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Sample records for leishmanin skin test

  1. Evaluation of Leishmanin Skin Test Reaction in Different Variants of Cutaneous Leishmaniasis

    PubMed Central

    Sadeghian, Giti; Ziaei, Hengameh; Bidabadi, Leila Shirani; Nilforoushzadeh, Mohammad Ali

    2013-01-01

    Introduction: Cutaneous leishmaniasis (CL) is a parasitic disease which has different clinical forms. The aim of this study is to compare the response to leishmanin skin test (LST) in three forms of CL including plaque type, lupoid type, and sporotrichoid type. Materials and Methods: This was a descriptive cross-sectional study. The patients enrolled in this study had three clinical forms of CL confirmed by positive smear of their lesions and then LST was performed for them. Results were categorized as negative (0-5 mm induration), positive (6-14 mm), and strongly positive (≥15 mm). The data were documented in the patients’ files and analyzed with SPSS windows software version 16 (Inc.Chicago, USA). Results: 200 patients were enrolled in the study. In the group with plaque type, 86% had a positive LST, 13.3% were negative, and 0.7% were strongly positive. In the lupoid group, these figures were 45.8%, 8.4%, 45.8%, respectively. In the sporotrichoid group, LST was positive in 27.3%, negative in 72.7%, and none of the patients had a strongly positive reaction (P < 0.05). Discussion: The most of the positive LST were belong to plaque and lupoid groups, the most of strongly positive were belong to lupoid, and the most of negative LST were related with sporotrichoid type. Conclusion: It can be suggested that lupoid and sporotrichoid types of CL are parts of a continuous spectrum of the disease with an enhanced cellular immunity in lupoid form and a decreased state in sporotrichoid type. PMID:23723480

  2. Usefulness of the rK39-immunochromatographic test, direct agglutination test, and leishmanin skin test for detecting asymptomatic Leishmania infection in children in a new visceral leishmaniasis focus in Amhara State, Ethiopia.

    PubMed

    Gadisa, Endalamaw; Custodio, Estefanía; Cañavate, Carmen; Sordo, Luis; Abebe, Zelalem; Nieto, Javier; Chicharro, Carmen; Aseffa, Abraham; Yamuah, Lawrence; Engers, Howard; Moreno, Javier; Cruz, Israel

    2012-05-01

    In areas where visceral leishmaniasis is anthroponotic, asymptomatically infected patients may play a role in transmission. Additionally, the number of asymptomatic patients in a disease-endemic area will also provide information on transmission dynamics. Libo Kemkem and Fogera districts (Amhara State, Ethiopia) are now considered newly established areas to which visceral leishmaniasis is endemic. In selected villages in these districts, we conducted a study to assess the usefulness of different approaches to estimate the asymptomatic infection rate. Of 605 participants, the rK39 immunochromatographic test was able to detect asymptomatic infection in 1.5% (9 of 605), direct agglutination test in 5.3% (32 of 605), and leishmanin skin test in 5.6% (33 of 589); the combined use of serologic methods and leishmanin skin test enabled detecting asymptomatic infection in 10.1% (61 of 605). We conclude that the best option to detect asymptomatic infection in this new visceral leishmaniasis-endemic focus is the combined use of the direct agglutination test and the leishmanin skin test.

  3. Usefulness of the rK39-Immunochromatographic Test, Direct Agglutination Test, and Leishmanin Skin Test for Detecting Asymptomatic Leishmania Infection in Children in a New Visceral Leishmaniasis Focus in Amhara State, Ethiopia

    PubMed Central

    Gadisa, Endalamaw; Custodio, Estefanía; Cañavate, Carmen; Sordo, Luis; Abebe, Zelalem; Nieto, Javier; Chicharro, Carmen; Aseffa, Abraham; Yamuah, Lawrence; Engers, Howard; Moreno, Javier; Cruz, Israel

