Histamine Wheal Research Articles

Detection of Steroids in Topical Fairness Preparations Using Histamine Wheal Test

Abstract Topical corticosteroid (TC) abuse is a common, worldwide, problem. One of the recent emerging concerns is the adulteration of TC in fairness cream. The presence of TC in skin-whitening cosmetic creams can be detected by high-performance liquid chromatography (HPLC). Since HPLC is expensive, time-taking and not easily available, we suggest the use of histamine wheal test as a simple and inexpensive test to detect the presence of topical steroids in fairness cream.

Functional brain alterations in symptomatic dermographism patients-An exploratory magnetoencephalography study.

Symptomatic dermographism (SD) is a common form of urticaria, which is triggered by stroking the skin. Brain involvement in its aetiology was investigated by means of magnetoencephalography (MEG) after provocation with histamine and dermography. Wheals were induced by histamine skin prick test and dermography in twelve SD patients and fourteen controls. Itch severity was scored on a Visual Analogue Scale (VAS). Relative power and functional connectivity (FC) were measured using a 306-channel whole-head MEG system at baseline and 10 min after histamine and dermography, and contrasted between groups and conditions. Furthermore, wheal diameter and itch scores after these procedures were correlated with the MEG values. SD patients had higher itch scores after histamine and dermography. No significant group-differences were observed in relative power or FC for any condition. In both groups, power decreases were mostly observed in the beta band, and power increases in the alpha bands, after provocation, with more regions involved in patients compared to controls. Increased FC was seen after histamine in patients, and after dermography in controls. In patients only, dermography and histamine wheal size correlated with the alpha2 power in the regions of interest that showed significant condition effects after these procedures. Our findings may be cautiously interpreted as aberrant itch processing, and suggest involvement of the central nervous system in the aetiology of SD.

Skin Prick Automated Test device offers more reliable allergy test results compared to a manual skin prick test.

The skin prick test (SPT) is the gold standard for identifying allergic sensitization in individuals suspected of inhalant allergy. A novel device, SPAT or Skin Prick Automated Test, that enables more standardized allergy testing has been developed. Previous research has shown reduced intra-subject variability of histamine wheals by SPAT. This study aimed to evaluate within-test agreement (% of patients with consistent test results) to detect sensitization to common inhalant allergens when a SPT is executed automated by SPAT or by manual SPT (SPMT) procedure. The 110 volunteers prospectively enrolled underwent both SPAT and SPMT with 3 pricks of house dust mite, timothy grass and birch, 2 pricks of histamine and 1 prick of glycerol. The proportion of consistent (3x positive â€" 3 x negative) and inconsistent (2x positive/negative â€" 1x positive/negative) test results were analysed. The proportion of inconsistent test results was significantly lower in the SPAT compared to the SPMT group. The delta histamine to control pricks was significantly higher in SPAT compared to SPMT group. Coefficient of variation was lower in SPAT compared to SPMT for house dust mite, timothy grass, birch pollen. Visual analogue scale for discomfort was significantly lower in SPAT compared to SPMT group. SPAT showed a 34% reduction in the number of inconsistent test results compared to manual SPT with common inhalant allergens. Patient experience is significantly improved when an allergy test is performed by SPAT compared to a manual SPT.

Comparison of Skin Prick Tests (SPT), Intradermal Tests (IDT) and In Vitro Tests in the Characterization of Insect Bite Hypersensitivity (IBH) in a Population of Lusitano Horses: Contribution for Future Implementation of SPT in IBH Diagnosis.

Thirty controls (C) and 30 IBH-affected (T) Lusitano horses were evaluated. T horses were included based on anamnesis and physical examination, supported by questionnaires. All horses were submitted to skin tests, Intrademal (IDT) and Skin Prick Tests (SPT), on the neck with 14 specific allergens, 13 recombinant proteins (r-proteins) from Culicoides nubeculosus (Cul n) and Culicoides obsoletus (Cul o) salivary glands and Culicoides nubeculosus Whole Body Extract (Cul n WBE). Addicionally, a cluster of six T and six C horses were also tested with Cul n 3 and Cul n 4 produced in insect cells and barley, as well as E. coli produced Cul o 3 and Cul o WBE. Allergen concentrations were 10 µg/mL for IDT and 100 µg/mL for SPT, and wheal diameters assessed at 20 min, 6 and 48 h. IDTs were considered positive when wheal diameter was ≥50% of the histamine wheal and SPT's ≥ 0.9 cm. In vitro tests, allergen-specific serum IgE and sulfidoleukotriene (sLT) release assay were also carried out. Results showed that Cul n WBE, Cul n 7, 8, 9, Cul o1P and Cul o 2P were the best performing allergens for SPTs (p ≤ 0.0001) for the 1st allergen panel and Cul o WBE, Cul n 3 Bar and Cul n 4 Bac (p ≤ 0.05) for the 2nd, presenting a higher discriminatory diagnostic potential than IDTs, at a concentration of 100 µg/mL, with readings assessed at 20 min. Regarding in vitro tests overall, the sLT release assay performed best.

