Skin Scratch Test Research Articles

Myotonic Dystrophy Type 1 with Syringomyelia in a Young Patient

Myotonic Dystrophy Type 1 with Syringomyelia in a Young Patient

Identification of different pigeon allergens and its trigger toward increase in inner city Asthma

Background: Upon exposure, allergic reactions to breathing pigeon feces are common. The dust of dried droppings irritates the nasal passages, causing sneezing, coughs, excess mucus and shortness of breath, dizziness and a sense of vertigo. Hence exposure to pigeon allergens in the surroundings has led to increase in hypersensitivity reactions due to pigeon proteins present in their feathers and droppings. Aims and Objectives: The aim and objective of the following study is to investigate the role of pigeon droppings in the increase of inner city asthma. To study the different allergens present in the pigeon droppings. Materials and Methods: A total of 500 asthmatics were screened for hypersensitivity reactions toward protein extracts from pigeon droppings. 100 asthmatic patients were selected showing 3+ reactions by skin scratch test and an induration of more than 5 mm with inflammation. Total immunoglobulin E (IgE) as well as specific IgE quantitated by enzyme-linked immunosorbent assay (ELISA) and circulating immunoglobulin G (IgG) antibody toward pigeon allergens was studied by western blot. Results: Totally 87 asthmatic patients and 23 healthy normal showed reactivity toward allergens of pigeon feathers and droppings by skin test with induration of 1.48 ± 0.12** in patients (P < 0.000) and 0.17 ± 0.81 in healthy controls. Reactivity shown toward pigeon dropping allergen was 13 ± 0.121 in patients and that shown by healthy controls being 0.26 ± 0.094*(P < 0.001), which was also statistically significant. The total IgE was 1906.84 ± 3696.27 IU/ml in patients **(P < 0.0001) when compared to healthy controls 86.21 ± 50.18 IU/ml. Specific IgE detected in patients toward allergens was 0.31 ± 0.10 OD. *(P < 0.001) to that of normal being 0.19 ± 0.06 OD. Patients serum reacted to 129 kD and 43 kD protein extract of pigeon dropping by western blotting and total IgG by ELISA was 1802.0 ± 66.5 mg/dl in patients (P < 0.016). The normal range being 581-1630 mg/dl. The pulmonary function test by spirometry was 60%, 40% lesser when compared with healthy normals. Conclusions: Observed results showed an increase in the hypersensitivity reactions toward the pigeon allergens and increase in the antibody levels of IgG in circulation. This probably may have added to the increase in asthma cases in our city.

EPA-0034 – A case of late-onset angioedema due to clozapine and redevelopment of angioedema with olanzapine

Angioedema is a rare but potentially life-threatening adverse effect of antipsychotics. The late-onset angioedema is a rare clinical condition which occurs months or years after. To describe the case of a female patient who developed late-onset angioedema following treatment with clozapine after 5 years and redevelopment of angioedema with introduction of olanzapine which resolved on discontinuation of both drugs. A case report 27-year-old woman was diagnosed with psychotic disorder and mental retardation five years ago. Her clinical condition was going well with clozapine 150 mg/day. At one of her follow-up visits, the physical examination revealed swelling over the face and eruption on perioral region. A diagnosis of ‘acute angioedema’ was established. After discontinuation of clozapine, skin symptoms were resolved within one week and olanzapine was started. Few days after introduction of olanzapine, the same skin symptoms emerged over the face and repeated laboratory tests were unremarkable. Skin scratch test revealed hypersensitivity with the medications of clozapine, olanzapine and sulpiride. Olanzapine discontinued and quetiapine 900 mg/day was started. She remained well under quetiapine therapy without any recurrence of psychiatric symptoms or angioedema. To our knowledge, this is the first reported case of late-onset angioedema due to clozapine monotherapy. This case report indicates the need for clinicians to be aware of late-onset adverse events in patients treated with antipsychotics.

