scholarly journals THE VALUE OF THE SKIN TEST WITH TYPE-SPECIFIC CAPSULAR POLYSACCHARIDE IN THE SERUM TREATMENT OF TYPE I PNEUMOCOCCUS PNEUMONIA

1933 ◽  
Vol 57 (4) ◽  
pp. 617-631 ◽  
Author(s):  
Thomas Francis
Keyword(s):  
Skin Reaction ◽  
Skin Test ◽  
Capsular Polysaccharide ◽  
Skin Tests ◽  
Type I ◽  
Agglutination Reaction ◽  
Positive Skin ◽  
Specific Antibodies ◽  
Circulating Antibodies ◽  
Serum Therapy

Skin tests were made with Type I S.S.S. in 53 cases of Type I pneumococcus lobar pneumonia, 48 of which were treated with antipneumococcus Type I serum. In all but 1 of the 46 recovered cases a positive, immediate skin reaction was obtained at about the time of recovery. In 7 fatal cases reactions were consistently negative, even in the presence of circulating type-specific antibodies. The skin test has proved to be an extremely valuable guide to serum therapy, and a definite prognostic aid. The test has distinct advantages over the agglutination reaction in that it is not merely an index of circulating antibodies. When positive, it invariably denotes that recovery has begun; when negative, it indicates further serum therapy. The mechanism of the positive skin test is closely related to that operative in recovery from pneumonia, and is apparently the resultant of antibody and tissue activity.

Studies With Live Varicella Vaccine and Inactivated Skin Test Antigen: Protective Effect of the Vaccine and Clinical Application of the Skin Test

PEDIATRICS ◽  
1978 ◽  
Vol 61 (4) ◽  
pp. 550-555
Author(s):  
Koichi Baba ◽  
Hyakuji Yabuuchi ◽  
Hidekazu Okuni ◽  
Michiaki Takahashi
Keyword(s):  
Skin Reaction ◽  
Skin Test ◽  
Index Case ◽  
Varicella Vaccine ◽  
Index Patient ◽  
Skin Tests ◽  
Positive Skin ◽  
Reaction Test ◽  
History Of ◽  
Viral Dose

In December 1975, a patient with varicella was admitted to a ward for children less than 2 years of age. Among 76 children without a history of varicella, 33 children more than 1 year of age were immediately vaccinated with a small viral dose of 80 plaque-forming units per person. Forty-three children less than 1 year of age were left unvaccinated. Among the vaccinated children, only eight exhibited mild varicella, while typical varicella developed in all 43 unvaccinated children during the next ten weeks. In July 1976, another patient with varicella was admitted to a ward with 49 children 3 to 5 years old. The children were immediately given the skin reaction test with mactivated varicella antigen. Seventeen of the 20 children with negative reactions were vaccinated, while the index patient and two children with fever were not vaccinated. Only one of the 17 vaccinated children showed mild varicella symptoms within two weeks after vaccination, while typical varicella developed in two unvaccinated children during the four weeks after appearance of the index case. Varicella developed in none of the 29 children who had positive skin tests. In the sequential skin test of seven vaccinated children, a positive skin reaction was observed as early as five days after vaccination, which preceded the appearance of neutralization antibody by seven to nine days.

Penicillin Hypersensitivity

1979 ◽  
Vol 1 (5) ◽  
pp. 132-158
Keyword(s):  
Skin Test ◽  
Multicenter Study ◽  
Positive Skin Test ◽  
Penicillin Allergy ◽  
Skin Tests ◽  
Penicillin G ◽  
Positive Skin ◽  
Positive History ◽  
History Of

A (massive) multicenter study of 3,000 patients has demonstrated that skin tests to penicillin G and penicilloyl-polylysine (PPL-now commercially available) predict and confirm penicillin allergy. Of patients with a history of penicillin reaction, 19% were positive to either, compared to 7% of controls. A history of anaphylaxis led to 46% positive. Of those with a history of urticaria 17% were positive, and those with maculopapular eruptions did not differ from controls (7% positive). Challenge with penicillin led to a reaction in 6% with a positive history (compared to 2% with a negative) and 67% with a combined positive history and positive skin test (to either).

