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At least 973 records · Page 54Linked to original sources
PubMed1977

Exfoliative dermatitis from Chinese herbs (decoction)--an example of purely epidermal contact-type hypersensitivity to ingested medicines.

A patient, aged 78, with exfoliative dermatitis due to the ingestion of Chinese herbs (decoction) was presented. Provocative medication showed that he was sensitive to 4 composite materials (Radix angelicae acutilobae, Rhizoma zingiberis, Radix paeoniae and Radix glycyrrhizae). Patch tests were positive to each of these materials while the intradermal test was negative. These results indicate that systemic contact-type hypersensitivity to the ingested medicines is involved in evoking the exfoliative dermatitis lesion and that, in addition, purely epidermal contact sensitivity as defined by S. Epstein and Baer plays an important role.

Administration, Oral↗
PubMed1986

Observations on the long term effects of Brucella abortus infection in the horse, including effects during pregnancy and lactation.

Five mares and a stallion were studied from three to 30 months after experimental infection with Brucella abortus strain 544. The mares bred normally. No organisms were recovered from horses or from pregnant Friesian heifer contacts. Titres of serum antibody in the antiglobulin (Coombs) and complement fixation tests fell more slowly than those assessed by other tests. The serum of one foal yielded maternal antibody. An intradermal test was positive in infected adults only, and negative in all foals.

Animals↗
PubMed1981

Hydatid cyst of the liver with intrathoracic rupture.

In the last 10 years we have operated on 33 cases of hydatid cyst of the liver with intrathoracic rupture. Twenty-one out of 33 cases ruptured into bronchi, in seven the rupture affected the pleural cavity, and in six simultaneous rupture into the bronchus and pleural cavity occurred. Laboratory tests were not carried out in all cases. The Casoni intradermal test was carried out in 23 cases and was positive in 18. A liver scan was performed in 10 and was positive in all. Conservative operations were carried out in 22 patients. In these the hepatic cavity was evacuated and separately drained. This was followed by suturing the diaphragmatic rupture and also closing the bronchial opening if present. Lung resections were performed in 11 out of 33 cases. In eight lobectomy was carried out and in three segmental resections. Resection was necessary when suppuration and bronchiectatic changes affected the lung. Ruptured cyst into the pleural cavity requires emergency thoracotomy after the anaphylactic shock is over. Removal of the parasite, re-expansion of the lung, and drainage of the pleural and hepatic cavities is necessary. Immediate and late complications occurred in 13 patients. In two postoperative haemorrhage occurred and in two postoperative empyema developed. Recurrent haemoptysis was seen in five, persistent bile fistula in one, and dissemination of hydatid cyst in three. In the remaining 20 cases there was no complication. Operative mortality was nil.

Adult↗
PubMedDate not supplied

Evaluation of delayed hypersensitivity: from PPD to poison ivy.

Intact cell mediated immunity (CMI) requires a complex interaction between lymphocytes, macrophages, and cytokines. The presence of functional CMI can be easily tested in vivo by delayed hypersensitivity (DTH) skin testing. Delayed hypersensitivity skin testing has been commonly used in three ways; anergy screening, testing for infection with intracellular pathogens, and testing for sensitivity to contact allergens. Accurate anergy screening requires intradermal testing with four or more common recall antigens such as Candida albicans, tetanus toxoid, mumps, and purified protein derivative. Problems of antigen potency and availability can be overcome by using a multiple time test-like device that contains seven different recall antigens (Multitest CMI). Although testing for infection was once common, it is now only recommended for tuberculosis screening because most other antigens are either not predictive of infection or not commercially available. Accurate testing for contact allergy requires careful attention to technique, and limitation of allergens to the 20 antigens that are approved by the American Academy of Dermatology.

Allergens↗
PubMed1975

Allergy skin testing of children.

Skin tests are important aids in the management of patients with inhalant allergy. Their usefulness will be increased if these basic principles are kept in mind: (1) Scratch test should be sufficiently deep, (2) Antigen extracts used for intradermal tests should be fresh enough to insure their activity, (3) Two control tests should be used each time tests are done, (4) Hydroxyzine and promethazine may diminish skin reactivity; therefore, negative skin tests should not be relied upon until repeated in the absence of such medication, and (5) Skin tests for food allergy are quite unreliable, whether positive or negative. Food allergy is best studied by means of elimination trial diets.

