Can Mold Allergy be Diagnosed with a Skin Test or Specific IgE Antibodies?

Abstract

In this issue of the Journal of the Chinese Medical Association, Liang et al describe a study that evaluates the skin test (Tori Ltd, Tokyo, Japan) and specific IgE antibodies (ImmunoCAP system; Pharmacia, Uppsala, Sweden), which are designed to identify mold allergy. Five fungal antigens (Candida, Alternaria, Aspergillus, Cladosporium and Penicillium) were included in this study. With the steadily increasing prevalence of atopic disorders in the pediatric population over the past several decades, it is more essential than ever to develop a simple, rapid test that identifies inhalant allergens in these atopic individuals. Fungi are well known as sources of allergens that cause allergic rhinitis and allergic asthma in Taiwan. Penicillium citrinum and Aspergillus fumigatus are prevalent indoor airborne fungal species that have been implicated in human respiratory allergic disorders. Fungal allergens, on the whole, show significant differences in incidence among different age groups. Allergy skin testing for immediate hypersensitivity is a cornerstone in the evaluation of the patient with allergic disease. Skin prick tests are quick, low cost, highly sensitive and safe. This seemingly simple test, however, is subject to multiple variables that can affect the result. Some of them are patient-dependent, such as the patient age, underlying skin condition, or use of medications that can interfere with the test results. Testing-dependent variables include the quality of the extracts used, the testing technique and device used, the location on the body to which the tests are applied, and the distance between individual test sites. Finally, individual physician scoring and interpretation of allergen skin test results may add further variability. Can Mold Allergy be Diagnosed with a Skin Test or Specific IgE Antibodies?