Alfaxalone provides reliable sedation for intradermal allergen testing in dogs and does not significantly affect results when compared to dexmedetomidine.

Dexmedetomidine (Dexmedetomidine hydrochloride-Dexdomitor; Zoetis) is the preferred sedative used for canine intradermal allergen testing (IDT) in the United States. Alfaxalone (Alfaxan Multidose; Jurox Animal Health) is a neuroactive steroid, and its effect on sedation and allergen reactivity scores is unknown. We hypothesised that alfaxalone would produce an adequate level of sedation with fewer cardiovascular adverse effects and would not affect allergen reactivity scores or histamine wheal size compared to dexmedetomidine. Twenty client-owned dogs were included in two groups: 10 atopic and 10 nonatopic. In a randomised, controlled, blinded, cross-over design all dogs underwent two modified IDT, 1-4 weeks apart, using intravenousdexmedetomidine (2.87-5.22 μg/kg) or alfaxalone (1.8-2.4 mg/kg). Anaesthetic parameters and sedation level were recorded over 25 min using a validated canine sedation scale described by Grint et al. (Small Anim Pract, 2009, 50, 62). Simultaneously, both objective and subjective reactivity scores were measured in technical triplicates at 10, 15 and 20 min. The modified IDT included eight allergens, histamine-positive and saline-negative controls. Alfaxalone produced a significantly higher sedation score across all time points (p < 0.05). All objective scores were significantly correlated to the corresponding subjective scores (Spearman R = 0.859, p < 0.0001). Sedative used did not significantly affect subjective allergen scores for nine atopic dogs (p > 0.05, 15 min). Sedative used did not affect the diameter of objective scores for individual allergens and histamine wheals (p > 0.05, 15 min). Intravascular alfaxalone is an alternative sedative for IDT in dogs. Alfaxalone may be preferred to dexmedetomidine in some clinical scenarios as a result of having fewer cardiovascular adverse effects.

Histamine intolerance (HIT)

Histamine intolerance (HIT) is food intolerance of non-immunological origin, and it results from an imbalance between the consumption of histamine with food and the organism ability to metabolize it. The patients with HIT were found to have a significantly reduced concentration of histamine-degrading enzymes, diamine oxidase (DAO) and histamine N-methyltransferase (HNMT). Factors which have been identified that are conducive to histamine intolerance are: genetic factors, dysbacteriosis, chronic diseases – especially allergic and intestinal diseases, chronic infections, mastocytosis and some drug use. Clinical symptoms of histamine excess may affect various organs and systems - the most common are skin symptoms (pruritis, erythema) nausea, vomiting, abdominal pain, diarrhea, headaches and sometimes severe reactions with shortness of breath, arrhythmias, blood pressure drop, and even cardiac arrest. Diagnostic methods in HIT utilize determination of serum DAO, determination of histamine metabolites in urine, measurement of the histamine wheal in the 50th minute of the skin prick test (SPT), gastroscopy with intestinal biopsy, diagnostic and therapeutic test, oral histamine-challenge test and genetic tests. The mainstay of histamine intolerance treatment if a low-histamine diet. Patients should avoid products belonging to the three groups of food: containing large amounts of histamine, histamine liberators, and products inhibiting the activity of DAO. Additionally, supplements containing DAO and antihistamines can be used.

Diurnal Variations in Skin Prick Testing.

