Skip to main content

Advertisement

SpringerLink
Log in

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

  • Original Paper
  • Published:
European Journal of Pediatrics Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Abbreviations

AD:

Atopic dermatitis

APT:

Atopy patch test

ARIA:

Allergic Rhinitis and Its Impact on Asthma

SPT:

Skin prick test

References

  1. Boguniewicz M, Leung DYM (2006) Atopic dermatitis. J Allergy Clin Immunol 117:S475–S480

    Article  CAS  PubMed  Google Scholar 

  2. Bousquet J, Van Cauwenberge P (eds) (2001) Allergic Rhinitis and its Impact on Asthma (ARIA). J Allergy Clin Immunol 108(suppl 5):S146–S150

    Google Scholar 

  3. Cork MJ, Robinson DA, Vasilopoulos Y, Ferguson A, Moustafa M, McGowan A et al (2006) New perspectives on epidermal barrier dysfunction in atopic dermatitis: gene–environment interactions. J Allergy Clin Immunol 118:3–21

    Article  CAS  PubMed  Google Scholar 

  4. Darsow U, Vieluf D, Ring J (1995) Atopy patch test with different vehicles and allergen concentrations: an approach to standardization. J Allergy Clin Immunol 95:677–684

    Article  CAS  PubMed  Google Scholar 

  5. Darsow U, Vieluf D, Ring J (1999) Evaluating the relevance of aeroallergen sensitization in atopic eczema with the atopy patch test: a randomized, double-blind multicenter study. Atopy patch test study group. J Am Acad Dermatol 40:187–193

    Article  CAS  PubMed  Google Scholar 

  6. Darsow U, Laifaoui J, Kerschenlohr K et al (2004) The prevalence of positive reactions in the atopy patch test with aeroallergens and food allergens in subjects with atopic eczema: a European multicenter study. Allergy 59:1318–1323

    Article  CAS  PubMed  Google Scholar 

  7. Daschner A, Cuellar C, Valls A (2008) Toward a differential definition of atopy: Anisakis simplex and the relationship between parasites and arthropods in respiratory allergy. Parasite Immunol 30:417–424

    Article  CAS  PubMed  Google Scholar 

  8. Donnelly S, Dalton JP, Loukas A (2006) Proteases in helminth- and allergen-induced inflammatory responses. Chem Immunol Allergy 90:45–64

    Article  CAS  PubMed  Google Scholar 

  9. Dreborg S (ed) (1989) Skin tests used in type I allergy testing. Position paper of the European Academy of Allergology and Clinical Immunology. Allergy 44 (suppl 10)

  10. Edston E, van Hage-Hamsten M (2003) Death in anaphylaxis in a man with house dust mite allergy. Int J Legal Med 117:299–301

    Article  PubMed  Google Scholar 

  11. Fuiano N, Incorvaia C (2003) Comparison of skin prick test and atopy patch test with dust mite extracts in patients with respiratory symptoms or atopic eczema dermatitis syndrome. Allergy 58:828

    Article  CAS  PubMed  Google Scholar 

  12. Fuiano N, Incorvaia C, Prodam F, Procaccini DA, Bona G (2008) Relationship between the atopy patch test and clinical expression of the disease in children with atopic eczema/dermatitis syndrome and respiratory symptoms. Ann Allergy Asthma Immunol 101:174–178

    Article  PubMed  Google Scholar 

  13. Gaffin JM, Phipatanakul W (2009) The role of indoor allergens in the development of asthma. Curr Opin Allergy Clin Immunol 9:126–135

    Google Scholar 

  14. Guler N, Kilerleri E, Tamay Z, Ones U (2006) Atopy patch testing in children with asthma and rhinitis symptoms allergic to house dust mite. Pediatr Allergy Immunol 17:346–350

    Article  CAS  PubMed  Google Scholar 

  15. Hanifin JM, Rajka G (1980) Diagnostic features of atopic dermatitis. Acta Dermatoven (Stock) 92:44–47

    Google Scholar 

  16. Huss-Marp J, Eberlein-Koenig B, Breuer K, Mair S, Ansel A, Darsow U et al (2006) Influence of short-term exposure to airborne Der p 1 and volatile organic compounds on skin barrier function and dermal blood flow in patients with atopic eczema and healthy individuals. Clin Exp Allergy 36:338–345

    Article  CAS  PubMed  Google Scholar 

  17. Kanof NB (1977) The American Academy of Dermatology patch test series for contact dermatitis. Int J Dermatol 16:827–829

    Article  CAS  PubMed  Google Scholar 

  18. Kjaer HF, Eller E, Andersen KE, Høst A, Bindslev-Jensen C (2009) The association between early sensitization patterns and subsequent allergic disease. The DARC birth cohort study. Pediatr Allergy Immunol (in press)

  19. Kramer U, Lemmen C, Bartusel E et al (2006) Current eczema in children is related to Der f 1 exposure but not to Der p 1 exposure. Br J Dermatol 154:99–105

    Article  CAS  PubMed  Google Scholar 

  20. Leung DYM (1995) Atopic dermatitis: the skin as a window into the pathogenesis of chronic allergic diseases. J Allergy Clin Immunol 96:302–318

    Article  CAS  PubMed  Google Scholar 

  21. Leung DY, Bieber T (2003) Atopic dermatitis. Lancet 361:151–160

    Article  PubMed  Google Scholar 

  22. Leung DYM, Boguniewicz M, Howell MD, Nomura I, Hamid QA (2004) New insights into atopic dermatitis. J Clin Invest 113:651–657

