The Hymenoptera venom study II: Skin test results and safety of venom skin testing

Allergic disorders may be classified into four main categories of immunologic hypersensitivity reactions: type I, immediate or anaphylactic; type II, cytotoxic; type III, involving immune complexes; and type IV, delayed or cell mediated. Type I reactions are those most commonly encountered in clinical allergy. They may be well defined by skin testing, provided the patients to be tested are carefully selected and the tests are applied properly and interpreted critically. Major indications for direct skin testing are: (1) to separate atopic from nonatopic patients; (2) to help in identifying specific allergens in atopic persons; and (3) to reassess the allergic profile in patients receiving immunotherapy. Other indications for skin-testing, of more limited applicability, include: (1) screening for hypersensitivity to vaccines; (2) testing for reactivity to drugs (and particularly penicillin); (3) testing for immediate and delayed reactions in such conditions as bronchopulmonary aspergillosis; and (4) in evaluation of patients with reactions to insect stings. Skin-testing has limited usefulness in early infancy, in chronic urticaria, in the investigation of food allergies, in atopic dermatitis not accompanied by other manifestations of atopy, or in allergic reactions to drugs other than penicillin. A checklist to be consulted prior to performing or interpreting skin tests should include: (1) assurance of the potency of the extract used in testing; (2) knowledge of the nonspecific irritant properties of any extracts used for testing; (3) history of administration of antihistamine drugs or epinephrine prior to testing; and (4) the correlation of skin test results with clinical history. The help of a qualified allergist should be sought if: (1) skin test results are at variance with the historical data; or (2) systemic reactions are induced by skin testing; or (3) the patient fails to respond to the therapy dictated by the skin test results. Alternatives or supplements to skin-testing include RAST testing and measurement of histamine release from sensitized leukocytes. These have rendered passive transfer testing (PK or Prausnitz-Küstner) substantially obsolete. Direct allergy skin testing remains the most sensitive, most specific, and most reliable method presently available to the physician for investigation of IgE-mediated allergic disorders.

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Inverse association between positive tuberculin tests and positive allergy skin tests in children

Paediatrica Indonesiana ◽

10.14238/pi49.1.2009.7-10 ◽

2009 ◽

Vol 49 (1) ◽

pp. 7

Author(s):

Nur Rochmah ◽

Dyahris Kuntartiwi ◽

Anang Endaryanto ◽

Aryanto Harsono

Keyword(s):

Skin Test ◽

Skin Testing ◽

Tuberculin Test ◽

Skin Tests ◽

Food Allergies ◽

Inverse Association ◽

Test Results ◽

Cross Sectional ◽

Allergy Test ◽

Mite Allergy

Background The association between Mycobacterium tuberculosisinfection and atopy remains controversial. Reaction to tuberculosisinfection is mediated by Th-1 immune responses whereas allergicreactions are mediated by Th- 2 immune response. In patients withatopic syndrome who also suffer from tuberculosis infection, theTh-2 response will be suppressed and allergy manifestations willdecrease. Therefore, it is important to determine the appropriateallergy test and to predict outcome after completing tuberculosistreatment.Objective To evaluate the influence of a positive tuberculin teston skin test results in diagnosing atopic disease.Methods A cross sectional study was conducted in the pediatricallergy outpatient clinic, Soetomo Hospital, Surabaya, Indonesiabetween 2004 and 2007. Eighty-five patients were enrolled inthis study. The tuberculin test was performed on all patientswith allergy. The allergy test was carried out by performing a skinscratch test.Results There was a weak inverse correlation between positivetuberculin tests and positive allergy skin tests in children (housedust mite, food and pet allergies). The correlation between apositive tuberculin test and house dust mite allergy test wasr: -0.364 (P=O.OOl; a=O.Ol). The correlation between thetuberculin test and food allergies was r: -0.420 (P=O.OOl;a=O.Ol). The correlation between the tuberculin test and petallergies was r: -0.344 (P= 0.001; a=O.Ol).Conclusions A positive tuberculin test is weakly correlated withpositive allergy skin test results, suggesting that it is appropriate todo allergy skin testing even in children with a positive tuberculintest.