Seasonal allergic rhinitis in the Komi Republic

Background. Seasonal allergic rhinitis (SAR) presents a great problem of public health all over the world, being widespread among allergic diseases. SAR considerably impacts on social and economic aspects of life. The prevalence rate of SAR and it’s etiology need to be studied to develop the preventive measures and qualified medical attendance. There is limited knowledge concerning the prevalence rate of SAR in Russian Federation. This article presents the results of epidemiological study of pollen allergy, including SAR, in Komi Republic (KR) among adolescents and adults. We found out that SAR is the most widespread pollen allergy, and it’s prevalence rate is 12%. The most frequent etiological factors of SAR are tree pollen and cereals, but the polyvalent sensitization to all kinds of pollen is the most prevalent. The results of studying of epidermal and domestic allergens etiology role are also presented. Objective. To evaluate the prevalence rate and main etiological factors of SAR in KR. Methods. The epidemiological study was carried out in KR within the framework of international program GA2LEN. During questioning we included 2002 respondents, 1038 of them with mentioned allergy reactions in questionnaire underwent allergological examination, including skin scratch tests (men 49,3% and women 50,7%; rural dwellers 18,5% and city dwellers 81,5%). Results. Of the 1038 patients surveyed, 253 were diagnosed with SAR, with a total prevalence rate of 12,6%. There was no significant difference in sex between rural and city dwellers. In 50% of cases allergic conjunctivitis accompanies SAR. The most prevalent sensitization was to tree pollen and cereals. In 44% of SAR we estimated polyvalent sensitization to tree pollen, weeds and cereals. About 50% of patients with SAR were also diagnosed with perennial allergic rhinitis and 20% of them had sensitization to epidermal and domestic allergens. Conclusion. We evaluated the prevalence rate of SAR in KR, that is considerably higher than official data. The most prevalent etiological factors of SAR were also revealed.

Skin Scrape Test: An Inexpensive and Painless Skin Test For Recognition Of Immediate Hypersensitivity In Children And Adults

Background: Skin testing is a mainstay in allergology, and its importance is increasing in several fields. The ability to choose the most suitable technique according to the clinical setting is an advantage for the medical team. Objectives: To describe in detail an alternative technique of the coetaneous allergy test (skin scrape test) conceived as a variation of the former skin scratch test; to evaluate its value as a tool for diagnosis of immune sensitization; and to compare its accuracy with the skin prick test. Methods: The skin scrape test and skin prick test were performed side by side with the same allergen extracts in 162 human subjects classified in two groups according to the known presence or absence of serum specific-IgE to these allergens. Results: The sensitivity of the skin scrape test to detect immediate reactions was 85.0%. The sensitivity of the skin prick test was 86.5%. The sensitivity of both techniques analyzed together as a unique procedure was 94.2%. The specificity of the skin scrape test was 90.1%.The specificity of the skin prick test was 72.9%.The specificity of both tests analyzed together as a unique procedure was 70.5%. Conclusions: The skin scrape test is an alternative and complementary technique for allergic skin testing, and it is able to detect IgE-specific immune sensitization without the disadvantages of the skin scratch test. The skin scrape test has similar outcomes to the skin prick test.

Skin sensitivity reactions to some allergens in different population groups of Ethiopian subjects

The prevalence of allergic diseases to a variety of allergens has only been studied in a few countries and it has never been studied in Ethiopia. This study was aimed at assessing the prevalence of skin sensitivity reactions to allergens in Ethiopian subjects. A total of 216 subjects were tested with a skin scratch test using five types of allergens and also for total and differential white blood cell counts. Positive reaction to one or more allergens was detected in 49.5% of the subjects, the most prevalent allergen being mite extract. Some 27% showed a positive reaction to multiple allergens. The mean eosinophil count was higher in the subjects reacting to at least one of the allergens compared to those with no reaction (p = 0.038). The results demonstrate a high prevalence of allergic reactions to the few allergens tested. Further studies using several allergens are recommended to substantiate this finding.

Japanese cedar pollen as an exacerbation factor in atopic dermatitis: results of atopy patch testing and histological examination

Atopy patch testing with Japanese cedar pollen extract has been used to investigate patients with atopic dermatitis whose condition is exacerbated by contact with Japanese cedar pollen. Comparative atopy patch testing, scratch tests, and assays for total IgE and specific IgE were performed in 74 patients with atopic dermatitis, 5 patients with Japanese cedar pollinosis and 15 control subjects. A skin biopsy was performed on any sites that were positive to Japanese cedar pollen patch test. The results after 48 h of atopy patch testing were compared with the patient's history, skin scratch test and specific IgE. Twenty-two of the 74 patients (30%) had a history of exacerbation every spring after contact with Japanese cedar. Of these patients 68% showed a positive reaction to Japanese cedar pollen extract, as did 21% of patients with atopic dermatitis without a history of exacerbation by Japanese cedar pollen, 20% of patients with Japanese cedar pollinosis without eruption and 7% of control subjects. A histological examination revealed eczematous changes and infiltration of lymphocytes and eosinophils in atopy patch testing positive sites. In conclusion, atopy patch testing with Japanese cedar pollen extract is a useful method for investigating trigger factors for eczematous skin lesions in a subgroup of patients with atopic dermatitis.

