A Comparative Study of Atopy Patch Test Using House Dust Mite Antigens with Skin Prick Test and Specific Serum IgE Level in Atopic Dermatitis

Yim, Yong Soon; Park, Chun Wook; Lee, Cheol Heon

Abstract

BACKGROUND: In some patients with atopic dermatitis (AD), eczematous skin lesions can be induced by atopy patch test (APT) with house dust mite antigen. The results of APT in patients with AD varies in different studies, probably because of different test techniques. OBJECT: This study was done to evaluate the differences in three different APT techniques, and the relationship between APT and skin prick test, total IgE, and specific serum IgE level.
METHODS
We performed patch test in 93 patients with AD and 30 normal controls on clinically lesional and normal appearing skin with commercial house dust mite allergens in three different techniques (standard, scratch, DMSO). Reactions were evaluated after 48hours, and compared with the results of skin prick test, total and specific IgE levels. Detailed atopy history and severity scoring were taken.
RESULTS
There were no significant differences in positive APT results with three different techniques and different areas (lesional and normal appearing skin). The APT results showed significant concordances with skin prick test and RAST for house dust mite antigens. But there were no statistical significances between APT results and severity score and total IgE level.
CONCLUSION
The correlation of APT and RAST-skin prick test in this study suggests a possible role of delayed allergic reaction in the development of eczematous skin lesions after house dust mite antigen contact. The APT seems to be a valuable tool in diagnostic work-up in patients with atopic dermatitis.