Supplementary Files
Keywords
Skin prick test
Respiratory allergy diagnosis
Abstract
Background: The skin prick test is recognized as the gold standard for the specific diagnosis of allergy.
Objective: To determine the sensitivity and specificity of the epicutaneous patch test that has been modified for the diagnosis of respiratory allergy to Dermatophagoides pteronyssinus.
Methods: An observational, interpretative, prolective, and transversal study. The included patients were between 6 and 49 years old, with symptoms of a respiratory allergy, and a skin test was performed on them by using the European standardized prick test and a modified epicutaneous patch test with the variable of the scarification that occurred before the antigen was applied, and its homogenization with a wooden applicator, which occurred after the antigen was applied. The levels of sensitivity, specificity, and prevalence influence and positive and negative predictive values were calculated.
Results: 104 patients were included, of which 72 (69.2%) were women. The age category of the patients was 24 ± 11.3 years of age. 78.9% of the patients were diagnosed with allergic rhinitis, 1.9% were diagnosed with asthma, and 19.2% were diagnosed with both rhinitis and asthma. The prevalence of the respiratory allergy to Dermatophagoides pteronyssinus was of 62.5%; 94.23% with a correct diagnosis. The sensitivity and specificity of the test was of 93.85% and 94.87%; the positive and negative predictive values were of 96.83% and 90.24%, and the positive and negative likelihood ratios were of 18.30 and 0.06.
Conclusions: The modified epicutaneous patch test was highly sensitive and specific; it decreased the risk of allergen carryover and it lowered the cost of the material that was used.
References
Estrada RE, Barragán MM. Pruebas cutáneas en alergia. En: Méndez IJ, Huerta LJ, Bellanti J, Ovilla MR, Escobar GA, editores. Alergia. Enfermedad multisistémica: fundamentos básicos y clínicos. Puerto Rico: Panamericana; 2008.
Sicherer HS, Wood AR, American Academy of Pediatrics Section On Allergy And Immunology. Allergy testing in childhood: using allergen-specific IgE tests. Pediatrics. 2012;129:193-199. DOI: 10.1542/peds.2011-2382
Eigenmann PA, Atanaskovic-Markovic M, O’B Hourihane J, Lack G, Lau S, Matricardi PM, et al. Testing children for allergies: why, how, who and when: an updated statement of the European Academy of Allergy and Clinical Immunology (EAACI) Section on Pediatrics and the EAACI-Clemens von Pirquet Foundation. Pediatr Allergy Immunol. 2013;24(2):195-209. DOI: 10.1111/pai.12066
Larenas-Linnemann D, Mayorga-Butrón JL, Sánchez-González A, Ramírez-García A, Medina-Ávalos M, Figueroa-Morales MA, et al. ARIA México 2014. Adaptación de la Guía de Práctica Clínica ARIA 2010 para México. Rev Alerg Mex. 2014;61(Supl 1):S3-S116. Disponible en: http://revistaalergia.mx/ojs/index.php/ram/article/view/52/94
Fatteh S, Rekkerth DJ, Hadley JA. Skin prick/puncture testing in North America: a call for standars and consistency. Allergy Asthma Clin Immunol. 2014;10(1):1-9. DOI: 10.1186/1710-1492-10-44
Bernstein LI, Li TJ, Bernstein ID, Hamilton R, Spector LS, Tan R, et al. Allergy diagnostic testing: an updated practice parameter. Ann Allergy Asthma Immunol. 2008;100(Suppl 3):S1-S148. Disponible en: https://www.aaaai.org/Aaaai/media/MediaLibrary/PDF%20Documents/Practice%20and%20Parameters/allergydiagnostictesting.pdf
Peláez HA, Dávila GI. Tratado de alergología. España: Ergon; 2007.
Nieto A, Nieto M, Mazón A. Progresos en el diagnóstico de la alergia. Rev Alerg Mex. 2014;61:336-356. Disponible en: http://revistaalergia.mx/ojs/index.php/ram/article/view/8/8
Adkinson NF, Bochner SB, Busse WW, Holgate TS, Lemanske FR, O’Heir ER, et al. Middleton´s Allergy. Principles and practice. EE. UU.: Mosby; 2014.