Background: Prior research suggests that skin prick testing (SPT) might be larger in the afternoon, with unclear clinical significance. Methods: This retrospective chart review analyzed SPT results from patients between June 2008 and June 2017, organized into 4 time groups for analysis (Group 1: 7:00 AM -10:29 AM, Group 2: 10:30 AM -11:59 AM, Group 3: 12:00 PM -2:29 PM, and Group 4: 2:30 PM -8:15 PM). Results: In total, 12,982 (n) patient test results had positive histamine and were included in final analysis. Histamine wheal size was not significantly increased in the PM compared with AM (P = 0.89). Food allergen and aeroallergen wheal sizes were not significantly increased in PM. Histamine erythema size was increased in the PM compared with AM (P ≤ 0.01). Food allergen and aeroallergen erythema sizes trended toward an increase in the PM. Conclusions: There were not significant differences in SPT wheal size based on time of day for histamine, food allergens, or aeroallergens. SPT can be reliably performed at any time of day.

Study of Allergen Patterns in Cases of Moderate to Severe Persistent Allergic Rhinitis in Central India.

The prevalence of Allergic rhinitis (AR) is associated with a variety of environmental allergens and the level of exposure is through inhalation, or ingestion. It is clear from several studies and guidelines that screening and identification of various allergens in a particular region can facilitate in diagnosing, treating and formulating preventive strategies against AR. To study the allergen patterns in patients with Moderate to severe persistent allergic rhinitis from Central India. Male/female of 6 to 63years age group, presenting with itching of the nose, sneezing, rhinorrhoea, nasal congestion and nasal obstruction. Patients suffering from infective pathology of nose and sinuses. The study group comprised of 1350 male/female of the age group between 6 and 63years. Modified skin prick test was performed according to the method of Pepys and Bernstein. The ratio of allergen wheal and histamine wheal was used to evaluate the results. The reactions with wheal diameter 3mm or greater than the reading in the negative control were considered as positive reaction. Results of the study indicate that in Central India, the common allergens are pollens (78.5%), insects (64.5%), dust (38.5%), dust mites (18%) and food (10%) causing moderate to severe persistent allergic rhinitis. The study provided an insight and identified the allergen pattern in Central India. The results were of great help in counseling for avoidance therapy and for deciding allergen specific immunotherapy which is the standard treatment protocol to modify natural course of allergic rhinitis at this point of time.

Bifonazole Exerts Anti-Inflammatory Effects in Human Three-Dimensional Skin Equivalents after UVB or Histamine Challenge

Background: In addition to its role as a broad-spectrum imidazole antifungal drug, data from animal models as well as human clinical trials also demonstrated an anti-inflammatory efficacy of bifonazole (BFZ). In the histamine wheal test and after UV radiation, BFZ showed antiphlogistic effects that were comparable to those of hydrocortisone. However, the underlying molecular mechanisms of the anti-inflam­matory properties of BFZ are poorly understood. Methods: Performing an in vitro study we used full-thickness three-dimensional (3D) skin models containing macrophages as mediators of inflammation. We conducted two sets of experiments. In a first set we exposed our models to UVB irradiation to provoke an inflammation. A second approach used the addition of histamine into the culture medium. In both approaches, models were treated topically with a BFZ-containing ointment or a placebo ointment for 24 h, and then the effects were examined histologically as well as with microarray and quantitative real-time PCR analyses. Results: Histological examination showed that the BFZ-containing ointment reconstituted UVB- and histamine-mediated disorders within the skin models. Performing gene expression profiling in models that were treated with the BFZ-containing ointment after UVB irradiation, we detected an upregu­lation of differentiation markers (fillagrin, loricrin, and keratin 1), antimicrobial peptides (DEFB103A), and members of the cytochrome P450 family (CYP1A1 and CYP1B1) as well as a downregulation of genes that are involved in immune response (CCL22, CXCL12, CCL7, IRF1, ICAM1, TLR3, and RARRES3) and matrix metalloproteinases (MMP12 and MMP7). Models that were treated with the BFZ-containing ointment after histamine application showed an upregulation of members of the cytochrome P450 family (CAP1A1, CYP1B1, and CYP24A1) and a downregulation of immune response-associated genes (CXCL6, CXCL12, CCL8, IL6, and IL32). Conclusion: We present the first in vitro study showing anti-inflammatory effects of BFZ in human 3D skin models. To our knowledge, this is the first time that these effects could be translated from human clinical trials into an in vitro test system, allowing a more detailed examination of molecular mechanisms that were regulated by BFZ.