Meglumine antimoniate-induced DRESS: original case with a positive skin test

2018 ◽  
Vol 63 (4) ◽  
pp. 845-847 ◽  
Author(s):  
Amel Chaabane ◽  
Haifa Ben Romdhane ◽  
Hajer Ben Brahim ◽  
Nadia Ben Fredj ◽  
Zohra Chadli ◽  
...  
Keyword(s):  
Skin Test ◽  
Clinical Picture ◽  
Drug Withdrawal ◽  
Skin Tests ◽  
Positive Skin ◽  
Meglumine Antimoniate ◽  
Blood Tests ◽  
Intradermal Tests ◽  
Original Case ◽  
Hepatic Cytolysis

Abstract We report a case of a 64-year-old woman treated with meglumine antimoniate (Glucantime®). On day 20, she developed fever, a pruriginous skin rash and myalgia. The blood tests showed eosinophilia and hepatic cytolysis. The clinico-biological picture improved gradually and the symptoms disappeared 4 weeks after the drug withdrawal. Six weeks later, intradermal tests to Glucantime® were performed and were positive at 48 hour-reading. This clinical picture suggests DRESS induced by meglumine antimoniate. To the best of our knowledge, only one case of meglumine antimoniate-induced DRESS has been reported in the literature and we are the first to report a case confirmed by skin tests.

THE CUTANEOUS REACTION TO EGGWHITE

PEDIATRICS ◽  
1959 ◽  
Vol 24 (6) ◽  
pp. 1009-1015
Author(s):  
Richard L. London ◽  
Jerome Glaser
Keyword(s):  
Skin Test ◽  
Skin Testing ◽  
Intradermal Test ◽  
Skin Tests ◽  
Etiologic Factor ◽  
Initial Reaction ◽  
Age Group ◽  
Positive Skin ◽  
Clinical Sensitivity ◽  
Number Of Patients

A study of 400 allergic patients of all ages, who were skin tested with eggwhite, is reported. The authors agree with those who believe that a positive reaction in infants who have in no known way been exposed to eggwhite after birth is in all probability due to intrauterine sensitization. There is a possibility, however, that some reactions to eggwhite may be due to a primary histamine or serotonin releasing substance present in the eggwhite which has no relationship to antigen-antibody reaction. The circumstances under which this takes place are not known. In all age groups the family history was positive in about 65% of cases. It was surprising to find, in view of previous opinions, that in the youngest age group (infants up to 2 years of age), the skin test was positive in less than half the patients (42%) in the presence of clinical sensitivity. It was also unexpected to find that the number of patients clinically sensitive to eggwhite but giving negative skin tests increased as age advanced. This justifies the common practice of eliminating egg as a trial measure in the diet of the first age group, regardless of the results of skin testing, and suggests that this should be done in any age group where food is considered a possible etiologic factor. In the youngest age group somewhat more than one-third (34%) of the patients reacted positively to eggwhite but were not clinically sensitive. This finding was completely unexpected as it had been thought that in this age group a positive skin test to eggwhite was practically pathognomonic of clinical sensitivity. In this study more positive reactions in children to eggwhite were obtained (70.5%) than in a somewhat comparable series where the incidence was much less (20%). We attribute this to the fact that in our series both scratch and intradermal tests were made while in the other series only scratch tests were done. This reflects the greater sensitivity of the intradermal test. Only about half the patients of all ages who react to eggwhite are also clinically sensitive. Attention is drawn to a theory which explains why a positive cutaneous test to a food, as eggwhite, may be clinically significant in atopic dermatitis even though the test (wheal reaction) does not reproduce the type of dermatitis being studied. There was no definite evidence, because the number of cases studied is far too small, to indicate that the severity of asthma which may ultimately develop in infants not asthmatic at the time of skin testing is proportional to the strength of the initial reaction to eggwhite.

Neue Charakteristika klinisch manifester Latexallergiker

2019 ◽  
Vol 7 (1) ◽  
pp. 29-31
Author(s):  
Vera Mahler
Keyword(s):  
Medical History ◽  
Skin Test ◽  
Correct Diagnosis ◽  
Natural Rubber Latex ◽  
Specific Ige ◽  
Latex Allergy ◽  
Skin Tests ◽  
Diagnostic Challenge ◽  
Positive Skin ◽  
Significant Difference

Background: Natural rubber latex (NRL) allergy is commonly diagnosed according to medical history, skin allergy tests, and serological analyses. However, skin tests are increasingly being abandoned because of (i) their time-consuming nature, (ii) latex preparations for skin tests being not commercially available, and (iii) the use of in-house prepared test solutions is becoming ever more difficult due to increasing regulatory hurdles. In this light, we have evaluated differences in the profiles of current and former patients with suspected latex allergy. Methods: Sera of skin test-positive patients from a historic cohort (1995-2001, n = 149 patients) and currently (2014-2015, n = 48 patients) were simultaneously analyzed for specific IgE to latex by ImmunoCAP. If the serological screening was positive (≥ 0.35 kU/l), component-resolved diagnostics including profilins and cross-reactive carbohydrate determinants (CCDs) were performed. Results: In contrast to 88% (131/149) of the skin test-positive patients from the 1990s, only 51.1% (24/47) of the current cohort were found positive for specific IgE to latex. While 48.3% (72/149) of the patients had a convincing positive history in the 1990s, current skin test-positive patients rarely reported a relevant medical history (8.5%, 4/47). Specific IgE levels to latex were significantly higher in former patients with suspected latex allergy (p < 0.001) than in former sensitized individuals without allergy. However, this significant difference was lost in current allergic and sensitized patients with positive skin tests. Conclusion: Sensitization profiles in patients with latex allergy have changed significantly over the last 2 decades. Discrimination between NRL sensitization and clinical allergy remains a diagnostic challenge. Our data highlight the need for a combination of all 3 criteria, i.e., patient history, skin test, and analysis of specific IgE, for a correct diagnosis of latex allergy.

