House dust mite-related allergic diseases: role of skin prick test, atopy patch test, and RAST in the diagnosis of different manifestations of allergy

Abstract

The atopy patch test (APT) was recently defined as an important tool in diagnosis of atopic dermatitis (AD) and also of rhinitis and asthma caused by hypersensitivity to the house dust mites. We evaluated 465 children (279 males and 186 females) aged 0.4-17.6 years (mean 6.6 +/- 3.8 years), by dividing them into four groups: group A, current AD (40 patients); group B, current AD with respiratory symptoms (156 patients); group C, past AD with respiratory symptoms (203 patients); and the control group, respiratory symptoms with no history of AD (66 patients). The APT was significantly more frequently positive in groups with current AD (groups A and B) or past AD (group C) than in the control group, while skin prick test (SPT) and radioallergosorbent test (RAST) were significantly more frequently positive in the control group. With multivariate analysis, for APT, significant differences were found in the comparison between group A vs group B (odds ratio (OR) 1.55) and between group A vs group C (OR 1.81). The mean age was significantly lower in group A than in groups B, C, and the control group and with less significance in groups C vs D. Children sensitized to mites with current or past AD, with or without respiratory symptoms, have a different response to diagnostic tests, which is characterized by a highly significantly more frequent positive APT in comparison with subjects who have respiratory symptoms but a negative history for AD, who show the common response to SPT and RAST.

Atopic Dermatitis: From Pathophysiology to Diagnostic Approach

“…They were divided into four groups: group A, current AEDS (40 patients); group B, current AEDS with respiratory symptoms (156 patients); group C, past AEDS with respiratory symptoms (203 patients); and the control group, respiratory symptoms with no history of AEDS (66 patients). The APT was significantly more frequently positive in groups with current AEDS (groups A and B) or past AEDS (group C) than in the control group, while SPT and RAST were significantly more frequently positive in the control group (46). Such significant differences in response to APT in patients with diverse clinical expressions suggest that distinctive immunologic mechanisms lie beneath the different manifestations of hypersensitivity to dust mites.…”

The Turkish guideline for the diagnosis and management of atopic dermatitis-2018

“…Bu testte alerjenler yama testinde olduğu gibi kapalı uygulanıp değerlendirilmektedir 51,62,[65][66][67][68] . Avrupa Alerji ve Klinik İmmünoloji Akademisi tarafından yayınlanan raporda aşağıdaki durumlarda besinlerle APT uygulanması önerilmektedir [70][71][72][73][74][75] pozitif deri testleri ile saptanan alerjenlerin klinik ile ilişkisinin eliminasyon diyetleri ve oral provokasyon testleri ile doğrulanması gerekmektedir. Eliminasyon diyeti ile semptomların gerilemesi besin alerjisi tanısını doğrulamakla birlikte eliminasyon diyeti ve/veya semptom/besin günlüğü tutulmasının besin alerjisi tanısında tanısal değeri yeterli sayıda çalışmada gösterilememiştir 55 .…”

“…Aeroalerjenlerin inhalasyonu duyarlanmış bireylerde deriden pro-enflamatuvar sitokinlerin salınımına yol açabilir ancak kaçınma önlemlerinin etkinliği çalışmalarda tutarlı bir şekilde gösterilemediği gibi söz konusu alerjenlerle immünoterapinin de AD'deki etkinliği net olarak ortaya konulamamıştır 49,60,73 . Diğer yandan solunum yolu alerjisi olan hastalarda ve sağlıklı gönüllülerde aeroalerjenlerle yapılan APT ile nadiren pozitif sonuç elde edilirken AD'li hastalarda bu oran %30-50 arasında değişmektedir 49,66,74,75 . Özetle, AD'de, SPT, spesifik IgE ve APT sonuçlarının klinik ile ilişkisini belirleyecek ve aeroalerjenlerin rolünü aydınlatabilecek standardize provokasyon testleri bulunmamaktadır.…”

Validitas Hasil Pemeriksaan Skin Prick Test terhadap Imunoglobulin E RAST Tungau Debu Rumah dan Debu Rumah pada Dermatitis Atopik

“…Jenis TDR yang sering berhubungan dengan DA yaitu Dermatophagoides pteronyssinus (Der p) dan Dermatophagoides farinae (Der f). 6,7 Dermatitis atopik dibagi menjadi dua jenis, yaitu DA tipe alergik/ekstrinsik dan DA tipe nonalergik/intrinsik. Pada orang dewasa dengan DA, 70−80% merupakan tipe ekstrinsik, ketika terdapat paparan terhadap alergen lingkungan akan meningkatkan imunoglobulin E total serum (IgE total).…”