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Cutaneous Anergy in Pregnant and Nonpregnant Women With Human Immunodeficiency Virus

Infectious Diseases in Obstetrics and Gynecology ◽

10.1155/s1064744998000040 ◽

1998 ◽

Vol 6 (1) ◽

pp. 13-17 ◽

Cited By ~ 6

Author(s):

N. L. Eriksen ◽

A. W. Helfgott

Keyword(s):

Human Immunodeficiency Virus ◽

Skin Test ◽

T Lymphocyte ◽

Lymphocyte Count ◽

Skin Testing ◽

The Other ◽

Tuberculin Skin Testing ◽

Test Results ◽

Significant Difference ◽

Immunodeficiency Virus

Objective:To determine the prevalence of cutaneous anergy in pregnant and nonpregnant women who are seropositive for human immunodeficiency virus.Methods and materials:The medical records of 159 women seropositive for human immunodeficiency virus were reviewed. Demographic characteristics and tuberculin skin test results were abstracted from the chart. Tuberculin skin testing was performed by the Mantoux method (5 tuberculin units of purified protein derivative injected intradermally). Anergy testing was performed using any two of the three following antigens; tetanus toxoid, mumps, orCandidaskin test antigen. A positive tuberculin test was defined as induration of 5 mm or more, and a positive test for the other antigens was defined as any amount of induration over the skin test area. Anergy was defined as any amount of induration to the other antigens. A CD4+T lymphocyte count was obtained at the time of skin testing. Continuous variables were analyzed using the Mann Whitney—U test. Categorical data were analyzed with the chi-square or Fisher's exact test as appropriate. A two-tailedPvalue <0.05 was considered significant.Results:There were 102 nonpregnant and 57 pregnant women who returned to have their skin test results read. There was no significant difference in the prevalence of positive, negative or anergic skin test results between groups. The CD4+T lymphocyte count (mean ± standard deviation) in patients with anergic results was similar between pregnant (375 ± 256/mm3) and nonpregnant (358 ± 305/mm3) women (P= 0.64).Conclusion:The prevalence of cutaneous anergy is similar among pregnant and nonpregnant women seropositive for human immunodeficiency virus.

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The Importance of Two-Step Tuberculin Skin Testing for Newly Employed Healthcare Workers

Infection Control and Hospital Epidemiology ◽

10.1086/503640 ◽

2006 ◽

Vol 27 (5) ◽

pp. 512-514 ◽

Cited By ~ 6

Author(s):

Elizabeth C. Frenzel ◽

Georgia A. Thomas ◽

Hend A. Hanna

Keyword(s):

Tuberculin Skin Test ◽

Skin Test ◽

Healthcare Workers ◽

Skin Testing ◽

Older Age ◽

Second Step ◽

Tuberculin Skin Testing ◽

Test Results ◽

History Of ◽

Male Sex

At the time of hire, 4059 of 6522 healthcare workers required a 2-step tuberculin skin test; 114 workers (2.8%) demonstrated a boosted reaction after the second step. Boosted reactions were significantly associated with male sex and older age. A verbal history of previous tuberculin skin test results was not a reliable indicator of baseline tuberculin skin test status at the time of hire.

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Comparison of Subject-Reported Allergy versus Skin Test Results in a Common Cold Trial

American Journal of Rhinology ◽

10.1177/194589240301700309 ◽

2003 ◽

Vol 17 (3) ◽

pp. 159-162

Author(s):

Jason S. Krahnke ◽

Deborah A. Gentile ◽

Kelly M. Cordoro ◽

Betty L. Angelini ◽

Sheldon A. Cohen ◽

...