Re‐sensitization of desensitized histamine H1 receptors in the human skin takes more than 18 hours

It is known since the time of testing histamine on pieces of guinea pig's jejunum that histamine receptors can develop insensitivity. The aim was to find evidence for desensitization of histamine H1 receptors in the human skin in vivo and, if found, to study the time for such receptors to regain normal sensitivity. A skin prick test with histamine (10mgmL-1 ) was set in areas where a large histamine wheal was evoked 2, 6, 18, 24 or 72hours earlier. A skin prick test with histamine (10mgmL-1 ) was also set in an area where an allergen wheal was evoked 2 or 6hours earlier. Heights, diameters and areas were measured on photographs of side views of plaster casts of the evoked skin elevations. Histamine wheals, called test wheals, in areas where large histamine wheals were evoked 2, 6 or 18hours earlier, were smaller than histamine wheals, called initial wheals, in earlier non-stimulated areas. Test wheals from the 18hours experiment were smaller than test wheals from the 72hours experiment. Test wheals evoked in areas where allergen wheals were evoked 2 or 6hours earlier were smaller than corresponding initial wheals. Histamine-evoked wheals and IgE-mediated allergic wheals reduce the sensitivity of histamine H1 receptors in the human skin. It takes between 18 and 72hours to restore the sensitivity. Similarities between the development of histamine wheals in the human skin and histaminergic migraine with aura are discussed.

Evaluation of Skin Reactivity: The concept of Histamine Equivalent Allergen Threshold Concentration (Cha)

Background: Skin prick testing is the most common diagnostic tool used by allergists. There are limited, international rules on interpreting and reporting skin test results in a meaningful way. Aim: This communication describes methods to express the results of skin prick tests in a meaningful way. It is recommended to use allergen extracts with defined composition, potency and stability, to keep the precision of SPT within acceptable limits by using duplicate tests, and to regularly calculate the c.v. If duplicate tests cannot be performed for practical and or psychological reasons, e.g. in small children, then it are proposed that regular proficiency tests are performed and reported. The method of estimating the allergen threshold concentration, histamine equivalent allergen concentration Cha, is described Conclusion: By adjusting the allergen wheal response to that of histamine, Cha, differences in techniques between personnel and centres can be minimized and changes in skin reactivity can be calculated as a threshold concentration. To document the skin reactivity and changes over time it is even proposed to report the mean histamine wheal response of groups and of testing personnel at all-time points of therapeutic trials and in practice over time.

Comparison of intradermal and percutaneous testing to histamine, saline and nine allergens in healthy adult cats.

Intradermal testing (IDT) in cats has potential limitations; this has led to an interest in novel testing methods. A pilot study demonstrated that healthy cats produced reliable percutaneous glycerinated (PG) histamine wheals, whereas percutaneously applied glycerosaline did not lead to wheal formation. The purpose of this study was to determine if percutaneously applied aqueous and glycerinated allergens would lead to irritant reactions in healthy cats. Percutaneous testing (PCT) with both glycerinated and aqueous allergens and IDT were compared in twelve healthy cats. The lateral thorax was clipped and histamine, saline and nine allergens were tested in rows. Objective and subjective evaluations were performed at 15, 20 and 25 min, and 4 h. Results were evaluated as positive or negative at 15, 20, 25 min and 4 h. Skin test reactions for intradermal (ID) histamine wheals were larger when compared to PG and percutaneous aqueous (PA) at the immediate reading points (P < 0.05) subjectively and objectively; however, PG was not significantly different from ID when compared as either positive (2-4) or negative (0-1). PG histamine and allergen reactions, when present, were larger than equivalent PA reactions. PG and PA allergens did not cause irritant reactions at tested concentrations. Bassia scoparia (kochia), when tested at 1000 PNU/mL with IDT, was suspected to be an irritant. Percutaneously (PCT) applied allergens did not cause irritant reactions in healthy cats. PG histamine wheals, although smaller than ID histamine wheals, were easily recognizable and PCT was simple to perform.

Prediction of the Efficacy of Antihistamines in Chronic Spontaneous Urticaria Based on Initial Suppression of the Histamine- Induced Wheal.

