Skin prick testing is an essential test procedure to confirm sensitization in IgE-mediated allergic disease in subjects with rhinoconjunctivitis, asthma, urticaria, anapylaxis, atopic eczema and food and drug allergy. This manuscript reviews the available evidence including Medline and Embase searches, abstracts of international allergy meetings and position papers from the world allergy literature. The recommended method of prick testing includes the appropriate use of specific allergen extracts, positive and negative controls, interpretation of the tests after 15 – 20 minutes of application, with a positive result defined as a wheal ≥3 mm diameter. A standard prick test panel for Europe for inhalants is proposed and includes hazel (Corylus avellana), alder (Alnus incana), birch (Betula alba), plane (Platanus vulgaris), cypress (Cupressus sempervirens), grass mix (Poa pratensis, Dactilis glomerata, Lolium perenne, Phleum pratense, Festuca pratensis, Helictotrichon pretense), Olive (Olea europaea), mugwort (Artemisia vulgaris), ragweed (Ambrosia artemisiifolia), Alternaria alternata (tenuis), Cladosporium herbarum, Aspergillus fumigatus, Parietaria, cat, dog, Dermatophagoides pteronyssinus, Dermatophagoides farinae, and cockroach (Blatella germanica). Standardization of the skin test procedures and standard panels for different geographic locations are encouraged worldwide to permit better comparisons for diagnostic, clinical and research purposes.

SynopsisAs the proportion of the ageing population in industrialized countries continues to increase, the dermatological concerns of the aged grow in medical importance. Intrinsic structural changes occur as a natural consequence of ageing and are genetically determined. The rate of ageing is significantly different among different populations, as well as among different anatomical sites even within a single individual. The intrinsic rate of skin ageing in any individual can also be dramatically influenced by personal and environmental factors, particularly the amount of exposure to ultraviolet light. Photodamage, which considerably accelerates the visible ageing of skin, also greatly increases the risk of cutaneous neoplasms. As the population ages, dermatological focus must shift from ameliorating the cosmetic consequences of skin ageing to decreasing the genuine morbidity associated with problems of the ageing skin. A better understanding of both the intrinsic and extrinsic influences on the ageing of the skin, as well as distinguishing the retractable aspects of cutaneous ageing (primarily hormonal and lifestyle influences) from the irretractable (primarily intrinsic ageing), is crucial to this endeavour. Ré suméComme le pourcentage de la population vieillissante dans les pays industrialisés s'accroît, les préoccupations dermatologiques des personnes âgées augmentent en importance sur le plan médical. Les modifications structurelles intrinsè-ques sont une conséquence naturelle du vieillissement et sont génétiquement déterminées. La vitesse de vieillissement diffère significativement selon les différentes populations et selon les différ-ents sites anatomiques, même pour un seul individu. La vitesse intrinsèque du vieillissement de la peau pour un individu peut être aussi très influencée par les facteurs personnels et environnementaux, en particulier le taux d'exposition à la lumière ultra-violette. La photodégradation qui accélère considérablement le vieillissement visible de la peau augmente également beaucoup le risque de formation de néoplasme cutané. Au fur et à mesure que la population vieillit, il faut davantage se préoccuper de diminuer la morbidité réelle associée au vieillissement de la peau, plutôt que de palier à ses conséquences cosméti-ques. Il est donc crucial de s'efforcer à mieux comprendre les facteurs intrinsèques et extrinsè-ques qui agissent sur le vieillissement de la peau et aussi de faire la distinction entre les aspects réversibles du vieillissement cutané (facteurs essentiellement hormonaux et mode de vie) et les aspects irréversibles (principalement le vieillissement intrinsèque). The demographics of the U.S.A. are changing rapidly with respect to its elderly population; by 2030, one of every five Americans is expected to be over 65 [3]. It is predicted that life expectancy in the U.S.A. and other industrialized countries will continue to increase, hitting 100 years by about 2025 [4]. Women, with longer average life expectancies than men, can expect to spend more than one-third of th...

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A deeper understanding of the physiological basis of skin aging will facilitate progress in the treatment of the unwelcome sequelae of aging skin, both cosmetic and pathogenic.

Using a recently developed noninvasive, in vivo suction device for measuring skin elasticity, we evaluated age, sex, and regional differences in the viscoelastic properties of skin. A total of 33 volunteers participated in the study consisting of (a) 8 young females, (b) 9 old females, (c) 8 young males and (d) 8 old males. Measurements were performed on 11 anatomical regions; three different loads were applied: 100, 200, and 500 mbar. The parameters used were: immediate distension (Ue); delayed distension (Uv); immediate retraction (Ur); and, final deformation (Uf). To compare between subjects and anatomical regions, relative parameters independent of skin thickness were calculated: Uv/Ue, the ratio between the viscoelastic properties of skin and immediate distension, and Ur/Uf, which measures the ability of the skin to regain its initial position after deformation. Generally, Uv/Ue increased while Ur/Uf decreased with aging. Responses were variable with respect to load applied. Variability within anatomical regions was also noted. However, differences between the sexes were not statistically significant for most regions. These findings are in congruence with earlier studies suggesting the differences are mainly attributable to alterations in the elastic fiber network. This procedure provides a simple, quantitative assessment of elastic properties of the skin. Its application may help in future investigations of other connective tissue disorders.

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Much remains to be done if we are to reach consensus on the effects of age on skin structure and function. Future studies would be benefited by increased standardization of skin sites tested, methodology, and increased sample size.