Keyword(s):

Skin Test ◽

Common Cold ◽

Skin Testing ◽

Positive Skin Test ◽

Poor Correlation ◽

Test Results ◽

Positive Skin ◽

Test Response ◽

History Of ◽

Allergy Skin Testing

Background Few studies have examined the relationship between subject-reported allergy and results of allergy skin testing in large unselected or unbiased cohorts. The objective of this study was to compare the results of self-reported allergy via verbal questioning with the results of allergy skin testing by the puncture method in 237 healthy adult subjects enrolled in a common cold study. Methods On enrollment, all subjects were verbally asked if they had a history of allergy and then underwent puncture skin testing to 19 relevant aeroallergens, as well as appropriate positive and negative controls. A skin test was considered positive if its wheal diameter was at least 3 mm larger than that obtained with the negative control. Results Forty-eight (20%) subjects reported a history of allergy and 124 (52%) subjects had at least one positive skin test response. A history of allergy was reported in 40 (32%) of the skin test-positive subjects and 8 (7%) of the skin test-negative subjects. At least one positive skin test response was found in 40 (83%) of those subjects reporting a history of allergy and 84 (44%) of those subjects denying a history of allergy. Conclusion These data indicate that there is a relatively poor correlation between self-reported history of allergy and skin test results in subjects enrolled in a common cold study. These results have implications in both clinical practice and research settings.

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Preparation of Listerin antigen as a tool for Diagnosis of listeriosis

The Iraqi Journal of Veterinary Medicine ◽

10.30539/ijvm.v28i1.1065 ◽

2004 ◽

Vol 28 (1) ◽

pp. 43-54

Author(s):

G. M. Al - Khatib ◽

Zainab A.A. Al - Haddad ◽

Sanaria Fawzi Al- Hissen ◽

Sahar Hassan Al- Kutbi

Keyword(s):

Skin Test ◽

Guinea Pigs ◽

Skin Testing ◽

Specific Antigen ◽

Water Soluble ◽

Skin Tests ◽

Test Results ◽

Soluble Extract ◽

Water Soluble Extract

This study was conducted to produce a specific antigen for detection L. monocytogenes infection. The antigen was prepared by culturing L. monocytogenes on suitable media and then disrupted by ultrasonicatorwaves. The water – soluble extract of sonically disrupted Listeria were used for skin testing guinea pigs infected with (1*108 CFU / ml) of a L. monocytogenes. Two infected doses were used for immunization at intervals of (10) days between them. Two skin tests were done, 10 days and 15 days after the 2nd infected dose. The skin test results were read after 24 & 48 hrs. which showed clear thickening differences and redness at the injection sites after 24 hrs. and become more clear after 48 hrs.

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Correlation of Modified Radioallergosorbent Test Scores and Skin Test Results

Otolaryngology ◽

10.1016/s0194-5998(96)70134-1 ◽

1996 ◽

Vol 115 (1) ◽

pp. 42-45 ◽

Cited By ~ 13

Author(s):

James R. Tandy ◽

Richard L. Mabry ◽

Cynthia S. Mabry

Keyword(s):

Skin Test ◽

Skin Testing ◽

Test Results ◽

North Texas ◽

The North ◽

Intradermal Tests ◽

Radioallergosorbent Test ◽

Increased Sensitivity ◽

The Relationship ◽

Allergic Disorders

In addition to a significantly increased sensitivity as compared with the initial Phadebas radioallergosorbent test, a major advantage of the Fadal-Nalebuff modified RAST is its correlation with skin testing using skin end point titration. This correlation allows physicians to use both these modalities in the diagnosis and treatment of allergic disorders. However, it has been anecdotally believed that the correlation of radioallergosorbent test classes and skin test end points varied somewhat with different antigens. Fifty-three patients were tested by radioallergosorbent test for 12 inhalant antigens common to the North Texas region. These patients subsequently underwent confirmation of their radioallergosorbent test results by application of intradermal tests at a concentration of one fivefold step weaker than the corresponding radioallergosorbent test level (a “RAST minus one” dilution). The relationship between radioallergosorbent test and skin test results will be critically analyzed.

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