    2012-01-01

    In areas where visceral leishmaniasis is anthroponotic, asymptomatically infected patients may play a role in transmission. Additionally, the number of asymptomatic patients in a disease-endemic area will also provide information on transmission dynamics. Libo Kemkem and Fogera districts (Amhara State, Ethiopia) are now considered newly established areas to which visceral leishmaniasis is endemic. In selected villages in these districts, we conducted a study to assess the usefulness of different approaches to estimate the asymptomatic infection rate. Of 605 participants, the rK39 immunochromatographic test was able to detect asymptomatic infection in 1.5% (9 of 605), direct agglutination test in 5.3% (32 of 605), and leishmanin skin test in 5.6% (33 of 589); the combined use of serologic methods and leishmanin skin test enabled detecting asymptomatic infection in 10.1% (61 of 605). We conclude that the best option to detect asymptomatic infection in this new visceral leishmaniasis–endemic focus is the combined use of the direct agglutination test and the leishmanin skin test. PMID:22556076

  4. Longitudinal study of dogs living in an area of Spain highly endemic for leishmaniasis by serologic analysis and the leishmanin skin test.

    PubMed

    Solano-Gallego, Laia; Llull, Joan; Ramis, Antonio; Fernández-Bellon, Hugo; Rodríguez, Alhelí; Ferrer, Lluís; Alberola, Jordi

    2005-06-01

    The literature contains few longitudinal studies that have assessed areas endemic for canine leishmaniasis and over the same time interval Leishmania-specific cellular and humoral immunity in healthy dogs. Fourteen dogs, three mixed breed and 11 Ibizian hounds, living in an area of Spain that was highly endemic for leishmaniasis were followed-up over a three-year period by serologic analysis and the leishmanin skin test (LST). All but one of these dogs remained clinically healthy during the study period. Seroconversion was observed in four dogs. The three mixed breed dogs had a negative reaction in the LST in the first and third years. The general trend in the Ibizian hounds was an increase in the diameter of the LST reaction at both the 48- and 72-hour readings in the third year. This study demonstrates that in addition to an increase in Leishmania-specific humoral immune response in Ibizian hounds, a parallel increase in cellular immune response was observed.

  5. Reappraisal of Leishmanin Skin Test (LST) in the management of American Cutaneous Leishmaniasis: A retrospective analysis from a reference center in Argentina.

    PubMed

    Krolewiecki, Alejandro Javier; Almazan, Maria Cristina; Quipildor, Marcelo; Juarez, Marisa; Gil, Jose Fernando; Espinosa, Marco; Canabire, Maria; Cajal, Silvana Pamela

    2017-10-05

    Leishmania (Viannia) braziliensis is the species most frequently implicated with cutaneous and mucosal leishmaniasis in the Americas; its diagnosis is based on the identification of amastigotes in lesions, which is limited by low parasite burden. Leishmanin Skin Test (LST) is a support tool for diagnosis, based on delayed type hypersensitivity responses to Leishmania antigens injected intradermally, used in endemic areas as a complement to diagnosis. A retrospective analysis of individuals evaluated for their first episode of tegumentary leishmaniasis at a reference center in Argentina during the period 2006-2015 was performed, with the goal of assessing its usefulness as a support tool in the diagnosis of leishmaniasis. Demographic, clinical and diagnostic work-up were analyzed in individuals with clinically compatible lesions, lesion`s smear and LST. A total of 733 cases that met the case definition were included in the analysis; 678 (93%) localized cutaneous cases, 50 (7%) with mucosal involvement and 5 (<1%) disseminated. Diagnostic confirmation was reached in 474 (65%) cases through positive smears from skin or mucosal lesions, with only 6 cases among this group having negative LST. Among smear negative cases, 190 were negative also by LST, but in 69 instances LST was positive. Across age groups, similar ratios of sensitivity between smear and LST were calculated. Lesions older than 21 days-old were found to correlate with positive results both for smear and LST significantly more than younger lesions. These findings support the clinical use of LST as a diagnostic complement for American Cutaneous Leishmaniasis across all age groups even in endemic areas. In this analysis, the correlation with smear was high. Standardization of this technique and further research into its most adequate preparation and utilization protocols across different sites will help in the management of suspicious clinical cases.

