The Diagnostic Value of Delayed-Type Reactions to Perennial Aeroallergens for Atopic Disease.

IF 4 3区医学 Q1 DERMATOLOGY

Dermatitis Pub Date : 2024-01-01 Epub Date: 2023-05-03 DOI:10.1089/derm.2022.0050

Puneet Arora, Rebecca L Freese, Paul L Bigliardi

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Abstract

Background: Delayed-type reactions to aeroallergens have been observed, however, their clinical significance continues to be debated. Objective: We assessed the prevalence and significance of delayed-type reactions to aeroallergens in atopic patients. Methods: Retrospective study including 266 patients with history or evidence of atopic disease (atopic dermatitis [AD], allergic rhinitis, and/or allergic asthma) and tested via either the intradermal skin test (IDT) or atopy patch test for common aeroallergens, specifically house dust mites (Dermatophagoides farinae, Dermatophagoides pteronyssinus) and perennial molds (Aspergillus fumigatus, Penicillium notatum). All patients were tested via IDT with both immediate (15 minute) and delayed (2 and 4 days) readings. Delayed reading was considered positive if the IDT injection site demonstrated at least 5 mm induration 48 hours after inoculation. Results: In total, 195 (73.3%) patients demonstrated an immediate-type reaction, whereas 118 (44.4%) had a delayed-type reaction. In total, 75 (28.2%) patients experienced both immediate- and delayed-type reactions, 43 (16.2%) reacted delayed-type only, and 85.3% of delayed-type reactions to individual aeroallergens were associated with eczematous lesions predominantly in air-exposed areas. Conclusion: Delayed-type reactions to aeroallergens are prevalent and clinically significant as a component of extrinsic AD and atopic diseases. The data support delayed reading of the IDT to guide diagnosis and management in these patients.

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对多年生空气过敏原的延迟型反应对特应性疾病的诊断价值。

背景：已观察到对航空过敏原的延迟型反应，但其临床意义仍存在争议。目的：我们评估了过敏症患者延迟型反应的发生率和意义：我们评估了特应性患者对空气过敏原的延迟型反应的发生率和意义。方法：回顾性研究回顾性研究纳入了 266 名有特应性疾病（特应性皮炎 [AD]、过敏性鼻炎和/或过敏性哮喘）病史或证据的患者，并通过皮内皮肤测试（IDT）或特应性贴片测试对常见的过敏原进行了检测，特别是屋尘螨（Dermatophagoides farinae、Dermatophagoides pteronyssinus）和多年生霉菌（Aspergillus fumigatus、Penicillium notatum）。所有患者都通过 IDT 进行了即时（15 分钟）和延迟（2 天和 4 天）读数检测。如果 IDT 注射部位在接种 48 小时后出现至少 5 毫米的压痕，则延迟读数为阳性。结果共有 195 名患者（73.3%）出现即时型反应，118 名患者（44.4%）出现延迟型反应。总共有 75 名（28.2%）患者同时出现即刻型和延迟型反应，43 名（16.2%）患者仅出现延迟型反应，85.3% 的延迟型反应与个别空气过敏原有关，主要是在暴露于空气的部位出现湿疹病变。结论是作为外源性 AD 和特应性疾病的一个组成部分，对空气致敏原的延迟型反应普遍存在，并具有重要的临床意义。这些数据支持延迟阅读 IDT，以指导这些患者的诊断和治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Dermatitis 医学-皮肤病学

CiteScore

5.30

自引率

11.50%

发文量

251

审稿时长

>12 weeks

期刊介绍： Dermatitis is owned by the American Contact Dermatitis Society and is the home journal of 4 other organizations, namely Societa Italiana di Dermatologica Allergologica Professionale e Ambientale, Experimental Contact Dermatitis Research Group, International Contact Dermatitis Research Group, and North American Contact Dermatitis Group. Dermatitis focuses on contact, atopic, occupational, and drug dermatitis, and welcomes manuscript submissions in these fields, with emphasis on reviews, studies, reports, and letters. Annual sections include Contact Allergen of the Year and Contact Allergen Alternatives, for which papers are chosen or invited by the respective section editor. Other sections unique to the journal are Pearls & Zebras, Product Allergen Watch, and news, features, or meeting abstracts from participating organizations.