    CAS  PubMed  Google Scholar 

  23. Novak N, Bieber T, Leung DYM (2003) Immune mechanisms leading to atopic dermatitis. J Allergy Clin Immunol 112:S128–S139

    Article  CAS  PubMed  Google Scholar 

  24. Palmer CN, Irvine AD, Terron-Kwiatkoski A, Zhao Y, Liao H, Lee SP et al (2006) Common loss-of-function variants of the epidermal barrier protein filaggrin are a major predisposing factor for atopic dermatitis. Nat Genet 38:441–446

    Article  CAS  PubMed  Google Scholar 

  25. Palmer CN, Ismail T, Lee TH, Terron-Kwiatkoski A, Zhao Y, Liao H et al (2007) Filaggrin null mutations are associated with increased asthma severity in children and young adults. J Allergy Clin Immunol 120:64–68

    Article  CAS  PubMed  Google Scholar 

  26. Peroni DG, Piacentini GL, Alfonsi L, Zerman L, Di Blasi P, Visonà G, Nottegar F, Boner AL (2003) Rhinitis in pre-school children: prevalence, association with allergic diseases and risk factors. Clin Exp Allergy 33:1349–1354

    Article  CAS  PubMed  Google Scholar 

  27. Platts-Mills TA, Chapman MD (1987) Dust mites: immunology, allergic diseases, and environmental control. J Allergy Clin Immunol 80:755–775

    Article  CAS  PubMed  Google Scholar 

  28. Pucci S, Incorvaia C (2008) Allergy as an organ and a systemic disease. Clin Exp Immunol 153(Suppl 1):1–2

    Article  PubMed  Google Scholar 

  29. Ring J, Kunz B, Bieber T, Vieluf D, Przybilla B (1989) The “atopy patch test” with aeroallergens in atopic eczema. J Allergy Clin Immunol 82:195

    Google Scholar 

  30. Sandilands A, Sutherland C, Irvine AD, McLean WH (2009) Filaggrin in the frontline: role in skin barrier function and disease. J Cell Sci 122:1285–1294

    Article  CAS  PubMed  Google Scholar 

  31. Shah D, Hales J, Cooper D, Camp R (2002) Recognition of pathogenically relevant house dust mite hypersensitivity in adults with atopic dermatitis: a new approach? J Allergy Clin Immunol 109:1012–1018

    Article  PubMed  Google Scholar 

  32. Spergel JM, Mizoguchi E, Oettgen H, Bhan AK, Geha R (1998) Epicutaneous sensitization with protein antigens induces localized allergic dermatitis and hyperresponsiveness to methacholine after single exposure to aerosolized antigens in mice. J Clin Invest 101:1614–1622

    Article  CAS  PubMed  Google Scholar 

  33. Spergel JM, Paller AS (2003) Atopic dermatitis and the atopic march. J Allergy Clin Immunol 112:S128–S139

    Article  Google Scholar 

  34. Tovey ER, Almqvist C, Li Q et al (2008) Nonlinear relationship of mite allergen exposure to mite sensitization and asthma in a birth cohort. J Allergy Clin Immunol 122:114–118

    Article  CAS  PubMed  Google Scholar 

  35. Tupker RA, de Monchy JG, Coenraads PJ (1998) House-dust mite hypersensitivity, eczema and other non pulmonary manifestations of allergy. Allergy 53:92–96

    Article  CAS  PubMed  Google Scholar 

  36. van Voorst Vader PC, Lier JG, Woest TE, Coenraads PJ, Nater JP (1991) Patch test with house dust mite antigens in atopic dermatitis patients: methodological methods. Acta Dermatol Venereol 71:301–305

    Google Scholar 

  37. Wistokat-Wulfing A, Schmidt P, Darsow U, Ring J, Kapp A, Werfel T (1999) Atopy patch test reactions are associated with T lymphocyte-mediated allergen-specific immune response in atopic dermatitis. Clin Exp Allergy 29:513–521

    Article  CAS  PubMed  Google Scholar 

  38. Zock JP, Heinrich J, Jarvis D et al (2006) Distribution and determinants of house dust mite allergens in Europe: the European Community Respiratory Health Survey II. J Allergy Clin Immunol 118:682–690

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

We would like to thank Laura Jane Shearer for her language revision of this article.

Conflicts of interest

The authors declare no conflict of interest

Author information

Authors and Affiliations

  1. Paediatric Allergy Service, ASL FG, 9/A, Via Aspromonte, San Severo, Foggia, Italy

    Nicola Fuiano

  2. Health Service IRCCS “Casa Sollievo della Sofferenza”, San Giovanni Rotondo, Italy

    Saverio Fusilli

  3. Allergy/Pulmonary Rehabilitation, ICP Hospital, Milan, Italy

    Cristoforo Incorvaia

Authors
  1. Nicola Fuiano
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Saverio Fusilli
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Cristoforo Incorvaia
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nicola Fuiano.

Additional information

The study was conducted according to the Declaration of Helsinki. Being based on routine diagnostic tests, no authorization by local ethical committee was needed.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fuiano, N., Fusilli, S. & Incorvaia, C. House dust mite-related allergic diseases: role of skin prick test, atopy patch test, and RAST in the diagnosis of different manifestations of allergy. Eur J Pediatr 169, 819–824 (2010). https://doi.org/10.1007/s00431-009-1118-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00431-009-1118-6

Keywords

Search

Navigation