  6. Evaluation of the efficacy of two leishmanins in asymptomatic dogs.

    PubMed

    Solano-Gallego, L; Llull, J; Arboix, M; Ferrer, L; Alberola, J

    2001-12-03

    There are few studies in dogs concerning leishmanin skin test. We evaluated and compared the efficacy of two leishmanin preparations for the detection of dog Leishmania cellular-mediated immunity. Clinically healthy dogs living in an endemic area were studied. A leishmanin preparation 1 (3 x 10(8) promastigotes/ml) was superior to a leishmanin preparation 2 (5 x 10(6) promastigotes/ml), measured as the percentage of positive reactions and the diameter of the induced induration. The leishmanin skin test is a valuable tool, although the results show that the degree of response, as it has been shown in human beings, depends on the preparation used.

  7. PPD skin test

    MedlinePlus

    ... is a method used to diagnose silent (latent) tuberculosis (TB) infection. PPD stands for purified protein derivative. ... skin test; Tuberculin skin test; Mantoux test Images Tuberculosis in the kidney Tuberculosis in the lung Positive ...

  8. Allergy Skin Tests

    MedlinePlus

    ... allergic rhinitis) Allergic asthma Dermatitis (eczema) Food allergies Penicillin allergy Bee venom allergy Latex allergy Skin tests are ... may recommend this test to check for an allergy to insect venom or penicillin. Patch test Patch testing is generally done to ...

  9. Leishmania Skin Test

    DTIC Science & Technology

    2010-03-01

    Ninhydrin ), SDS-PAGE and non-viability testing . See Table 3 below: Table 3: Drug Substance Specifications Test Method Specification SDS-PAGE...AD_________________ Award Number: DAMD17-00-C-0030 TITLE: Leishmania Skin Test PRINCIPAL INVESTIGATOR: Nielsen, H.S., Jr...TYPE FINAL, PHASE II ADDENDUM 3. DATES COVERED (From - To) 1 APR 2009 - 28 FEB 2010 4. TITLE AND SUBTITLE Leishmania Skin Test 5a

  10. Tuberculin Skin Testing

    MedlinePlus

    ... perpendicular to the long axis). How Are TST Reactions Interpreted? Skin test interpretation depends on two factors: ... among high-risk groups. What Are False-Positive Reactions? Some persons may react to the TST even ...

  11. Allergy testing - skin

    MedlinePlus

    ... may order allergy skin tests if you have: Hay fever ( allergic rhinitis ) and asthma symptoms that are not ... team. Related MedlinePlus Health Topics Allergy Food Allergy Hay Fever Browse the Encyclopedia A.D.A.M., Inc. ...

  12. CSD skin test

    MedlinePlus

    ... features on this page, please enable JavaScript. The cat scratch disease (CSD) skin test was once used to help ... Slater LN, Welch DF, Koehler JE. Bartonella, including cat-scratch disease. In: Bennett JE, Dolin R, Blaser MJ, eds. ...

  13. Echo: skin stress test

    NASA Technical Reports Server (NTRS)

    1960-01-01

    Skin Stress Test of the 12-foot satellite built as a prototype of the full-scale Echo satellite. The 12-foot diameter of the sphere was chosen because that was the ceiling height in the Langley model shop. The proposal to build the 12-foot satellite was made in November 1957. - Published in James R. Hansen, Spaceflight Revolution: NASA Langley Research Center From Sputnik to Apollo, NASA SP-4308, pp. 170-171.

  14. Histoplasma skin test

    MedlinePlus

    ... Histoplasma capsulatum. The fungus causes an infection called histoplasmosis. How the Test is Performed The health care ... have been exposed to the fungus that causes histoplasmosis . Normal Results No reaction (inflammation) at the site ...

