Combined skin prick and patch testing enhances identification of food allergy in infants with atopic dermatitis - PubMed (original) (raw)
Clinical Trial
Combined skin prick and patch testing enhances identification of food allergy in infants with atopic dermatitis
E Isolauri et al. J Allergy Clin Immunol. 1996 Jan.
Abstract
Background: Early recognition of dietary allergies in infants with atopic dermatitis is essential for avoidance of unnecessary elimination diets, amelioration of the skin disease, and secondary prevention of the development of multiple food allergies. Simple and accurate methods of identifying provocative foods are urgently needed.
Methods: The usefulness of skin prick and patch tests as indicators of cow milk allergy was evaluated in 183 patients ranging in age from 2 to 36 months with double-blind, placebo-controlled (n = 118) or open (n = 65) cow milk challenges.
Results: The oral cow milk challenges were interpreted as positive in 54% of both challenge types. Positive challenge rapidly elicited pruritus, urticaria, and/or exanthema in 49% of cases and delayed-onset eczematous lesions in 51%. The skin prick and patch tests gave markedly discrepant results; prick tests were positive in 67% of the cases with acute-onset reactions to milk challenge, whereas patch tests tended to be negative. Patch tests were positive in 89% of those with delayed-onset reactions, although prick tests were frequently negative.
Conclusions: The observations indicate that IgE and T cell-mediated responses to cow milk can be distinguished in atopic dermatitis. Parallel skin testing with combined prick and patch tests can significantly enhance the accuracy in diagnosis of specific dietary allergies in patients with atopic dermatitis.
Similar articles
- Differences in skin-prick and patch-test reactivity are related to the heterogeneity of atopic eczema in infants.
Kekki OM, Turjanmaa K, Isolauri E. Kekki OM, et al. Allergy. 1997 Jul;52(7):755-9. doi: 10.1111/j.1398-9995.1997.tb01234.x. Allergy. 1997. PMID: 9265992 Clinical Trial. - Late onset reactions to oral food challenge are linked to low serum interleukin-10 concentrations in patients with atopic dermatitis and food allergy.
Sütas Y, Kekki OM, Isolauri E. Sütas Y, et al. Clin Exp Allergy. 2000 Aug;30(8):1121-8. doi: 10.1046/j.1365-2222.2000.00861.x. Clin Exp Allergy. 2000. PMID: 10931119 Clinical Trial. - Atopy patch test in the diagnosis of food allergy in children with atopic eczema dermatitis syndrome.
Cudowska B, Kaczmarski M. Cudowska B, et al. Rocz Akad Med Bialymst. 2005;50:261-7. Rocz Akad Med Bialymst. 2005. PMID: 16358980 - Accuracy of skin prick tests in IgE-mediated adverse reactions to bovine proteins.
Fiocchi A, Bouygue GR, Restani P, Bonvini G, Startari R, Terracciano L. Fiocchi A, et al. Ann Allergy Asthma Immunol. 2002 Dec;89(6 Suppl 1):26-32. doi: 10.1016/s1081-1206(10)62119-9. Ann Allergy Asthma Immunol. 2002. PMID: 12487201 Review. - "Atopy patch tests" in the diagnosis of delayed food hypersensitivity.
Turjanmaa K. Turjanmaa K. Allerg Immunol (Paris). 2002 Mar;34(3):95-7. Allerg Immunol (Paris). 2002. PMID: 12012795 Review.
Cited by
- The use of patch testing in the diagnosis of food allergy.
Spergel JM, Brown-Whitehorn T. Spergel JM, et al. Curr Allergy Asthma Rep. 2005 Jan;5(1):86-90. doi: 10.1007/s11882-005-0061-5. Curr Allergy Asthma Rep. 2005. PMID: 15659270 Review. - Allergic proctocolitis refractory to maternal hypoallergenic diet in exclusively breast-fed infants: a clinical observation.
Lucarelli S, Di Nardo G, Lastrucci G, D'Alfonso Y, Marcheggiano A, Federici T, Frediani S, Frediani T, Cucchiara S. Lucarelli S, et al. BMC Gastroenterol. 2011 Jul 16;11:82. doi: 10.1186/1471-230X-11-82. BMC Gastroenterol. 2011. PMID: 21762530 Free PMC article. - Allergic components of eosinophilic esophagitis.
Spergel J, Aceves SS. Spergel J, et al. J Allergy Clin Immunol. 2018 Jul;142(1):1-8. doi: 10.1016/j.jaci.2018.05.001. J Allergy Clin Immunol. 2018. PMID: 29980277 Free PMC article. Review. - Pediatric food allergy update.
Bangash SA, Bahna SL. Bangash SA, et al. Curr Allergy Asthma Rep. 2005 Nov;5(6):437-44. doi: 10.1007/s11882-005-0023-y. Curr Allergy Asthma Rep. 2005. PMID: 16216167 Review. - Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel.
NIAID-Sponsored Expert Panel; Boyce JA, Assa'ad A, Burks AW, Jones SM, Sampson HA, Wood RA, Plaut M, Cooper SF, Fenton MJ, Arshad SH, Bahna SL, Beck LA, Byrd-Bredbenner C, Camargo CA Jr, Eichenfield L, Furuta GT, Hanifin JM, Jones C, Kraft M, Levy BD, Lieberman P, Luccioli S, McCall KM, Schneider LC, Simon RA, Simons FE, Teach SJ, Yawn BP, Schwaninger JM. NIAID-Sponsored Expert Panel, et al. J Allergy Clin Immunol. 2010 Dec;126(6 Suppl):S1-58. doi: 10.1016/j.jaci.2010.10.007. J Allergy Clin Immunol. 2010. PMID: 21134576 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical