Skin prick test with self saliva as a diagnostic test for Behçet’s disease

Mohamed, Manar F; Latif, Osama Mohamed Abdel; Mahmoud, Mohamed; Abo-Ali, Fawzia Hassan Ahmed

doi:10.1016/j.ejr.2020.06.006

Cited by 2 publications

(5 citation statements)

References 22 publications

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“…In our study, all tests were negative in normal healthy controls, although in a previous study by Mohamed et al [21], which compared PT and neat self-saliva PT in 30 patients with BD, 30 patients with RAS, and 30 healthy controls, the 20G PT was positive in 7% of the controls. In a study by Togashi et al [22], none of the control group developed positive PT with neat self-saliva or with filtered self-saliva.…”

Section: Discussioncontrasting

confidence: 79%

“…In our study, the 20G PT and self-saliva PT were also positive (10% and 40%, respectively) in patients with RAS, with no significant difference (p-value = 0.068), while Mohammad et al [21] showed positive PT with neat saliva in 37% (11/30) of the RAS group (although the description of a positive test was somewhat different). The Togashi et al [22] study showed a weak reaction (mild erythema) with neat saliva PT in 60% (3/5) of the RAS group…”

Section: Discussioncontrasting

confidence: 51%

“…After dividing the patients to active and inactive BD, we had no positive test using 20G PT and dry 23G PT in our inactive BD patients, although the PT with self-saliva was positive in 30% of the inactive BD group. Mohamed et al [ 21 ] found 50% sensitivity of 20G PT among BD patients with inactive disease, who were not receiving steroids or immune suppressive drugs 2 week prior to the study, so probably the low number of our patients with inactive disease and also taking immunosuppressant or steroid medications was the reason for this negativity of the tests.…”

Section: Discussionmentioning

confidence: 83%

“…The study by Togashi et al [ 22 ] showed a positivity of 90% using PT with neat self-saliva on 10 BD patients and the study of Mohammad et al also showed positive PT with neat self-saliva in 83% (25/30) of patients with BD [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

“…Davatchi et al [ 14 ] revealed a significant decrease in test sensitivity from 64.2% to 35.8% over 35 years in the Iranian population. Multiple factors have been suggested that can increase test positivity, including using 2 skin prick tests [ 15 ], multiple puncturing [ 16 ], use of a blunt needle [ 17 ], resting the needle in the dermis for 90 seconds [ 18 ], the diameter of the needle [ 19 ], avoidance of surgical cleaning of the skin with antiseptic povidone-iodine (PVP-I) before insertion of the needle [ 20 ], and the use of neat self-saliva (as done recently by Mohamed et al using a sample of fresh saliva diluted with water and then sterilized using a filter paper) [ 21 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

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Pathergy test with a 23G needle with and without self-saliva in patients with Behçet’s disease, recurrent aphthous stomatitis and control group compared to the 20G test

Shenavandeh¹,

Sadeghi²,

Aflaki³

2021

Reumatologia

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IntroductionThe pathergy test (PT) is part of the diagnostic criteria of Behçet’s disease (BD). Factors like needle character and number of punctures can affect the sensitivity of PT. We tried to compare its positivity using a thinner needle with and without self-saliva in active and inactive BD, recurrent aphthous stomatitis (RAS), and healthy people.Material and methodsTwenty patients with active and 13 with inactive BD, 20 with RAS, and 34 healthy controls underwent 3 types of PT: 1 – the most recommended 20G dry needle PT, 2 – 23G dry needle PT, and 3 – 23G PT with self-saliva. The positivity and diagnostic accuracy of the tests between groups were compared.ResultsAll tests were negative in the normal healthy group. In active BD, the positivity of PT with self-saliva (70%) was higher than the 20G PT (20%) (p-value = 0.004), being more correlated to disease activity (p-value = 0.046). In the RAS group, there was no difference in the positivity of all tests (p-value = 0.068). All tests had high diagnostic accuracy in discriminating between patients with active BD and the controls (p < 0.05). The pathergy test with self-saliva showed significant diagnostic accuracy in discriminating BD from non-BD participants (p < 0.001). The results of dry 23G PT were the same as those of 20G PT.ConclusionsThe self-saliva PT test was more positive in patients with active BD, correlated with disease activity, was more sensitive, had equal specificity in detecting BD from the control group, and was more sensitive but less specific in detecting BD, compared to the RAS group. The positivity and accuracy of dry 23G needle PT were the same as the 20G PT. Pathergy test with self-saliva using a thin (23G) needle is more sensitive has equal specificity in detecting patients with BD compared to the control group and is more sensitive but less specific in detecting the patients with BD compared to the RAS group. The positivity and accuracy of dry 23G needle PT is the same as the most recommended 20G dry PT. Pathergy test by wet 23G needle (with self-saliva) is more positive in patients with active BD compared to PT by dry 20G needle.

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Section: Discussioncontrasting

confidence: 79%

Section: Discussioncontrasting

confidence: 51%

Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%