  15. Quiz: Test Your Skin Cancer IQ

    MedlinePlus

    ... to fight against melanoma. Read More "Skin Cancer" Articles Skin Cancer Can Strike Anyone / Skin Cancer: Biology, Risk Factors & ... and Sun – Safety First / Quiz: Test Your Skin Cancer IQ Summer 2013 Issue: Volume 8 Number ... Us | Viewers & Players Friends of the National Library of Medicine (FNLM)

  16. A strategy for skin irritation testing.

    PubMed

    Robinson, Michael K; Perkins, Mary A

    2002-03-01

    Skin irritation safety testing and risk assessment for new products, and the ingredients they contain, is a critical requirement before market introduction. In the past, much of this skin testing required the use of experimental animals. However, new current best approaches for skin corrosion and skin irritation testing and risk assessment are being defined, obviating the need for animal test methods. Several in vitro skin corrosion test methods have been endorsed after successful validation and are gaining acceptance by regulatory authorities. In vitro test methods for acute, cumulative (repeat exposure), and chronic (prolonged exposure) skin irritation are under development. Though not yet validated, many are being used successfully for testing and risk assessment purposes as documented through an expanding literature. Likewise, a novel acute irritation patch test in human subjects is providing a valid and ethical alternative to animal testing for prediction of chemical skin irritation potential. An array of other human test methods also have been developed and used for the prediction of cumulative/chronic skin irritation and the general skin compatibility of finished products. The development of instrumental methods (e.g., transepidermal water loss, capacitance, and so on) has provided the means for analyzing various biophysical properties of human skin and changes in these properties caused by exposure to irritants. However, these methods do not directly measure skin inflammation. A recently introduced skin surface tape sampling procedure has been shown to detect changes in skin surface cytokine recovery that correlate with inflammatory skin changes associated with chemical irritant exposures or existing dermatitis. It holds promise for more objective quantification of skin irritation events, including subclinical (sensory) irritation, in the future.

  17. Cumulative skin irritation test of sanitary pads in sensitive skin and normal skin population.

    PubMed

    Farage, Miranda A; Maibach, Howard

    2007-01-01

    We performed a randomized, paired, double-blind trial involving 14 participants with self-declared normal skin and 15 participants with self-declared sensitive skin to test the cutaneous compatibility of materials of low irritation potential for skin irritation (sanitary pads) elicited by repetitive topical application. Two test products patches and two control substance patches were applied to the lateral aspect of the upper arm once daily under fully occlusive conditions for 4 days. The positive control patch was moistened with sodium lauryl sulphate (0.1% w/v) and the negative control patch was moistened with 0.9% sodium chloride, as were the two test material patches. The patches were removed, skin irritation (erythema) graded, and new patches applied after each 24-hour period. There was no significant difference in skin irritation from the test patches between the sensitive and normal skin groups. The two test patches and the negative control patch were significantly less irritating than the positive control in both test groups. Both test patches were comparable to the negative control patch in the normal and sensitive skin groups. The test materials produced similar degrees of skin irritation among both groups. Overall, there was no statistically significant difference in skin compatibility when the two feminine hygiene product test patches were worn by self-declared normal and sensitive skin groups.

  18. [Skin tests in chronic hand dermatitis].

    PubMed

    Bernier, C; Gélot, P

    2014-06-01

    Chronic hand dermatitis is often multifactorial but allergic causes are frequent and can complicate atopic dermatitis or irritant dermatitis. The management of patients affected by hand dermatitis includes detailed interrogation and a complete examination of the skin. Allergologic tests must be systematically realized if examination is suggestive of contact dermatitis or protein contact dermatitis, if an occupational origin is suspected but also in all patients in which treatment is ineffective. Skin tests include patch tests with the European standard series, specialized or additional series if necessary. Skin tests may also include personal items used by patients on a daily basis. If protein contact dermatitis is suspected skin tests include prick tests. Only complete and definitive eviction of allergens can allow a complete and definitive cure of chronic hand dermatitis. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  19. Aspergillus antigen skin test (image)

    MedlinePlus

    ... After 48 to 72 hours the site of injection is evaluated by a physician. If a positive reaction occurs (the test site is inflamed), the person has been exposed to the aspergillus mold and is at risk for developing aspergillosis.