医薬品アレルギーとヒスタミン 医薬品添加物カルボキシメチルセルロースナトリウムによるアレルギー反応に関する研究

Histamine plays an important role in both inflammation and gastric acid secretion, while it also acts as a neurotransmitter in the mammalian brain. In particular, histamine plays a central role in the immediate hypersensitivity and allergic response as a mediator released from mast cells and basophils.The use of in vitro histamine release experiments to identify antigens in drug allergies is thus considered to be useful. A highly sensitive assay for histamine is required for in vitro release experiments.We experienced a patient who developed an anaphylactic reaction to a barium sulfate suspension after under-going an upper gastrointestinal examination, and identified carboxymethylcellulose sodium (CMC-Na) to be an antigen in the barium sulfate suspension, using the skin-scratch test and in vitro histamine release.A 63-year-old woman was admitted to the hospital because of an anaphylactic reaction after undergoing a double-contrast upper gastrointestinal examination. After obtaining the patient informed consent, we conducted skin-scratch tests for each of the components in the barium sulfate suspension to identify any antigens. A positive reaction was observed for CMC-Na. No such reaction was observed for any other components of the barium sulfate suspension and gas producing granules. The three normal subjects had no response to all agents tested. In addition, the degree of histamine release from the isolated leukocytes induced by CMC-Na was studied in vitro. The leukocytes were isolated by the centrifugation of the peripheral blood on the Ficoll-iothalamate meglumine solution. The histamine content was determined by lon-Pair HPLC.The leukocytes from the patient responded to CMC-Na at a concentration range from 10-4.5% to 10-2.6%, while those from normal subjects did not. The dose-response curve for the effect of CMC-Na on the histamine release from leukocytes from the patient was bell-shaped. The results of the present study as a whole indicated CMC-Na to be the antigen responsible for the anaphylactic response to the barium suspension in our patient. Although not a common complication, such a reaction may occur in patients sensitized to CMC-Na.CMC-Na is widely used as a suspending agent in pharmaceuticals, certain food products and cosmetics. Although CMC-Na has been thought to be inert and not absorbed, our findings suggest that the patient was sensitized to CMC-Na through such routes.

A comparison of the sensitization according to skin scratch tests between Japanese and Chinese university students

A comparison of the sensitization according to skin scratch tests between Japanese and Chinese university students

FOOD AND FOOD ADDITIVES HYPERSENSITIVITY IN ADULT ASTHMATICS : I Skin Scratch Test with Food Allergens and Food Challenge in Adult Asthmatics

FOOD AND FOOD ADDITIVES HYPERSENSITIVITY IN ADULT ASTHMATICS : I Skin Scratch Test with Food Allergens and Food Challenge in Adult Asthmatics

喉頭全摘の際発見された無カタラーゼ血液症の1症例

In 1949, Takahara first reported acatalasemia, which was a constitutional abnormality characterized by a deficit of catalase in the blood. Acatalasemia patients inherited autosomal recessive genes and its incidence was high in children born of consanguineous marriage.The patient was a 71-year-old male who underwent total laryngectomy because of recurrence of laryngeal cancer. The operative area was prepared with Oxidol®, a widely used disinfectant in otolaryngological disease. This antiseptic treatment induced methemoglobinemia, and it took about 16 days to recover from the critical postoperative condition.In order to clarify the causative factor, a blood hydrogen peroxide mixing test, a skin scratch test, and gene analyses were performed, and catalase activity was measured. He was made the diagnosis of acatalasemia because of the significant decrease in catalase. The patient's family history was also studied and it was found that his parents were first cousins. A catalase activity test of his mother and three children was carried out, and the result showed that all of them had suffered from hypocatalasemia. His gene abnormality was considered as a Japanese-type.As in the present case, acatalasemia has been often induced accidentally by the use of hydrogen peroxide solution. The detection rate of acatalasemia was high in otolaryngology and oral surgery.It must be borne in mind that the risk of methemoglobinemia can be minimized by paying special attention to the treatment of patients with Oxidol®.

