改良皮肤点刺试验在慢性荨麻疹中的应用研究

目的 改良皮肤点刺试验在筛查皮肤过敏原中的应用评价.方法 随机入选475例慢性荨麻疹患者,年龄3～81岁,分别进行改良法(240例)和传统法(235例)皮肤点刺试验,比较两种点刺方法的过敏原阳性检出率.结果 过敏原总阳性检出率改良法为65.4％,传统法为67.2％,两组差异无统计学意义(P＞0.05),最常见的过敏原均...     

816例皮肤点刺试验过敏原结果分析

目的 探讨特应性皮炎、慢性荨麻疹、慢性湿疹常见过敏原的可能致病情况.方法 用标准变应原液在前臂屈侧皮肤进行皮肤点刺试验,分别用0.1%组胺和0.9%氯化钠液作阳性和阴性对照,统计分析采用x2检验.结果 尘螨(屋尘螨+粉尘螨)的阳性率最高,达50.0%～78.6%,其次为动物毛,达7.1%～21.4%,霉菌的阳性率也较高,达7.1%～14.3%,并且这3种变应原在3种疾病间的阳性率差异均有统计学意义(P＜0.01),以特异性皮炎的阳性率最高.食物组过敏原中虾的阳性率(6.6%～14.3%)最高,但在3种疾病间的阳性率差异无统计学意义(P＞0.05);金枪鱼在慢性荨麻疹中的阳性率(9.5%)较高,鸡蛋、牛奶、芹菜在特异性皮炎中的阳性率(7.1%～14.3%)较高,这4种变应原在3种疾病间的阳性率差异均有统计学意义(P＜0.05).结论 吸入组过敏原是慢性过敏性皮肤病的常见过敏原,尘螨为首要过敏原,以特异性皮炎的阳性率为最高.     

北京地区慢性荨麻疹阿罗格皮肤点刺试验变应原检测分析

目的研究北京地区慢性荨麻疹患者的常见过敏原。方法应用阿罗格皮肤点刺试验检测北京地区318例慢性荨麻疹患者的常见过敏原并对结果进行分析。结果318例患者中过敏原阳性133例,粉尘螨、户尘螨阳性率分别为28.93%和34.59%,其次是艾蒿、杂草和禾本科/谷类,分别占21.38%、15.09%和10.06%。结论粉尘螨和户尘螨是北京地区慢性荨麻疹患者重要过敏原,其次是艾蒿、杂草和禾本科/谷类。     

天津地区296例过敏性疾病皮肤点刺试验结果分析

目的分析天津地区296例过敏性疾病患者的常见变应原。方法采用皮肤点刺试验检测天津地区296例过敏性疾病患者的常见过敏原并对其结果进行分析。结果 296例患者中阳性患者125例,总阳性率为42.23%;其中粉尘螨、屋尘螨阳性率最高,分别为17.91%和15.20%,其次是蟑螂、艾蒿、干草尘埃,分别占9.12%、8.78%和6.08%。荨麻疹、湿疹和特应性皮炎患者的阳性率最高,分别为44.83%、42.64%和40.0%。结论粉尘螨和屋尘螨是天津地区过敏性疾病患者的常见致敏原,其次是蟑螂、艾蒿、干草尘埃,点刺试验是检测过敏原的重要手段。     

儿童湿疹872例血清过敏原特异性IgE检测结果分析

目的:检测湿疹患儿常见的过敏原,寻找儿童湿疹可能的过敏促发因素,为其治疗及预防提供依据。方法:采用Mediwiss公司AllergyScreen Analytic GmbH过敏原检测系统,对872例湿疹患儿进行血清特异性IgE(specific IgE,sIgE)和总IgE检测,并在不同年龄组间进行比较。结果:872例湿疹患儿slgE阳性690例(79.13%),总IgE阳性709例(81.30%)。其中吸入性过敏原最常见的依次为户尘螨(34.60%)、点青霉(22.71%)、屋尘(16.28%)和狗毛皮屑(10.89%);食物性过敏原中,最常见的依次为牛奶(36.12%)、羊肉(22.94%)、鸡蛋白(20.07%)和牛肉(13.88%)。比较1岁组,1~3岁组和3岁组,户尘螨、屋尘、狗毛皮屑、点青霉、鸡蛋白、牛奶、羊肉和蟹的sIgE阳性率的差异有统计学意义(P0.05)。结论:户尘螨、点青霉和屋尘是湿疹患儿最主要的吸入性过敏原,牛奶、羊肉、鸡蛋白是湿疹患儿最常见的食物性过敏原。随年龄增大,吸入性过敏原逐步取代食物成为主要过敏原。血清sIgE检测为湿疹患儿提示了相关过敏原,可以针对性地回避相关过敏原。     