  20. [Skin tests for trophallergens and asthma].

    PubMed

    Delacourt, C

    2002-12-01

    The place of trophallergens in the allergy investigation of asthmatic children is controversial. Asthma is only rarely the isolated manifestation of food allergy. The clinical history is essential for research of the associated signs that reveal a food allergy. In the absence of these associated signs, the presence of a positive test for trophallergens only rarely reflects a true food allergy, of which the presence can only be assured by a double blind oral provocation test. In addition, in nurslings, the presence of a positive skin test to a trophallergen indicates atopy in the infant, but is only a mediocre predictive factor of eventual asthma, in the absence of an associated clinical allergy.

  1. The skin prick test - European standards.

    PubMed

    Heinzerling, Lucie; Mari, Adriano; Bergmann, Karl-Christian; Bresciani, Megon; Burbach, Guido; Darsow, Ulf; Durham, Stephen; Fokkens, Wytske; Gjomarkaj, Mark; Haahtela, Tari; Bom, Ana Todo; Wöhrl, Stefan; Maibach, Howard; Lockey, Richard

    2013-02-01

    Skin prick testing is an essential test procedure to confirm sensitization in IgE-mediated allergic disease in subjects with rhinoconjunctivitis, asthma, urticaria, anapylaxis, atopic eczema and food and drug allergy. This manuscript reviews the available evidence including Medline and Embase searches, abstracts of international allergy meetings and position papers from the world allergy literature. The recommended method of prick testing includes the appropriate use of specific allergen extracts, positive and negative controls, interpretation of the tests after 15 - 20 minutes of application, with a positive result defined as a wheal ≥3 mm diameter. A standard prick test panel for Europe for inhalants is proposed and includes hazel (Corylus avellana), alder (Alnus incana), birch (Betula alba), plane (Platanus vulgaris), cypress (Cupressus sempervirens), grass mix (Poa pratensis, Dactilis glomerata, Lolium perenne, Phleum pratense, Festuca pratensis, Helictotrichon pretense), Olive (Olea europaea), mugwort (Artemisia vulgaris), ragweed (Ambrosia artemisiifolia), Alternaria alternata (tenuis), Cladosporium herbarum, Aspergillus fumigatus, Parietaria, cat, dog, Dermatophagoides pteronyssinus, Dermatophagoides farinae, and cockroach (Blatella germanica). Standardization of the skin test procedures and standard panels for different geographic locations are encouraged worldwide to permit better comparisons for diagnostic, clinical and research purposes.

  2. The skin prick test – European standards

    PubMed Central

    2013-01-01

    Skin prick testing is an essential test procedure to confirm sensitization in IgE-mediated allergic disease in subjects with rhinoconjunctivitis, asthma, urticaria, anapylaxis, atopic eczema and food and drug allergy. This manuscript reviews the available evidence including Medline and Embase searches, abstracts of international allergy meetings and position papers from the world allergy literature. The recommended method of prick testing includes the appropriate use of specific allergen extracts, positive and negative controls, interpretation of the tests after 15 – 20 minutes of application, with a positive result defined as a wheal ≥3 mm diameter. A standard prick test panel for Europe for inhalants is proposed and includes hazel (Corylus avellana), alder (Alnus incana), birch (Betula alba), plane (Platanus vulgaris), cypress (Cupressus sempervirens), grass mix (Poa pratensis, Dactilis glomerata, Lolium perenne, Phleum pratense, Festuca pratensis, Helictotrichon pretense), Olive (Olea europaea), mugwort (Artemisia vulgaris), ragweed (Ambrosia artemisiifolia), Alternaria alternata (tenuis), Cladosporium herbarum, Aspergillus fumigatus, Parietaria, cat, dog, Dermatophagoides pteronyssinus, Dermatophagoides farinae, and cockroach (Blatella germanica). Standardization of the skin test procedures and standard panels for different geographic locations are encouraged worldwide to permit better comparisons for diagnostic, clinical and research purposes. PMID:23369181