Age Factors↗
PubMedDate not supplied

Allergen-specific low-dose immunotherapy in perennial allergic rhinitis: a double-blind placebo-controlled crossover study.

In a double-blind placebo-controlled crossover study, 36 adults with perennial allergic rhinitis were treated with daily subcutaneous injections of inhalant allergens, the doses of which had been predetermined by intradermal testing. The dose chosen for each allergen was the maximum intradermally tolerated dose (MITD) of that allergen, defined as 0.05 ml of the strongest concentration in a 1:5 dilution series which did not produce a positive wheal. Of the 27 who expressed a preference, 21 (78%) preferred the active preparation and six (22%) the placebo (p = 0.006). Significant symptom relief was apparent on an analysis of total rhinitis symptom scores (p = 0.006), nasal blockage (p = 0.02), nasal discharge (p = 0.006), postnasal drip (p = 0.02) and anosmia (p = 0.02). These results support the validity of allergen-specific low-dose immunotherapy using the MITD.

Adolescent↗
PubMedDate not supplied

Dapsone syndrome--a five year retrospective analysis.

Seventeen cases of dapsone syndrome were seen in five years from 1992 onwards. Their mean age was 27.8 years (range 11 to 60 years). Male to female ratio was 1.1:1. Of these cases, seven had confirmed leprosy, nine were cases of suspected leprosy and one case had lichen planus. On an average, they developed the symptoms 27 days after the intake of dapsone. The cutaneous lesions were in the form of erythematous papules and plaques (13 cases), eczematous lesions (four cases) and associated bullous lesions (two cases). The other manifestations were: fever (16 cases), pruritus (15 cases), lymphadenopathy (14 cases), hepatomegaly (10 cases), icterus and oral erosions (five cases each), photosensitivity (four cases) and splenomegaly (two cases). Previous drug allergy was present in four cases. Elevated ESR and liver enzyme levels were invariable findings. Raised bilirubin levels and hemolytic anaemia were seen in eight cases. Apart from one case with hepatic encephalopathy, all other cases had a favourable outcome either on conservative management (eight cases) or on oral corticosteroids (eight cases). Oral provocation test was done in two cases with positive response while intradermal test was not very reliable.

Adolescent↗
PubMed2002

[The importance of allergic skin test with Johnin, antibody ELISA, cultural fecal test as well as vaccination for the sanitation of three chronically paratuberculosis-infected dairy herds in Rhineland-Palatinate].

Three chronically paratuberculosis infected herds were tested for six years twice a year (intradermal Johnin test, antibody ELISA (IDEXX Corp.), microbial culture) according to a sanitary program. Culling of shedding animals and vaccination of calves with NEOPARASEC (Merial Corp.) were part of the program. In course of experiment, 1015 samples of 228 non vaccinated cows and 1502 samples of 293 vaccinated cattle have been tested. 3.8% of the vaccinated animals proved positive in microbial culture. Nearly all vaccinated calves developed granulomas sized from hazelnut to loaf at the injection site. Positive reactions in intradermal test as well as in antibody ELISA were found in very young calves. 24.3%, 33.7%, 25.9%, respectively of the non vaccinated animals were identified as shedders of M. avium subsp. paratuberculosis (MAP) by microbial culture. In the first and in the second herd most shedders of MAP were found in the first herd examination (66.7%, 42.9%, respectively), whereas in the third herd they were detected in the fifth examination (31.0%). At the beginning, 17.9% of non vaccinated animals proved positive in intradermal test, 14.4% in antibody ELISA. Afterwards, the number of positive test results decreased but increased again towards the end of the experiment. 48.5% of the 66 shedders showed positive reactions in intradermal test, 57.6% in antibody ELISA, 77.3% in at least one of these both tests. Antibodies in ELISA were found in rising frequency from two years before the time of shedding. 50.0% of the shedders reacted positive in ELISA at the time of shedding. In selected shedders first positive results were found at the age of about two years. Unfortunately, only incomplete hygienic measures were realized by the farmers. Under field conditions the realisation of attending sanitary programs is difficult. MAP is spread mainly by buying of animals, therefore a certification program for paratuberculosis free herds is urgently necessary as well as an improvement of diagnostic methods.