温室大棚菜农慢性荨麻疹的患病情况及影响因素

目的探讨温室大棚内的环境因素与慢性荨麻疹的关系,并对大棚菜农慢性荨麻疹的影响因素进行分析。方法采用问卷方式对分层抽样方法得到的温室大棚菜农进行慢性荨麻疹患病率的调查,以普通菜农作对照,并对两组菜农患者行点刺试验,分析两组阳性过敏原的异同。结果大棚菜农慢性荨麻疹的患病率为5.15%高于普通菜农的患病率4.05%。两组菜农点刺试验中大棚组最常见的过敏原依次为尘螨、多价真菌Ⅰ、虾、多价真菌Ⅱ,普通组依次为尘螨、虾、蟑螂、夏秋花粉Ⅱ。吸入性过敏原中,大棚组尘螨阳性率(74.29%)远高于普通组(53.66%),且差异有统计学意义(P0.05)。大棚组真菌反应阳性率:Ⅰ为35.71%,Ⅱ为28.57%,与普通组相比均高,差异有统计学意义(P均0.05)。结论温室大棚菜农慢性荨麻疹的患病率高于普通菜农,且大棚内的高尘螨、真菌环境对菜农慢性荨麻疹的发生有影响,而花粉则影响不大。     

皮炎湿疹的速发型和迟发型变态反应检测分析

目的探讨对皮炎湿疹患者同时进行速发型和迟发型变态反应检测的必要性。方法对2007年3月～2009年3月间同时进行斑贴试验和点刺试验检查的复发性皮炎湿疹患者进行回顾性分析。结果212例同时进行斑贴试验和点刺试验检查的复发性皮炎湿疹患者中斑贴试验有一项或一项以上过敏原阳性者106例,阳性率为50.00%,阳性率最高的前三位过敏原为重铬酸钾(61/212)、硫酸镍(18/212)和甲醛(15/212)。点刺试验有一项或一项以上过敏原阳性者98例,阳性率为46.23%,阳性率最高的前三位过敏原为屋尘螨(46/212)、粉尘螨(42/212)和红辣椒(24/212);斑贴和点刺试验均有一项或一项以上过敏原阳性者42例,占总人数的19.81%,占斑贴试验阳性者的39.62%,占点刺试验阳性者的42.86%。结论为更好地筛查和有效避免变应原,有必要对反复发作的皮炎湿疹患者同时进行速发型和迟发型变态反应检查。     

荨麻疹患者尘螨变应原皮肤点刺试验与特异性IgE的关系

由于部分荨麻疹患者皮肤受压后会发红、起风团,因而可能或多或少地扩大变应原皮肤点刺试验的反应,甚至引起点刺试验假阳性,从而导致变应原的误诊,慢性荨麻疹最常见的变应原是尘螨[1].我们对最常见的尘螨过敏引起的慢性荨麻疹,在点刺试验的基础上,再进行血清特异性IgE(slgE)检测,比较尘螨变应原点刺试验阳性强度与其对应的血清slgE阳性级别,评估两者之间的相关性.     

特应性皮炎和慢性荨麻疹患者皮肤点刺试验检查结果分析

目的:了解皮肤点刺试验对特应性皮炎和慢性荨麻疹患者的临床意义。方法:对进行皮肤点刺试验的33例特应性皮炎和20例慢性荨麻疹患者的结果进行总结分析。结果:在特应性皮炎和慢性荨麻疹患者中均以粉尘螨(分别为78.79%,75.00%)和屋尘螨(分别为75.76%,70.00%)的阳性率最高,粉尘螨和屋尘螨在两者中的阳性率比较,差异均有统计学意义(χ2=9.04,P<0.05;χ2=12.35,P<0.05)。牛奶在慢性荨麻疹患者中的阳性率(30.00%)高于在特应性皮炎患者中的阳性率(6.06%),差异有统计学意义(χ2=8.00,P<0.05)。结论:特应性皮炎患者较慢性荨麻疹患者对粉尘螨、屋尘螨更易过敏,而后者较前者对牛奶更易过敏。进行皮肤点刺试验可以有效寻找过敏原,减少病情反复机会。     