  3. Use of thermography in testing skin creams

    NASA Astrophysics Data System (ADS)

    Anttonen, Hannu; Kauppinen, Timo T.; Lehmuskallio, Eero; Rintamaki, Hannu

    1994-03-01

    The aim of the study was to test the effect of skin creams and their components in windy (3 m/s) and cold (-15 degree(s)C) conditions on face temperature and heat flux. The tests were carried out in a climatic chamber with 18 persons sitting in front of the opening of the wind tunnel, the wind directed against the face. Skin temperatures were measured from 4 points on both sides of the face with thermistors and the heat fluxes were measured using heat flux sensors on both cheeks. Also the ambient temperature and wind were registered. In addition to these measurements an IR thermal scanner was also used to measure the spatial and temporal distribution of temperature variation on the face during the exposure. The results were continuously recorded on VHS-video tape. Using still pictures from recorded material the area temperature of the cheek was measured, which described the mean temperature of the cheek. Test periods were 30 minutes and the same test subjects were not used until 48 h after the previous cold exposure. The test persons were young (20 - 30 years) healthy male persons. The total number of tests was 38.

  4. Skin fungal biocontamination and the skin hydrogel pad test.

    PubMed

    Paquet, P; Piérard-Franchimont, C; Piérard, G E; Quatresooz, P

    2008-04-01

    Previous observations have revealed that environmental nondermatophyte molds (NDM) can grow inside specific hydrogel pads (LaserAid). Some of these NDM might be responsible for superficial and invasive mycoses as well as for allergic respiratory and cutaneous disorders. The load of NDM propagules in the environment is considered to be an important risk factor for all these diseases. It is postulated that the quantification of the responsible fungi deposited at the skin surface may be an indicator of a recent exposure to environmental fungi. The aim of the present study was to assess using the LaserAid hydrogel pads, the density of living NDM adhering to the skin surface of healthy subjects. Sterile hydrogel pads were applied in a repeat procedure onto the normal-looking skin of the palms and face of 35 healthcare workers who were active in low exposure areas. Similar samplings were performed after washing the skin with a regular skin cleanser, or after applying an alcohol solution or a povidone iodine solution. As controls, 20 sterile pads were exposed for a few minutes to ambient air of the laboratory without any contact with the skin. Each of these samples was stored for 2 weeks at room temperature in a clean protected environment. After that period, visual inspection of the pads was followed by microscopic examination of PAS-stained 6 microm-thick sections. In addition, mycological cultures were performed from pieces of the pads deposited onto Sabouraud agar plates. While 19/20 air-exposed samples were not contaminated by environmental air-borne fungi, 61/70 of the initial skin samplings and 6/70 of the repeat skin samplings showed foci of fungal colonization confirmed by microscopic examination. No specific differences were disclosed between the face and palm samplings. Cultures revealed the presence of NDM in the majority (64/67) of the colonized pads, and a few Candida albicans contaminations (3/67) were also disclosed. The cleansing with a non

  5. Development and Testing of Living Skin Equivalent.

    DTIC Science & Technology

    1988-05-01

    Model a) The use of Isografts in an inbred strain of rats. In a preliminary series of experiments the potential use of Fischer strain rats has been...tested by preparing a series of isografts made by grafting skin equivalents with cells from female donors to male hosts. On the average, wound...Autograft--rat 4 1 4 3 5 17 Autograft--rabbit 6 3 1 1 11 Isograft --rat 37 13 13 1 64 Allo fib., iso ker--rat 15 12 3 30 Allo fib, iso ker--rab 8 6 14 Iso

