Negative atopy patch test and negative skin prick test reduce the need for oral food challenge in children with atopic dermatitis

Angela Peron, Rossana Tenconi, Maddalena Leone, Patrizia Macellaro, Elena Ceriani, Alberto Flores D'Arcais

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Atopic dermatitis (AD) is commonly associated with food allergy. Oral food challenge is the gold standard in the diagnosis of food allergy, but still has some troubles. The aim of this study was to evaluate whether a single test among skin prick test (SPT), measurement of specific immunoglobulin E (IgE), and atopy patch test (APT) or a combination of them could make food challenges unnecessary in patients with AD. Twenty patients affected by AD, under 6 years of age, were evaluated. Every child was investigated for cow's milk and hen's egg allergy using SPT, measurement of serum IgE (sIgE), APT, diagnostic elimination diet for 4 weeks, and open food challenges for milk and egg. The diagnosis of food allergy was established according to the results of the food challenge. We compared the results of all the tests with those of the open food challenge and calculated for each test the following parameters: sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Eight of 40 open food challenges were assessed as positive. None of the diagnostic tools showed a sufficient accuracy to be able to replace the food challenge. However, SPT, APT, and the measurement of sIgE as single parameters showed an NPV of 90%, and the combination of SPT and APT showed an NPV of 92%. Food challenge remains the gold standard for food allergy diagnosis in young children with AD, but the combination of SPT and APT is useful when both tests are negative, because this result provides a guidance in excluding an allergy to the investigated food and could make the food challenge superfluous in this case.

Original languageEnglish
Pages (from-to)107-112
Number of pages6
JournalPediatric, Allergy, Immunology, and Pulmonology
Volume24
Issue number2
DOIs
Publication statusPublished - Jun 1 2011

Fingerprint

Patch Tests
Atopic Dermatitis
Skin Tests
Food
Food Hypersensitivity
Immunoglobulin E
Milk
Egg Hypersensitivity
Serum
Ovum
Hypersensitivity
Diet
Sensitivity and Specificity

ASJC Scopus subject areas

  • Immunology and Allergy
  • Pediatrics, Perinatology, and Child Health
  • Pulmonary and Respiratory Medicine

Cite this

Negative atopy patch test and negative skin prick test reduce the need for oral food challenge in children with atopic dermatitis. / Peron, Angela; Tenconi, Rossana; Leone, Maddalena; Macellaro, Patrizia; Ceriani, Elena; D'Arcais, Alberto Flores.

In: Pediatric, Allergy, Immunology, and Pulmonology, Vol. 24, No. 2, 01.06.2011, p. 107-112.

Research output: Contribution to journalArticle

Peron, Angela ; Tenconi, Rossana ; Leone, Maddalena ; Macellaro, Patrizia ; Ceriani, Elena ; D'Arcais, Alberto Flores. / Negative atopy patch test and negative skin prick test reduce the need for oral food challenge in children with atopic dermatitis. In: Pediatric, Allergy, Immunology, and Pulmonology. 2011 ; Vol. 24, No. 2. pp. 107-112.
@article{0e3a295c7c624c1eb94bd54b2596c1b3,
title = "Negative atopy patch test and negative skin prick test reduce the need for oral food challenge in children with atopic dermatitis",
abstract = "Atopic dermatitis (AD) is commonly associated with food allergy. Oral food challenge is the gold standard in the diagnosis of food allergy, but still has some troubles. The aim of this study was to evaluate whether a single test among skin prick test (SPT), measurement of specific immunoglobulin E (IgE), and atopy patch test (APT) or a combination of them could make food challenges unnecessary in patients with AD. Twenty patients affected by AD, under 6 years of age, were evaluated. Every child was investigated for cow's milk and hen's egg allergy using SPT, measurement of serum IgE (sIgE), APT, diagnostic elimination diet for 4 weeks, and open food challenges for milk and egg. The diagnosis of food allergy was established according to the results of the food challenge. We compared the results of all the tests with those of the open food challenge and calculated for each test the following parameters: sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Eight of 40 open food challenges were assessed as positive. None of the diagnostic tools showed a sufficient accuracy to be able to replace the food challenge. However, SPT, APT, and the measurement of sIgE as single parameters showed an NPV of 90{\%}, and the combination of SPT and APT showed an NPV of 92{\%}. Food challenge remains the gold standard for food allergy diagnosis in young children with AD, but the combination of SPT and APT is useful when both tests are negative, because this result provides a guidance in excluding an allergy to the investigated food and could make the food challenge superfluous in this case.",
author = "Angela Peron and Rossana Tenconi and Maddalena Leone and Patrizia Macellaro and Elena Ceriani and D'Arcais, {Alberto Flores}",
year = "2011",
month = "6",
day = "1",
doi = "10.1089/ped.2010.0044",
language = "English",
volume = "24",
pages = "107--112",
journal = "Pediatric, Allergy, Immunology, and Pulmonology",
issn = "2151-321X",
publisher = "Mary Ann Liebert Inc.",
number = "2",