835例变态反应性皮肤病变应原点刺试验结果分析

目的探讨皮肤变应原点刺试验在皮肤变态反应性疾病诊断中的意义。方法选用德国默克公司生产的阿罗格变应原点刺液17种进行试验，阳性对照用组胺，阴性对照用生理盐水，分别对835例荨麻疹、丘疹性荨麻疹等疾病进行皮肤点刺试验，大于3种过敏原阳性者和／或强阳性者为高敏感者。结果619例阳性（阳性率74．13％），高敏感者336例（40．24％），阳性率前五位的变应原分别为粉尘螨（58．44％）、屋尘螨（54．25％）、霉菌Ⅰ（32．8I％）、霉菌Ⅱ（27．31％）、树Ⅰ（19．04％）。随着年龄的增大，变应原．点刺试验阳性率呈阶梯状下降趋势（P〈0．01）。荨麻疹（83．29％）与丘疹性荨麻疹（80．14％）对变应原反应阳性率较高。结论粉尘螨和屋尘螨是本地区变态反应性皮肤病的最主要的变应原，许多患者可以对多种变应原产生过敏，可以出现强阳性，点刺阳性率随年龄的增大呈下降趋势。皮肤变应原点刺试验可以为变态反应性皮肤病患者避免接触相应过敏原和进行特异性脱敏治疗提供客观依据。     

Hand eczema in 45 bakers - a clinical study

The skin of bakers is heavily exposed to dough, spices, water and detergents. This is follow-up of a previous Swedish questionnaire study showing bakers to have a 3-fold increased risk of hand eczema. The aims were to establish diagnoses and to study consequences of hand eczema. From a cohort study of 2226 bakers, a random sample among bakers reporting hand eczema was examined. Of 60 randomly selected bakers reporting a history of hand eczema, 52 attended an examination comprising a standardized interview, documentation of clinical skin signs, patch testing and prick testing with standard and bakery series, and serum analyses. In all, 45 bakers confirmed a history of hand eczema, for which 11 (24%) had been on sick leave, with a median duration of 14 weeks. 13 (29%) had changed their occupation due to skin disease, 19 had positive patch test reactions to standard contact allergens - and 5 to bakery contact allergens. 16 bakers had positive prick tests to standard allergens, 10 to bakery allergens, of whom 9 reacted to flours. Since considerable medical and social consequences of hand eczema are seen, thorough diagnosis of contact allergy and IgE-mediated allergy in bakers, as well as preventive measures, are essential.     

Frequency of atopic dermatitis and relevance of food allergy in adults in Germany

Many factors may aggravate atopic dermatitis. The aim of this study was to determine the frequency of atopic dermatitis in an unselected population sample and to evaluate the role of food allergy. Patients with atopic dermatitis were recruited from the population in Berlin, Germany, using a postal questionnaire. Skin prick tests for allergens were performed, followed by food challenges. A total of 1739 questionnaires was returned. In all, 23.5% of patients stated that they had atopic dermatitis, and 146 persons (8.4%) fulfilled our atopic dermatitis criteria after a detailed telephone interview. Of these, 111 were examined, and 28 (1.6%) were identified as currently suffering from atopic dermatitis. Twenty-seven patients were further evaluated: 9/27 were found to be skin prick test negative, 19/27 were skin prick test positive either to pollen and/or food allergens. Nine of 27 were challenged with the suspected food allergen: 1/9 showed a worsening of the eczema, 3/9 had oral symptoms, and 5/9 were negative. In conclusion, only 20% of adults with a positive history of atopic dermatitis show active eczema lesions at a given time point. The data indicate that most individuals with atopic dermatitis were sensitized against pollen allergens and according to that, pollen-associated food allergens. A non-selected AD patient cohort does not frequently suffer from clinically relevant pollen-associated food allergy.     

特应性皮炎患者过敏原两种检测方法的相关性

目的探讨皮肤点刺试验和血清变应原特异性IgE检测的相关性。方法同时采用皮肤点刺试验(SPT)和德国MEDIwlss敏筛过敏原检测系统检测60例特应性皮炎(AD)患者的过敏原,并对检测结果进行比较。结果皮肤点刺试验和血清变应原特异性IgE的阳性率分别为3.89%(140/3600)和7.42%(89/1200),后者明显高于前者,差异有统计学意义(P=0.000),且这两种检测方法不相关(P=0.207)。结论皮肤点刺试验和血清变应原特异性IgE检测特应性皮炎过敏原不相关,必要时可同时进行这两种方法检测,并结合病史判断病情。     

Atopie-Patch-Test mit Aeroallergenen und Nahrungsmitteln

The atopy patch test (APT), a patch test employing allergens known to elicit IgE-mediated reactions which is assessed by evaluating eczematous skin lesions after 24 h to 72 h, was developed as a diagnostic tool for characterizing patients with aeroallergen-triggered atopic eczema (AE, atopic dermatitis). Positive APT reactions are associated with allergen-specific T-cell responses. The specificity of APT is higher than the specificity of skin prick tests or RAST. More studies for the standardization of APT methods are necessary, especially with regard to food APT.     