Antihistamines are the first line of treatment for chronic spontaneous urticaria. However, there is no effective method to predict whether an antihistamine will have a beneficial clinical effect or not. To assess whether the change in histamine-induced wheal and flare measurements 24 hours after administration of antihistamine can predict the efficacy of treatment. We performed a multicenter, triple-blind, randomized study. Patients received a daily oral dose of cetirizine, fexofenadine, bilastine, desloratadine, or ebastine over 8 weeks. After 4 weeks, a higher dose of antihistamine was administered to patients who did not experience a clinical response. A histamine skin prick test was carried out at baseline and 24 hours after the first dose of antihistamine. Disease severity (Urticaria Activity Score [UAS]), response to the histamine skin prick test, and impact on the patient's quality of life (Dermatology Life Quality Index [DLQI]) were determined every 2 weeks. The study population comprised 150 patients (30 per group) and 30 controls. Twenty-four hours after administration of antihistamine, inhibition of the histamine wheal by >75% was significantly associated with better UAS and DLQI scores. The safety and efficacy of the 5 antihistamines were similar. After updosing, rates of disease control (DLQI score <5) increased from 58.7% to 76.7%. Measurement of the histamine-induced wheal can predict which patients will have a strong clinical response to antihistamines but has limited utility for identifying nonresponders. The clinical significance of these data could be relevant in the search for new urticaria treatment regimens.

Inhibitory Effect of Phlai Capsule on the Histamine and Allergen-Induced Wheal and Flare Response on Skin Test Response Among Allergic Rhinitis Patients

Inhibitory Effect of Phlai Capsule on the Histamine and Allergen-Induced Wheal and Flare Response on Skin Test Response Among Allergic Rhinitis Patients

Histamine skin reactivity increases with body mass index in Korean children

ObjectiveHistamine skin prick testing is most commonly used to diagnose immunoglobulin E (IgE)-mediated allergic diseases, and histamine reactivity is used as a standardized positive control in the interpretation of a skin prick test. However, reactivity to histamine differs among individuals for reasons that are poorly understood. The present study aimed to evaluate the potential association between body mass index (BMI) and histamine skin reactivity in children. MethodsA total of 451 children (246 boys, 205 girls) aged 7–8 years were enrolled in this study. The skin prick test was performed with 26 aeroallergens commonly found in Korea. Other information was collected, including sex, age, BMI, parental allergy history, and parental smoking status. Multivariate analysis was used to confirm the association between histamine skin reactivity and BMI. ResultsThe histamine wheal size was revealed to be associated with BMI (Spearman's Rho 0.161, p<0.001). This association was confirmed by multivariate analysis, after adjusting for sex, age, parental allergy history, parental smoking status, and allergic sensitization (coefficient B 0.071, 95% confidence interval 0.030–0.112). ConclusionsSkin responses to histamine were primarily correlated with increased BMI. Further studies are needed to understand the clinical implication of BMI when interpreting the results of skin prick test.

Effect of photoaging on skin test response to histamine independent of chronologic age

BackgroundSkin prick-puncture test responses to histamine on the upper back and forearms in older individuals are frequently small or absent but are often present or larger when repeated on the lower back. ObjectiveTo determine whether photoaging or natural aging causes a smaller response to a prick-puncture skin test. MethodsPrick-puncture skin tests to histamine were performed on sun-exposed and sun-protected areas in younger (n = 61, aged 20–50 years) and older (n = 63, aged 60–87 years) adult volunteers. The skin was scored for photoaging by physical examination, and coloration was measured by a colorimeter. ResultsLarge variation of photoaging occurred within age groups. Histamine wheals and flare were not different between the 2 age groups, but those adults with the greatest photoaging had smaller histamine wheals and flare on the upper back, with a trend for smaller flares on the volar aspect of the forearms and lower back. There was marked variability in response to histamine within individual adults, depending on the locale of the tests. ConclusionPhotoaging, but not age alone, is associated with a smaller response to histamine in sun-exposed areas. Before prick-puncture skin tests are performed, the skin should be examined for sun damage, and a sun-protected area should be selected; in vitro allergy testing may be substituted if there is no sun-protected skin area.

Formulation and Clinical Evaluation of Triamcinolone Acetonide Niosomes: Effect of Iontophoresis on the Permeation Across Skin

Triamcinolone acetonide niosomes were prepared by thin film hydration technique using surfactants Brij 52, Span 20, cetrimide and cholesterol by 23 factorial design. Niosomes were evaluated for their morphology, vesicle size, in vitro drug release and skin permeation study using human skin. From the factorial design it was found that the cetrimide used in the formulation had greater effect on the entrapment efficiency, in vitro drug release and skin permeability and the particle size was found to be in the range of 50-80 nm. Clinical study was carried out using histamine wheal suppression test for the niosomal formulation and was compared with marketed product on healthy human volunteers with and without iontophoresis. It was found that niosomal formulation with iontophoresis at 15 min has more effect than at 60 min and 120 min when compared to the marketed product. Keywords: Histamine wheal suppression, human volunteers, iontophoresis, niosomes, triamcinolone acetonide.