}

TY - JOUR

T1 - Negative atopy patch test and negative skin prick test reduce the need for oral food challenge in children with atopic dermatitis

AU - Peron, Angela

AU - Tenconi, Rossana

AU - Leone, Maddalena

AU - Macellaro, Patrizia

AU - Ceriani, Elena

AU - D'Arcais, Alberto Flores

PY - 2011/6/1

Y1 - 2011/6/1

N2 - Atopic dermatitis (AD) is commonly associated with food allergy. Oral food challenge is the gold standard in the diagnosis of food allergy, but still has some troubles. The aim of this study was to evaluate whether a single test among skin prick test (SPT), measurement of specific immunoglobulin E (IgE), and atopy patch test (APT) or a combination of them could make food challenges unnecessary in patients with AD. Twenty patients affected by AD, under 6 years of age, were evaluated. Every child was investigated for cow's milk and hen's egg allergy using SPT, measurement of serum IgE (sIgE), APT, diagnostic elimination diet for 4 weeks, and open food challenges for milk and egg. The diagnosis of food allergy was established according to the results of the food challenge. We compared the results of all the tests with those of the open food challenge and calculated for each test the following parameters: sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Eight of 40 open food challenges were assessed as positive. None of the diagnostic tools showed a sufficient accuracy to be able to replace the food challenge. However, SPT, APT, and the measurement of sIgE as single parameters showed an NPV of 90%, and the combination of SPT and APT showed an NPV of 92%. Food challenge remains the gold standard for food allergy diagnosis in young children with AD, but the combination of SPT and APT is useful when both tests are negative, because this result provides a guidance in excluding an allergy to the investigated food and could make the food challenge superfluous in this case.

AB - Atopic dermatitis (AD) is commonly associated with food allergy. Oral food challenge is the gold standard in the diagnosis of food allergy, but still has some troubles. The aim of this study was to evaluate whether a single test among skin prick test (SPT), measurement of specific immunoglobulin E (IgE), and atopy patch test (APT) or a combination of them could make food challenges unnecessary in patients with AD. Twenty patients affected by AD, under 6 years of age, were evaluated. Every child was investigated for cow's milk and hen's egg allergy using SPT, measurement of serum IgE (sIgE), APT, diagnostic elimination diet for 4 weeks, and open food challenges for milk and egg. The diagnosis of food allergy was established according to the results of the food challenge. We compared the results of all the tests with those of the open food challenge and calculated for each test the following parameters: sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Eight of 40 open food challenges were assessed as positive. None of the diagnostic tools showed a sufficient accuracy to be able to replace the food challenge. However, SPT, APT, and the measurement of sIgE as single parameters showed an NPV of 90%, and the combination of SPT and APT showed an NPV of 92%. Food challenge remains the gold standard for food allergy diagnosis in young children with AD, but the combination of SPT and APT is useful when both tests are negative, because this result provides a guidance in excluding an allergy to the investigated food and could make the food challenge superfluous in this case.

UR - http://www.scopus.com/inward/record.url?scp=79959777129&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79959777129&partnerID=8YFLogxK

U2 - 10.1089/ped.2010.0044

DO - 10.1089/ped.2010.0044

M3 - Article

AN - SCOPUS:79959777129

VL - 24

SP - 107

EP - 112

JO - Pediatric, Allergy, Immunology, and Pulmonology

JF - Pediatric, Allergy, Immunology, and Pulmonology

SN - 2151-321X

IS - 2

ER -