scholarly journals The skin test with tuberculous recombinant allergen AT successful treated patients with lung tuberculosis

2018 ◽  
Vol 20 (3) ◽  
pp. 17-20
Author(s):  
G S Balasanyants ◽  
N V Skotnikova ◽  
V V Dantsev
Keyword(s):  
Skin Test ◽  
Dynamic Control ◽  
Skin Tests ◽  
Recombinant Allergen ◽  
Positive Skin ◽  
Group 13 ◽  
Group Iii ◽  
Lung Tuberculosis ◽  
Skin Response ◽  
The Moment

38 patients with newly diagnosed tuberculosis, immediately after the end of the main course of treatment, when they were transferred to the third group of dispensary supervision (6-9 months) and when they were removed from the dispensary supervision (2-3 years later), a skin test with an allergen tuberculous recombinant was made. The positive skin test with tuberculosis recombinant allergen was defined at 20 patients - 13 mm. At the moment of removing to the III group only one skin test with tuberculosis allergen recombinant became negative, 19 (94,5%) patients had positive reactions - 13±2,3 mm. At the time of discharging from dispensary the positive reactions were determined at 16 (80%) cases - 10±2,3 mm, p0,05. In this group, 13 (65%) patients had normergic skin tests with tuberculosis allergen recombinant and 7 (35%) - hyperergic tests. At the time of removing to the III group at five from seven patients with hyperergic tests the results remained the same, median and at the moment of discharging from tuberculosis service only one patient had the hyperergic skin test with tuberculosis allergen recombinant - 18mm. Among patients with normergic skin tests with tuberculosis allergen recombinant at the time of group III removing median was 11±2,1 mm. At the last dynamic control the normergic results were determined at 15 (75%) patients and the tests median remained almost unchanged - 10±1,8 mm, the differences are reliable compared to the initial data (p0,05). In group which included 18 patients with negative skin tests with tuberculous allergen recombinant, the skin response stayed negative throughout all examination period except for one patient so patients of this group had not only clinical, radiological and bacteriological, but immunological signs of involution of the tuberculosis process. The study of the influence of clinical, epidemic and social factors to skin reaction showed that first group patients were significantly more likely to be unemployed (30% versus 5,5%; p0,05) whereas in second group married patients were reliably registered (61,1% versus 25%; p0,05). Other factors differed unreliably.

Skin testing in allergy

2019 ◽  
Vol 40 (6) ◽  
pp. 366-368
Author(s):  
Gayatri Patel ◽  
Carol Saltoun
Keyword(s):  
Skin Test ◽  
Immunoglobulin E ◽  
Clinical Symptoms ◽  
Skin Testing ◽  
Smooth Muscle Contraction ◽  
Skin Tests ◽  
Test Reaction ◽  
Positive Skin ◽  
Intradermal Testing ◽  
Clinical Sensitivity

Skin tests are used in addition to a directed history and physical examination to exclude or confirm immunoglobulin E (IgE) mediated diseases, such as allergic rhinitis, asthma, and anaphylaxis, to aeroallergens, foods, insect venoms, and certain drugs. There are two types of skin testing used in clinical practice: percutaneous testing (prick or puncture) and intracutaneous testing (intradermal). Prick testing involves introducing a needle into the upper layers of the skin through a drop of allergen extract that has been placed on the skin and gently lifting the epidermis up. Various devices are available for prick testing. Intracutaneous (intradermal) testing involves injecting a small amount of allergen into the dermis. The release of preformed histamine from mast cells causes increased vascular permeability via smooth-muscle contraction and development of a wheal; inflammatory mediators initiate a neural reflex, which causes vasodilatation, which leads to erythema (the flare). Prick testing methods are the initial technique for detecting the presence of IgE. These may correlate better with clinical sensitivity and are more specific but less sensitive than intradermal testing. Sites of skin testing include the back and the volar aspect of the arm. By skin testing on the arm, the patient can witness the emergence and often sense the pruritus of the skin test reaction. Because more patients are sensitized (have IgE antibodies and positive skin test reactions) than have corresponding symptoms, the diagnosis of allergy can be made only by correlating skin testing results with the presence of clinical symptoms.