Animals↗
PubMed1985

Studies of human C5a as a mediator of inflammation in normal human skin.

C5a is an 11,000-D fragment of the fifth component of complement (C5) with potent anaphylatoxic and leukocyte chemotactic activities. C5a is believed to play an important role in the pathophysiology of certain skin disorders and systemic diseases with cutaneous manifestations. However, there is very little known about the in vivo reactivity of C5a in man. In this study we examined the effects of intradermal injections of human C5a in 17 normal volunteers. C5a was prepared by interacting highly purified human C5 with zymosan bound alternative pathway C5 convertase under conditions resulting in consumption of approximately 90% of the C5 substrate. C5a produced in this manner was chemotactic for human neutrophils and monocytes (0.5 X 10(-7) to 10(-9) M) and caused neutrophil aggregation and myeloperoxidase release (concentrations greater than or equal to 10(-10) M) in vitro. In vivo, C5a produced immediate wheal and flare reactions in all volunteers, and was active in doses as low as 1 ng (10(-13) mol). Intradermal testing with 20 ng of C5a in eight volunteers produced a maximal mean wheal of 11.75 mm (+/- 0.80 mm SEM) 20 min after anaphylatoxin injection, and a maximal mean erythema of 62.50 mm (+/- 3.27 mm SEM) 10 min after C5a administration. Reactions at C5a test sites were dose-related, associated with marked pruritus in some subjects, resolved without lesion formation, and were not associated with late phase reactions. In vivo testing revealed that human C5a was a more potent mediator of wheal and flare reactions than histamine, 48/80, human C3a, or morphine sulfate. Skin biopsies from eight volunteers 20 min after intradermal injection of 20 ng of C5a revealed a neutrophil-predominant perivascular infiltrate, endothelial cell edema, and sites of leukocytoclasis. Mast cell degranulation was observed on both light and electron microscopy of biopsies from C5a test sites. Although erythema at C5a injection sites was reduced by pretreating volunteers with hydroxyzine, whealing reactions and cellular infiltrates in biopsies were unaffected by this H1-antihistamine. Moderate doses of systemic corticosteroids did not alter clinical or histologic reactions at C5a injection sites in two volunteers. This study, using doses within the potential physiologic range of the anaphylatoxin, provides a comprehensive assessment of the effect of human C5a on normal human skin.

Adult↗
PubMed1977

Skin test for coeliac disease using a subfraction of gluten.

Gluten and various of its fractions and subfractions have been used for intradermal testing in 10 patients with coeliac disease and in 20 healthy control subjects. All the coeliac patients gave positive Arthus-type reactions (type III) to the subfractions of gluten, whereas all the control subjects were negative. The subfraction B2 evoked strong reactions in almost all the coeliac subjects. If tests with larger series confirm the present results, skin testing with B2 may prove to be a useful screening test for coeliac disease. As B2 has already been found to stimulate the lymphocytes of coeliac patients, the present findings are also of interest in relation to the pathogenesis of coeliac disease.

Adolescent↗
PubMed2005

Nonimmediate reactions to systemic corticosteroids suggest an immunological mechanism.

BACKGROUND: Administration of corticosteroids (CS) by different routes may cause varying types of allergic reactions, thereby hampering their further use in affected patients. In order to verify an immunological involvement we evaluated a group of patients with symptoms compatible with nonimmediate allergic reactions to CS. METHODS: Studies included patch and intradermal tests, immunohistochemical studies and controlled administration to reproduce the response. The cytokines interleukin (IL)-4, interferon (IFN)-gamma and tumor necrosis factor (TNF)-alpha were quantified in peripheral blood during the response. RESULTS: Of 32 subjects evaluated presenting nonimmediate urticaria or exanthema, 21 were finally considered positive after re-exposure. The drugs most frequently involved were betamethasone and dexamethasone. Fewer than half the patients responded to prednisolone whilst some responded to three or more CS. Hydrocortisone and deflazacort were well tolerated by all the patients. Subjects with a positive intradermal or patch test had a perivascular mononuclear cell infiltrate with the presence of CD4 and CD8 lymphocytes positive for CD45RO+ (memory) and CD69 (activation marker) cells. Monitoring peripheral blood during the acute response showed expression of IFN-gamma and TNF-alpha, with downregulation of IL-4. CONCLUSION: Adverse systemic responses to different CS are suggestive of a nonimmediate reaction. The symptoms elicited together with the immunlogical studies suggest a T-cell mediated response. The response to closely related CS was especially marked between betamethasone and dexamethasone, whereas hydrocortisone and deflazacort were well tolerated.

