Abstract
BackgroundEthyl-chloride (EC) spray was recently shown to be an effective antipruritic agent, when given 15 min after histamine skin-prick test (SPT), without changing the wheal and flare reaction. We aimed to investigate the antipruritic effect of EC on SPT, when given prior to SPT.MethodsA double-blind placebo-controlled prospective study. Overall, 44 volunteers underwent histamine SPT on both arms to trigger local pruritus. Prior to test, they were randomly treated with EC spray on one arm and saline spray (placebo) on the other. Subjects as well as researchers were blinded to the type of applied sprays. The wheal and flare reaction was measured after the SPT and subjects reported the intensity of pruritus following EC/placebo using a validated pruritus questionnaire (indexes 1–3) and a visual analog scale (VAS).ResultsSignificant improvement in pruritus was reported following treatment with EC compared with placebo for all four studied parameters. Index 1 in EC 3.7 ± 2.3 versus 5 ± 3.5 (p = 0.007) in placebo, index 2 in EC 2.6 ± 2.1 versus 3.8 ± 2.8 (p = 0.002) in placebo, index 3 of EC 6.3 ± 3.8 versus 8.8 ± 5.8 (p = 0.03) and VAS in EC 3.7 ± 1.9 versus 4.4 ± 2.3 (p = 0.003). There were no significant differences between EC and placebo in terms of the wheal and flare indurations area.ConclusionsEthyl-chloride has an effective antipruritic agent, when given before histamine SPT. Its use did not change the wheal and flare reaction, making it ideal for prevention of pruritus, secondary to allergy skin test, without masking the results.
Highlights
Ethyl-chloride (EC) spray was recently shown to be an effective antipruritic agent, when given 15 min after histamine skin-prick test (SPT), without changing the wheal and flare reaction
Ethyl-chloride (EC) is an anesthetic agent used in a vapo-coolant spray for topical anesthesia in minor surgical procedures, minor sports injuries, pre-injection anesthesia and myofascial pain [1, 6]
Scarce data exist on the potential effects of topical EC spray on pain and pruritus in skin allergy testing and whether its use may mask the wheal and flare indurations areas
Summary
Ethyl-chloride (EC) spray was recently shown to be an effective antipruritic agent, when given 15 min after histamine skin-prick test (SPT), without changing the wheal and flare reaction. Skin prick tests (SPT) for the diagnosis of IgE mediated allergy are relatively safe procedures. It may cause severe sensation of either pain or pruritus in both children and adults [1, 2]. Measures to prevent or reduce these symptoms may be warranted Topical agents such as eutectic mixture of local anesthetics (EMLA; AstraZeneca LP, Wilmington, DE), have been. Scarce data exist on the potential effects of topical EC spray on pain and pruritus in skin allergy testing and whether its use may mask the wheal and flare indurations areas.
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