Justo X, Díaz I, Gil JJ, Gastaminza G. Prick test: evolution towards automated reading. Allergy. 2016;71(8):1095-1102. DOI: 10.1111/all.12921
Masse MS, Granger Vallée A, Chiriac A, Dhivert-Donnadieu H, Bousquet-Rouanet L, Bousquet PJ, Demoly P, et al. Comparison of five techniques of skin prick tests used routinely in Europe. Allergy. 2011;66(11):1415-1419. DOI: 10.1111/j.1398-9995.2011.02679.x
Genser JK, Schmid GP. Diagnóstico de alergia in vivo: pruebas cutáneas. En: Akdis CA, Agache L, Demoly P, Hellings P, Muraro A, van Ree R, et al. Global atlas of allergy. Suiza: European Academy of Allergy and Clinical Immunology; 2014. Disponible en: http://www.eaaci.org/GlobalAtlas/GlobalAtlasAllergy.pdf
Haahtela T, Burbach GJ, Bachert C, Bindslev-Jensen C, Bonini S, Bousquet J et al. Clinical relevance is associated whith allergen-specific wheal size in skin prick testing. Clin Exp Allergy. 2014;44(3):407-416. DOI: 10.1111/cea.12240
Hendrick DJ, Davies RJ, D’Souza MF, Pepys J. An analysis of skin prick test reactions in 656 asthmatic patients. Thorax. 1975;30(1):1-2. DOI: 10.1136/thx.30.1.2
Pepys J. Laboratory methods in clinical allergy. Proc Roy Soc Med. 1972;65:271-272. Disponible en: https://journals.sagepub.com/doi/pdf/10.1177/003591577206500320
Ruwff F, Bergmann KC, Brockow K, Fuchs T, Grübl A, Jung K, et al. Skin test for diagnostics of allergic immediate-type reactions. Guideline of the German society for Allergology and Clinical Immunology. Pneumologie 2011;65(8):484-495. DOI: 10.1055/s-0030-1256476
Heizerling L, Mari A, Bergmann KC, Bresciani M, Burbach G, Darsow U, et al. The skin prick test-European standards. Clin Transl Allergy. 2013;3:1-10. DOI: 10.1186/2045-7022-3-3
Camacho-Ibarra VC, López-García AI, Galindo-García JA, Paz-Martínez D, Papaqui-Tapia J. Prevalencia de hipersensibilidad al látex en personal médico. Rev Alerg Mex. 1997;44(6):150-152.
Bousquet J, Heinzerling L, Bachert C, Papadopoulos NG, Burney PG, Canonica WG, et al. Practical guide to skin prick test in allergy to aeroallergens. Allergy. 2012;67(1):18-24. DOI: 10.1111/j.1398-9995.2011.02728.x
Ortega MJ, Huerta HR, Cossío OE. Pruebas cutáneas con extractos alergénicos. En: Larenas LD, Ortega MJ, Del Río-Navarro B, Rodríguez PN, Arias CA, Estrada A, et al. Guía Mexicana de Práctica Clínica de Inmunoterapia 2011. Rev Alerg Mex. 2011;58(1):16-21. Disponible en: http://www.elsevier.es/es-revista-revista-alergia-mexico-336-articulo-guia-mexicana-practica-clinica-inmunoterapia-X0002515111209882
Cox L, Williams B, Sicherer S, Oppenheimer J, Sher L, Hamilton R, et al. Pearls and pitfalls of allergy diagnostic testing: report from the American College of Allergy Asthma and Immunology/American Academy of Allergy, Asthma and Immunology Specific IgE Test Task Force. Ann Allergy Asthma Immunol. 2009;101(6):580-592. DOI: 10.1016/S1081-1206(10)60220-7
Australian Society of Clinical Immunology and Allergy. Skin prick testing for the diagnosis of allergic disease. A manual for practitioners. Australia: Australian Society of Clinical Immunology and Allergy; 2016.
Larenas LD, Guidos FG, Arias CA. Patrones de práctica de alergólogos mexicanos en cuanto a pruebas cutáneas con alérgenos durante 2005-2006. Rev Alerg Mex. 2008;55:10-17.
Nevis F, Binkley K, Kabali C. Diagnostic accuracy of skin-prick testing for allergic rinitis: a systematic review and meta-analysis. Allergy Asthma Clin Immunol. 2016;12:1-12. DOI: 10.1186/s13223-016-0126-0
Cardona VR, Serrano RC. Alergia: abordaje clínico, diagnóstico y tratamiento. Puerto Rico: Panamericana; 2010.
Schou-Nielsen J, Meterán H, Ulrik CS, Porsbjerg C, Backer V. Natural history of skin prick test reactivity: a 20-year prospective study of a random population sample of children and adolescents. Ann Allergy Asthma Immunol. 2017;119(2):184-188. DOI: 10.1016/j.anai.2017.05.001
Nam HY, Lee KS. Comparison between skin prick test and serum immunoglobulin E by CAP system to inhalant allergens. Ann Allergy Asthma Immunol. 2017;118(5):608-613. DOI: 10.1016/j.anai.2017.03.005
Chauveau A, Dalphin ML, Mauny F, Kaulek V, Hechfellner SE, Renz H, et al. Skin prick test and specific IgE in 10 years old children. Agreement and association with allergic diseases. Allergy. 2017;72(9):1-9. DOI: 10.1111/all.13148
Kwong YK, Jean T, Redjal N. Variability in measurement of allergen skin testing results among allergy-immunology specialists. J Allergy Ther. 2014;5:1-5. DOI: 10.4172/2155-6121.1000160
Önell A, Whiteman A, Nordlund B, Baldracchi F, Mazzoleni G, Hedlin G, et al. Allergy testing in children with persistent asthma: comparison of four diagnostic methods. Allergy. 2017;72(4):590-597. DOI: 10.1111/all.13047
Nevis FI, Binkley K, Kabali C. Diagnostic accuracy of skin prick testing for allergic rhinitis: a systematic review and meta-analysis. Allergy Asthma Clin Immunol. 2016;12:1-12. DOI: 10.1186/s13223-016-0126-0
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright (c) 2019 Revista Alergia México