Skin Tests in the Diagnosis of Allergic Conditions

1981 ◽  
Vol 2 (10) ◽  
pp. 327-332
Author(s):  
Lillian P. Kravis
Keyword(s):  
Skin Test ◽  
Skin Testing ◽  
Clinical History ◽  
Skin Tests ◽  
Food Allergies ◽  
Type I ◽  
Test Results ◽  
Type Iv ◽  
Transfer Testing ◽  
Allergic Disorders

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.

COMPARATIVE SKIN TESTS WITH ANIMAL AND SYNTHETIC CORTICOTROPHIN IN PATIENTS HYPERSENSITIVE TO ANIMAL CORTICOTROPHIN

1964 ◽  
Vol 47 (4) ◽  
pp. 613-618 ◽  
Author(s):  
H. J. Buytendijk ◽  
Fr. Maesen
Keyword(s):  
Skin Reaction ◽  
Anaphylactic Shock ◽  
Therapeutic Use ◽  
Skin Tests ◽  
Allergic Reactions ◽  
Skin Reactions ◽  
Positive Skin ◽  
Valuable Addition

ABSTRACT A study of the literature shows that 5 % of patients are hypersensitive to animal ACTH. Anaphylactic shock, even with a fatal issue, may occur (van Ufford 1952; Hill & Swinburn 1954; Eisalo et al. 1956). The same rather high percentage was also found for our own patients. In seven patients who had previously shown violent clinical reactions following the use of animal ACTH (Cortrophin), comparative skin tests were carried out with Cortrophin and the synthetic ACTH preparation, tetracosapeptide (CIBA 30.920-Ba). All patients showed a markedly positive skin reaction to the highly purified animal ACTH (Cortrophin); in two of these patients, the reaction occurred late. Skin reactions to the synthetic ACTH were negative. The synthetic ACTH, must be regarded as a valuable addition in the therapeutic use of ACTH, particularly in patients predisposed to allergic reactions (asthmatics).

scholarly journals SPECIFIC CUTANEOUS REACTIONS AND CIRCULATING ANTIBODIES IN THE COURSE OF LOBAR PNEUMONIA

1931 ◽  
Vol 54 (5) ◽  
pp. 637-652 ◽  
Author(s):  
Maxwell Finland ◽  
W. D. Sutliff
Keyword(s):  
Type I ◽  
Type Ii ◽  
Skin Reactions ◽  
Positive Skin ◽  
Similar Frequency ◽  
Hospital Patients ◽  
Protective Antibodies ◽  
Cutaneous Reactions ◽  
Circulating Antibodies ◽  
Almost All

1. A group of 41 non-serum treated patients with Type I, II or III pneumococcus pneumonia were studied during their disease and convalescence with respect to their skin reactions to specific pneumococcus polysaccharides and, in most instances, for the presence of circulating agglutinins and protective antibodies for all these 3 types. 2. One-half of the Type I and two-thirds of the Type II and Type III recovered cases gave the typical immediate "wheal and erythema" response to the homologous polysaccharide at or about the time of recovery. All cases tested showed protective antibodies and almost all showed agglutinins for the homologous pneumococcus. In the fatal cases, in general, positive cutaneous reactions and circulating antibodies were not obtained. 3. In cases of pneumonia receiving repeated cutaneous inoculations with various types of specific polysaccharide, antibodies for pneumococci differing from the infecting type but corresponding to the types of carbohydrate injected were present 1 week or later after such injections. These heterologous antibodies were most frequently demonstrated for Type II and were probably the result of immunization by means of the cutaneous injections. 4. Positive skin responses to homologous polysaccharides and corresponding circulating antibodies were demonstrated with similar frequency in the first 3 weeks after crisis in patients who had not previously received intracutaneous injections. In such patients heterologous antibodies were rarely found. 5. Typical skin reactions with the specific pneumococcus polysaccharides and mouse protective antibodies were demonstrated independently in a number of hospital patients who had had no recent history of pneumonia. 6. Some patients with demonstrable foci of persistent infection or with latent infections which later proved fatal showed positive cutaneous responses to the homologous type polysaccharide and circulating specific antibodies for the corresponding type. 7. The agglutination test, though less sensitive than the mouse protection test for determining the presence of antibody, has many advantages over the latter and is simplest to use in following the course of the untreated pneumonia.

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