Adolescent↗
PubMed1988

Guanine and mite allergenicity in house dust.

Guanine is the major nitrogenous waste product in arachnids. It may serve as an indicator for allergenic mite faecal pellets. The present study assesses the correlation between the mit allergenicity of different house dust (HD) samples and their guanine content. Guanine content in HD samples was evaluated either by the Acarex-Test or determined quantitatively, especially for in-vitro methods. Using intradermal tests in selectively sensitized Dermatophagoides pteronyssinus (Dpt) patients, we evaluated the mite allergenicity of eight extracts obtained from HD samples with varying guanine contents. The weal area appeared to be proportional to the HD samples' guanine content. A three-fold increase in skin reactivity was observed when the guanine content varied from 0.06% to more than 1%. Patients allergic to HD but not to Dpt had no significant reactions with HD extract prepared from a guanine-rich HD sample. For eighteen different HD samples coupled to paper discs, the percentage Dpt RAST binding values obtained with a Dpt-selectively sensitized patient serum pool was correlated with the guanine concentrations of HD samples (P less than 0.01). The potencies of different HD extracts obtained from HD samples that varied in guanine content were also clearly distinguished on histamine-release titration curves. House dust obtained from homes at high altitude or from hospitals was generally guanine free. The HD sample guanine contents in homes where twelve Dpt-sensitized patients experienced symptoms were significantly higher than in homes where these patients were symptom free. The guanine colour test, a quick and easy technique, represents an important new development in indoor environmental investigations. It makes it possible to demonstrate mite faecal exposure and can be used to monitor the effectiveness of mite allergen avoidance measures.

Allergens↗
PubMed1994

High frequency of contact allergy to gold sodium thiosulfate. An indication of gold allergy?

When gold sodium thiosulfate was added to the patch test standard series, positive reactions were obtained in 8.6% of 823 consecutive patients with suspect contact allergy. The test reactions were clinically of an allergic type and, in several cases, long-lasting. There was no correlation with other allergens in the standard series. In a special study on 38 patients with contact allergy to gold sodium thiosulfate, the following principal findings were obtained: positive patch tests to the compound itself in dilute concentration; positive patch tests to potassium dicyanoaurate; negative patch tests to gold sodium thiomalate, sodium thiosulfate, and metallic gold; positive intradermal tests to gold sodium thiosulfate. Our findings make gold sodium thiosulfate the 2nd most common contact allergen after nickel sulfate. It is suggested that a positive skin test to gold sodium thiosulfate represents gold allergy.

Adult↗
PubMed1990

[The use of the direct basophil degranulation test for the diagnosis of allergy].

Basophil degranulation test (BDT) was used in examinations of patients suffering from allergies. A modified technique was employed with toluidine blue staining and basophil scintillation in a counter chamber. The examinees were divided into three groups. Group 1 (n = 34) consisted of patients suffering from atopic bronchial asthma with suspected sensitization to home dust. Group 2 included 118 patients with a history of allergy to penicillin. Group 3 consisted of 51 patients with drug allergies (streptomycin, vitamin B1, procaine, analgin intolerance). In all the cases specific diagnosis was confirmed by skin and provocation test. 71.4 percent of the patients with sensitization to home dust allergen showed positive results in BDT, as did 68.6 percent of Group 3 subjects. Of the cases with penicillin sensitization confirmed by application test 91.7 percent were positive in BDT, of those with positive intradermal tests, 66.7 percent were BDT-positive, this being probably explained by individual sensitivity of the patients. These results recommend BDT, an informative and simple technique, for wide practice.

