Document Detail

Proposal for a standardized interpretation of the atopy patch test in children with atopic dermatitis and suspected food allergy.
MedLine Citation:
PMID:  16672009     Owner:  NLM     Status:  MEDLINE    
The interpretation of the atopy patch test (APT) to foods is not standardized. This study aimed to validate the reading of the APT in terms of the diagnostic accuracy of individual skin signs. Eighty-seven children (mean age 2.4 +/- 2.5 yr, range 0.5-13.5; 57 male) with atopic dermatitis (AD) and suspected food allergies underwent APT to cow's milk, hen's egg, wheat and soy. Twelve-millimetre Finn chambers were applied for 48 h, and results were read after 48 and 72 h. Skin changes were graded for erythema, induration, papule formation and 'crescendo' phenomenon (increase of skin sign severity from 48 to 72 h). Food allergy was assessed by double blind, placebo-controlled food challenges (DBPCFC). Sensitivity, specificity and predictive values were calculated for each skin signs in relation to challenge outcome. Of 165 DBPCFC children, 75 (45%) were positive. The combination of any skin induration plus papules (seven or more), or of moderate erythema plus any induration plus seven or more papules had a positive predictive value (PPV) and specificity for the challenge outcome of 100%; however, the sensitivity was low (8% and 15%). The best diagnostic accuracy for single signs was found for induration beyond the Finn chamber margin (PPV 88%, specificity 99%, sensitivity 9%) and presence of at least seven papules (PPV 80%, specificity 96% sensitivity 21%). Presence of both induration and of at least seven papules at 72 h were the APT skin signs with the greatest diagnostic accuracy for food allergy in children with AD.
Ralf G Heine; Andrea Verstege; Anne Mehl; Ute Staden; Claudia Rolinck-Werninghaus; Bodo Niggemann
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology     Volume:  17     ISSN:  0905-6157     ISO Abbreviation:  Pediatr Allergy Immunol     Publication Date:  2006 May 
Date Detail:
Created Date:  2006-05-04     Completed Date:  2007-08-06     Revised Date:  2008-05-28    
Medline Journal Info:
Nlm Unique ID:  9106718     Medline TA:  Pediatr Allergy Immunol     Country:  England    
Other Details:
Languages:  eng     Pagination:  213-7     Citation Subset:  IM    
Department of Pediatric Pneumology and Immunology, Children's Hospital Charité, Humboldt University, Berlin, Germany.
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MeSH Terms
Child, Preschool
Dermatitis, Atopic / etiology*,  pathology
Food Hypersensitivity / complications,  diagnosis*,  pathology
Patch Tests / standards*
Predictive Value of Tests
Prospective Studies
Skin / pathology
Time Factors

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