The Prevalence, Characteristics of and Risk Factors for Eczema in Belgian Schoolchildren

Abstract:  Childhood eczema is common in infants, but its nature and extent during later childhood remains unclear. In this cross-sectional study we examined the prevalence and characteristics of eczema in an unbiased community population of 2,021 Belgian schoolchildren, aged 3.4 to 14.8 years with skin prick testing and parental questionnaires. Our study identified an eczema prevalence of 23.3% and a considerable allergic co-morbidity, mainly in sensitized children. The reported prevalence of eczema in infancy was 18.5% and for current eczema 11.6%. The overall sensitization rate (33.2%) as well as sensitization rates for the individual allergens were significantly higher in children with "eczema ever." Sensitization to Dermatophagoides pteronyssinus (19.6%), mixed grass pollen (15.1%), and cat (9.1%) were most common. Until the age of 6 years, boys with eczema were significantly more sensitized than girls (p = 0.007). Children with both eczema in infancy and current eczema show a tendency to be more sensitized than children with eczema in infancy only or current eczema only, but significance was only noted for a few individual allergens. Analysis of factors associated with eczema revealed a predominantly atopic profile characterized by family or personal history of allergy. Breastfeeding and environmental factors seemed to assume little relevance except for a protective effect of prematurity and having a dog at birth.     

Allergic characteristics of urban schoolchildren with atopic eczema in Ghana

Background Atopic eczema is an increasing clinical problem in Africa. Objective To determine allergic characteristics and to identify possible risk factors for eczema among schoolchildren in an urbanized area in Ghana. Patients and methods Schoolchildren aged 3–16 years with eczema were recruited. For each patient, one to three age‐ and sex‐matched controls were selected. All children completed a questionnaire and were skin prick tested with a panel of allergens. Blood was drawn to determine the total and allergen‐specific IgE. Conditional logistic regression models with the matching factors included in the model were used to calculate the odds ratios and to adjust for possible confounders. Results A total of 52 children with eczema (27 boys and 25 girls) and 99 controls were included. Levels of total IgE were found to be 9.1 (1.1; 78.4) times more often elevated in children with eczema. This association was mainly driven by elevated IgE levels against cockroach antigen. Children with eczema were found to have 2.0 (0.87; 4.7) times more often positive skin prick tests (SPT), but this association diminished to 1.2 (0.40; 3.6) after adjustment for total IgE levels. Frequent washing with soap was identified as a risk factor for the development of eczema among these children. Conclusion Schoolchildren with eczema in Ghana were characterized by elevated IgE levels especially against cockroach antigen. The association between eczema and positive SPT was much weaker suggesting immune hyporesponsiveness of the skin. After adjustment for IgE level, SPT were less suitable to distinguish children with and without eczema.     

慢性湿疹和慢性荨麻疹患者1145例过敏原检测结果分析

目的了解沿海地区慢性湿疹和慢性荨麻疹患者的过敏原分布情况,探讨预防过敏性疾病发生的有效措施。方法采用皮肤点刺试验,对沿海地区1145例慢性荨麻疹和慢性湿疹患者进行过敏原检测。结果慢性荨麻疹和慢性湿疹患者的主要致敏原分别为牛奶(54.61%)、鸡蛋(52.34%)和鸡蛋(60.04%)、粉尘螨(58.97%)。东港市本地父母辈和子女辈的过敏原皮肤反应强度指数差异无统计学意义(P>0.05);父母辈为内地居民,而子女辈出生于东港市的二代之间对鱼虾蟹贝等海产品皮肤反应强度指数差异有统计学意义(P<0.001)。复习国内几个代表地区的过敏原检测情况,发现与本研究结果有相同趋势。结论沿海地区慢性荨麻疹和慢性湿疹患者的过敏原中鱼虾等海产品呈低敏感性,提示早期接触过敏原对预防过敏反应发生有重要意义。     

The association between contact allergy and hand eczema in 2 cross-sectional surveys 8 years apart

Hand eczema is a recurrent chronic skin disease related to contact allergy and atopic dermatitis. When possible, efforts should be redoubled to eliminate provoking factors. Our objective was to assess changes in the prevalence of self-reported hand eczema and to evaluate the association between contact allergy and hand eczema among adult Danes before and after nickel exposure regulation in Denmark. In 1990 and 1998, random samples of 15-41-year-old persons were examined in 2 cross-sectional studies of the general population in Copenhagen, Denmark. The studies included questionnaires, patch and prick testing. From 1990 to 1998 the prevalence of a history of hand eczema increased significantly. This increase did not appear to be fully explained by changes in the prevalence of flexural eczema, prick test reactivity, patch test reactivity, and nickel allergy. In 1990, nickel allergy and allergic nickel contact dermatitis were significantly associated with a history of hand eczema among women. In 1998, these associations were not found. It can be concluded that, from 1990 to 1998, the prevalence of a history of hand eczema rose significantly. It was indicated that it might be possible to prevent the hand eczema related to nickel allergy by exposure regulation, public education or both.