The atopy patch test: an increased rate of reactivity in patients who have an air-exposed pattern of atopic eczema

Darsow, Ulf; Vieluf, D.; Ring, Johannes

doi:10.1111/j.1365-2133.1996.tb01144.x

Cited by 94 publications

(27 citation statements)

References 21 publications

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“…Fifty-seven patients with AE were prospectively divid ed into two groups according to their clinical eczema dis tribution pattern and then underwent an APT with 4 aller gen concentrations (500, 3,000, 5,000 and 10,000 PNU/g) [17].…”

Section: Patterns O F Eczema Distributionmentioning

confidence: 99%

The ‘Atopy Patch Test’ in Evaluating the Role of Aeroallergens in Atopic Eczema

Ring¹,

Darsow²,

Gfesser³

et al. 1997

Int Arch Allergy Immunol

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The atopy patch test (APT) is a procedure involving epicutaneous patch tests with allergens known to elicit IgE-mediated reactions and the evaluation of eczematous skin lesions. APT can be performed on normal uninvolved skin without artificial manipulations such as tape stripping or use of irritants. APT has been standardized regarding the use of vehicle and dose response relationships. In several studies, approximately two thirds of patients with atopic eczema (AE) showed positive APT reactions to aeroallergens, most frequently to house dust mite. Positive APT reactions were significantly more frequent in patients with a typical air-exposed eczematous distribution pattern. Using evaporimetry to study transepidermal water loss, allergen-induced disturbance of epidermal barrier functions was found to be significantly more pronounced on APT reactions compared to classical contact allergy patch test sites in the same individual. It has been shown that with APT eczematous skin lesions can be elicited by skin contact with aeroallergens, at least in a subgroup of patients with AE, and thereby, that IgE-mediated allergy does play a role in the etiopathophysiology of this disease. Future studies should help to bring this test into clinical routine in order to establish an equivalent for ‘skin provocation’ comparable to nasal and bronchial provocation tests in respiratory allergy.

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Section: Patterns O F Eczema Distributionmentioning

confidence: 99%

The ‘Atopy Patch Test’ in Evaluating the Role of Aeroallergens in Atopic Eczema

Ring¹,

Darsow²,

Gfesser³

et al. 1997

Int Arch Allergy Immunol

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“…Allergen concentrations of 500, 3000, 5000, and 10,000 protein nitrogen units (PNU)/g in petrolatum were compared in another study[56] in 57 patients. The frequency of clear-cut positive APT reactions was significantly higher in patients with eczematous skin lesions in air-exposed areas (69%) as compared with patients without this predictive pattern (39%; P = 0.02).…”

Section: Methodological Studiesmentioning

confidence: 99%

Immunoglobulin E-Mediated Allergy Plays a Role in Atopic Eczema as Shown in the Atopy Patch Test

Darsow

Ring

2008

World Allergy Organization Journal

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Although the pathophysiology of immunoglobulin E (IgE)-mediated allergic rhinoconjunctivitis and bronchial asthma is rather well established, the role of allergy in atopic eczema (AE) is still controversial. By a technique called atopy patch test, aeroallergens like house dust mite, animal dander, or pollen were proven as relevant trigger factors in a subgroup of patients with AE. The atopy patch test is an epicutaneous patch test with such allergens known to elicit IgE-mediated reactions, and used for the evaluation of eczematous skin reactions. In a series of single-center and multicenter studies, a method was developed, standardized, and compared with other diagnostic techniques (radioallergosorbent test, skin prick test) in AE patients. With regard to clinical history, the most specific results were obtained with the atopy patch test (allergen-dependent, 69%-92%), whereas sensitivity was higher for skin prick test (range, 69%-82%) and specific IgE (range, 65%-94%). The characterization of a patient subgroup with relevant IgE-mediated allergy may lead to more efficient avoidance and eventually even specific immunotherapy strategies in the management of AE.

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“…Sequential biopsies taken from the same individuals during atopy patch testing revealed more detailed insights into the kinetics and nature of chemokine upregulation in the skin during early and late phases of eczema development. For this diagnostic test, allergens are applied to the skin occlusively for 24 hours and eczema develops within 24-72 hours in the region of allergen application in sensitized individuals (Darsow et al, 1996). Expression of CCL17 and CCL22 is among other chemokines rapidly upregulated on the mRNA level already 24 hours later and increases further during the following 48 hours.…”

Section: Ccl17 As a Biomarker For Disease Severity In Admentioning

confidence: 99%