The "Red Wine Reaction" Syndrome

A small portion of today9s wine consumers refrain from drinking red wine due to what has become popularly known as the "red wine allergy reaction" syndrome. Red wines were presented, allergic skin scratch tests, and antihistamine treatments were conducted in order to determine the existence and possible nature of the purported reaction. Results indicate the possible reaction is, in the most part, probably not an allergic reaction, but is either psychologically induced or a physiologically toxic action.

某製薬工場でみられた職業性アレルギーについて

A survey was made on workers handling powdered drugs in a pharmaceutical factory. In this factory, two kinds of anti-inflammatory enzyme (bromelain and trypsin), one anti-inflammatory agent (flufenamic acid), one antispasmodic (flopropion) and two kinds of antibiotics (ampicillin and cephalexin) are mainly produced. Twenty four workers were examined by interviews and checked by Cornell Medical Index, and 18 of them complained of respiratory symptoms. These 18 workers were physically examined by skin scratch tests, pulmonary function tests and serum immunological tests. Among 24 workers, 9 handled powdered drugs (A group), 5 handled the same in the past and had already been transferred to other sections for their symptoms (B group), 3 engaged in the process of capsul-filling (C group) and 7 handled several times occasionally during one year (D group). Their average months spent in handling powdered drugs were, in the case of anti-inflammatory enzyme, A group 53.2, B group 66.2, and in the case of antibiotics, 5 workers in A group 24.0, 2 workers in B group 7.0, 3 workers in C group 25.7. Twenty workers complained of symptoms which were mainly irritation of mucosa including the respiratory system and itching of the skin while they were working, and accelerated nasal discharge, urticaria and asthma after working. Group A and group B were higher than group D in the rate of respiratory complaints in C.M.I. (p less than 0.001). Fourteen workers pointed out anti-inflammatory enzyme as a cause of main symptoms, 7 workers flufenamic acid, 3 workers flopropion, 4 workers antibiotics. Three workers who had past history of asthma or articular rheumatism had been transferred to other sections. Of 18 workers who were physically examined, 11 workers showed positive reactions to skin scratch tests with handling drugs. On 8 workers of them, some kinds of drugs which were pointed out as drugs causing main symptoms reacted positively. Numbers of workers with increased immunoglobin values were, IgE 3, IgM 2, IgA 4, IgM 2. Two workers showed decreased FVC and FEV (1.0 sec.) values in pulmonary function tests. The causes of the occupational allergic reaction in this factory are guessed as follows: 1) control of powdered materials was incomplete in the process of production, 2) various kinds of sensitizing drugs were handled by the same workers.

Bronchial asthma, allergic rhinitis, and allergy skin tests among college students

Allergic conditions were evaluated for 2 successive years among 1,836 Brown University and Pembroke College freshmen (99.2 per cent). Students gave personal allergic histories and family histories of allergy, and information was supplemented by parents. Some type of allergy was present in 34.8 per cent of the population. A total of 25.0 per cent of students had a history of asthma, seasonal hay fever, or nonseasonal allergic rhinitis. The frequency of each of these conditions was 5.3 per cent for asthma, 21.1 per cent for seasonal hay fever, and 5.2 per cent for nonseasonal allergic rhinitis. Positive family histories of asthma and/or allergic rhinitis were found to localize among students who had these conditions. Skin scratch tests with 15 commercial allergens and a control were performed on 1,243 students (67.7 per cent); 30.9 per cent showed at least one positive reaction, with localization found among the allergic group. No association between scratch test reaction and family history was observed.

Allergen Testing on Monkeys passively sensitized by Hay Fever and Asthma Reagins of Human Sera

DIRECT skin-scratch tests upon allergic individuals are sometimes dangerous, and are inconvenient and time-consuming for both the patient and allergist. The classical Prausnitz–Kustner test (P-K test)1 is subject to the same objections and, in addition, subjects the volunteer serum recipient to the risk of infection with serum hepatitis. These considerations lead us to the use of an alternative method for indirect testing in our studies on the purification of castor allergens.