128 Colour Change in the Human Histamine Wheal; a Sign of Desensitized Histamine Vasoconstrictory Receptors

BackgroundThe aim was to find the cause and consequences of a colour change in histamine wheals found after ordinary histamine skin prick tests (SPTs) (10 mg/mL). A rapid change to a darker red colour from the 18th and to the 20th minute has been demonstrated by using a digital image-processing technique called LYYN and ImageJ to yield numerical values.1MethodsRepeated histamine SPTs in the middle of the site for earlier performed histamine SPTs in humans. Calculations of the sizes of photographed wheals. Histamine solutions perfused in isolated rabbit ears.ResultsHistamine SPT performed 90 minutes or 6 hours apart from initial histamine SPTs evoked a ring of wheal peripherally around the site of the initial wheal or no wheal at all. The initial wheals had at those times disappeared. Histamine perfusion in isolated rabbit ears indicated first vasoconstriction and after a mean of 17 minutes vasodilatation in post-capillary vessels despite continued histamine perfusion.ConclusionsThe results indicate that total desensitization of histamine-1 receptors in the wheal is the cause of the colour change in human histamine SPTs and that such desensitization lasts long time. If histamine released at allergen provocations also evokes such a long-lasting desensitization and post-capillary vasodilatation it opens new aspects on vascular events in allergic reactions.

Histamine 50-Skin-Prick Test: A Tool to Diagnose Histamine Intolerance

Background. Histamine intolerance results from an imbalance between histamine intake and degradation. In healthy persons, dietary histamine can be sufficiently metabolized by amine oxidases, whereas persons with low amine oxidase activity are at risk of histamine toxicity. Diamine oxidase (DAO) is the key enzyme in degradation. Histamine elicits a wide range of effects. Histamine intolerance displays symptoms, such as rhinitis, headache, gastrointestinal symptoms, palpitations, urticaria and pruritus. Objective. Diagnosis of histamine intolerance until now is based on case history; neither a validated questionnaire nor a routine test is available. It was the aim of this trial to evaluate the usefullness of a prick-test for the diagnosis of histamine intolerance. Methods. Prick-testing with 1% histamine solution and wheal size-measurement to assess the relation between the wheal in prick-test, read after 20 to 50 minutes, as sign of slowed histamine degradation as well as history and symptoms of histamine intolerance. Results. Besides a pretest with 17 patients with HIT we investigated 156 persons (81 with HIT, 75 controls): 64 out of 81 with histamine intolerance(HIT), but only 14 out of 75 persons from the control-group presented with a histamine wheal ≥3 mm after 50 minutes (P < .0001). Conclusion and Clinical Relevance. Histamine-50 skin-prickt-test offers a simple tool with relevance.

The efficacy of clobetasol propionate with varying dilutions of emollient determined by histamine wheal suppression test

Background:The ability of steroids to reduce the histamine wheal was used to assess the efficacy of topical clobetasol propionate with varying dilutions of emollients.Aim:To determine the wheal-suppressing ability of topical clobetasol with varying dilutions of emollient.Materials and Methods:It was a double-blinded randomized study. Twenty-five volunteers were included in the study. Five syringes of 5 ml were taken and the syringes were loaded with either clobetasol propionate 0.05%, emollient, or clobetasol propionate with emollient in dilutions of 1:1, 1:2, and 1:3. The syringes were coded 1 to 5. Five squares of 3 × 3 cm were marked on the flexor aspect of the forearm of the volunteers. After randomization, half fingertip unit of the cream was applied within each square uniformly. Three hours later histamine prick test was performed by the standard method. The wheal was measured after 15 min and the results were recorded. After decoding, results were statistically analyzed by analysis of variance.Result:The decrease in wheal suppression of steroid with emollient (1:1) was same as topical steroid and the wheal suppression decreased with increasing dilutions of steroid.Conclusion:We conclude that steroids and emollients can be mixed in equal proportion (1:1) and the effect is same as steroid alone and increasing dilution of steroids with emollients was not effective in suppressing the wheal.