergen preparations in petrolatum, applied in 12-mm diameter Finn chambers mounted on Scanpor tape to non-irritated, non-abraded, or tape-stripped skin of the upper back. The APT is read at 48 and 72 hours according to the test criteria and reading key of the ETFAD for appearance of erythema, and number and distribution pattern of the papules. In contrast with skin prick tests, the APT might even detect a relevant sensitization in the absence of specific IgE. Many studies have been undertaken to objectify the sensitivity and specificity of the APT to show its diagnostic use in clinical practice.

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“…APTs were standardized and performed using a Finn chamber occluded during 48 h, according to the method described by Kekki et al (1997). APTs were performed with CM, hen's egg, codfish, wheat flour, soy flour and roasted peanut.…”

Section: Outcomes Measurementmentioning

confidence: 99%

A non-hydrolyzed, fermented milk formula reduces digestive and respiratory events in infants at high risk of allergy

et al. 2010

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Background/Objectives: To determine the impact of a not hydrolyzed fermented infant formula containing heat-killed Bifidobacterium breve C50 and Streptococcus thermophilus 065 (HKBBST) on the incidence of allergy-like events during the first 2 years of life in children at high risk of atopy. Subjects/Methods: This multicenter, randomized, double-blind, controlled study included infants at high risk of atopy. Infants used HKBBST or a standard infant formula (SIF) since birth until 1 year of age, and were followed at 4, 12 and 24 months after birth. Skin prick tests (SPTs) for six foods and six aeroallergens were systematically performed and adverse events (AEs) were recorded. In case of potentially allergic AE (PAAE), allergy could be further tested by SPT, patch tests and quantification of specific IgEs. If cow's milk allergy (CMA) was suspected, an oral challenge could also be performed. Results: The study included 129 children, 63 were randomized to SIF, 66 to HKBBST. The use of HKBBST milk did not alter the proportion of CMA but decreased the proportion of positive SPT to cow's milk (1.7 vs 12.5%, P ¼ 0.03), and the incidence of digestive (39 vs 63%, P ¼ 0.01) and respiratory potentially allergic AEs (7 vs 21%, P ¼ 0.03) at 12 months, and that of respiratory PAAEs at 24 months (13 vs 35%, P ¼ 0.01). Conclusions: HKBBST decreased the incidence of PAAEs in children with family history of atopy, during the first months of life and after the formula was stopped. Oral tolerance to cow's milk in infants at high risk of atopy may therefore be improved using not hydrolyzed fermented formulae.

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Differences in skin‐prick and patch‐test reactivity are related to the heterogeneity of atopic eczema in infants

Cited by 72 publications

References 15 publications

Skin Localization of Cow’s Milk Proteins Delivered by a New Ready-to-Use Atopy Patch Test

Skin Localization of Cow’s Milk Proteins Delivered by a New Ready-to-Use Atopy Patch Test

Lessons from atopy patch testing in Atopic Dermatitis

A non-hydrolyzed, fermented milk formula reduces digestive and respiratory events in infants at high risk of allergy

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