Asthma↗
PubMedDate not supplied

Cost-effectiveness of various methods of diagnosing hypersensitivity to Alternaria.

This study was undertaken for two reasons: 1) It is more difficult to diagnose hypersensitivity to molds than to other allergens, so an evaluation of diagnostic tests was needed. 2) Alternaria is the principal cause of mold sensitization in our area. Sixty-six patients (20 +/- 4 years) were selected and divided into two groups. Group A was made up of patients with rhinitis and/or asthma due to Alternaria sensitization. Group B consisted of patients sensitized to other allergens and patients with nonrespiratory allergic disorders. Skin tests (prick and intradermal), challenge tests (conjunctival, nasal, and bronchial), and specific IgE determination were performed for all patients. A biologically standardized extract of Alternaria tenuis (Alergia e Inmunología Abelló, S. A., Madrid, Spain) obtained from a single batch was used for all tests. Our diagnostic criterion was a clinical history of rhinitis or asthma that coincided with the results of nasal/bronchial challenge. The diagnostic value of the other tests was compared to this criterion. In the group of rhinitic patients, skin tests and conjunctival challenge were more sensitive than specific IgE determination. In asthmatic patients, the most sensitive techniques were nasal and conjunctival challenges, followed by prick and intradermal skin tests, and, lastly, serum specific IgE determination. When rhinitis and asthma were considered jointly, the most sensitive test was conjunctival challenge, followed by skin-prick and intradermal tests. All tests had the same specificity, regardless of disorder. Nasal challenge was positive in all patients. Skin tests are easy to perform, cheap, non-traumatic for the patient, and sufficiently specific and sensitive for the diagnosis of Alternaria hypersensitivity.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Substance p-induced cutaneous and bronchial reactions in children with bronchial asthma.

We studied substance P-induced cutaneous and bronchial reactions in children with allergic disorders. Furthermore, inhibitory effects of lidocaine on these responses elicited by substance P were also studied. In the intradermal test, children with moderate or severe bronchial asthma showed significantly stronger reactions than controls. In bronchial challenge with substance P, children with bronchial asthma showed an increasing fall in FEV1 and V50 in proportion to the severity of their asthma. Concomitant use of lidocaine significantly inhibited not only substance P-induced intradermal erythema and wheal reactions but air flow limitations. It also inhibited histamine-induced erythema and house dust-induced wheal and erythema reactions. No adverse reactions to lidocaine were observed. These results suggest that substance P might play an important role in cutaneous and bronchial hypersensitivity reactions in humans and that lidocaine has an inhibitory effect on substance P-induced reactions.

Adolescent↗
PubMed2003

Anaphylaxis due to patent blue dye during lymphography, with negative skin prick test.

We report here a case of anaphylaxis due to patent blue dye, which was administered to an adult female during a lymphographic intraoperative procedure. The patient was not atopic, and other possible causes of anaphylaxis (anesthetics, latex) had been carefully excluded through routine tests. The skin-prick test and patch test carried out with patent blue (PB) dye were negative, but the intradermal test with 100 microliters of the dye showed a remarkable positivity. There was no available commercial, specific IgE assay for PB dye, but the negativity of prick tests would exclude the involvement of an IgE-mediated mechanism. We want to highlight the possible danger derived from a dye that is considered inert, and that is now increasingly being used in surgical procedures.

Anaphylaxis↗
PubMed1983

Effects of diluents on skin tests.

The role of diluents and preservatives on skin tests was examined in 41 allergic patients. The effect of glycerol in intradermal tests was studied. Concentrations of five percent glycerol were shown to induce a significant wheal which was not inhibited by clemastine fumarate, suggesting a direct toxic effect without the participation of histamine release. Twenty five Dermatophagoides pteronyssinus allergic patients were prick tested with standardized and lyophilized extracts reconstituted either in saline, 50% glycerol or human serum albumin. The wheal size induced by saline or HSA diluted extracts was very similar but greater than that elicited by extract dissolved in 50% glycerol. The correlation between prick tests induced by the three types of extracts tested was always significant.

Adolescent↗