  6. Allergies and skin testing: a Nairobi experience.

    PubMed

    De Souza, M

    1994-07-01

    A prospective study of 72 consecutive patients with symptoms of allergy is presented. Patients aged 20-39 years formed the bulk of the study population (55.6%). Most patients had allergic rhinitis (48.6%); bronchial asthma and atopic dermatitis occurred in 29 patients (40.3%) each. Drug allergies were found in 22 patients (30.6%), urticaria in 15 (20.8%), food allergies in 13 (18.1%), contact dermatitis in 10 (13.9%) and allergic conjuctivitis in 6 patients (8.3%). In many cases more than one allergic condition appeared simultaneously. Skin and prick tests and skin patch tests were done on 46 (63.9%) and 65 (90.3%) patients respectively. Soaps were most frequently implicated in positive reactions (75.0%); D. pteronyssinus, drugs, animal dander and foods gave positive reactions in 40.3%, 30.6%, 19.4% and 18.1% respectively. The need to have a high index of suspicion towards allergic conditions, especially extrinsic bronchial asthma, is stressed.

  7. [Allergens used in skin tests in Mexico].

    PubMed

    Larenas Linnemann, Désirée; Arias Cruz, Alfredo; Guidos Fogelbach, Guillermo Arturo; Cid del Prado, Mari Lou

    2009-01-01

    Immunotherapy is the only recognized causal treatment for allergies. It is prepared on an individual basis, based on the patient's clinical history and the result of the skin prick test (SPT). An adequate composition of the allergens with which to test the patient is crucial for an optimal diagnosis. To know allergens used in tests in allergy practices in Mexico. A national survey among all members of the Colegio Mexicano de Inmunología Clínica y Alergia (CMICA) and of the Colegio Mexicano de Pediatras Especialistas en Inmunología Clínica y Alergia (COMPEDIA) was carried out. In a second phase respondents were asked to send in the composition of a routine SPT in their clinic. The results are presented descriptively and the frequency is calculated by which certain allergen is tested in the interviewed practices. A survey response rate of 61 (17%) was obtained and 54% showed their SPT content. Weeds' representation in the SPT seems adequate; Atriplex is tested in all allergy practices. Some trees that show cross-reactivity might be eliminated from the SPT, but 20% doesn't test for Cynodon nor Holcus, and 25% doesn't for important allergens as cat, dog and cockroach. House dust and tobacco are still tested with certain frequency. The selection of which allergens to test in a SPT is based on multiple data, that change continuously with new investigations and discoveries. Our specialty is the most indicated--and obligated--to adjust constantly to these changes to have the best diagnostic tool to detect specific allergies.

  8. In vitro and human testing strategies for skin irritation.

    PubMed

    Robinson, M K; Osborne, R; Perkins, M A

    2000-01-01

    Prior to the manufacture, transport, and marketing of chemicals or products, it is critical to assess their potential for skin toxicity (corrosion or irritation), thereby protecting the worker and consumer from adverse skin effects due to intended or accidental skin exposure. Traditionally, animal testing procedures have provided the data needed to assess the more severe forms of skin toxicity, and current regulations may require animal test data before permission can be obtained to manufacture, transport, or market chemicals or the products that contain them. In recent years, the use of animals to assess skin safety has been opposed by some as inhumane and unnecessary. The conflicting needs of the industrial toxicologist to (1) protect human safety, (2) comply with regulations, and (3) reduce animal testing have led to major efforts to develop alternative, yet predictive, test methods. A variety of in vitro skin corrosion test methods have been developed and several have successfully passed initial international validation. These have included skin or epidermal equivalent assays that have been shown to distinguish corrosive from noncorrosive chemicals. These skin/epidermal equivalent assays have also been modified and used to assess skin irritation potential relative to existing human exposure test data. The data show a good correlation between in vitro assay data and different types of human skin irritation data for both chemicals and consumer products. The effort to eliminate animal tests has also led to the development of a novel human patch test for assessment of acute skin irritation potential. A case study shows the benefits of in vitro and human skin irritation tests compared to the animal tests they seek to replace, and strategies now exist to adequately assess human skin irritation potential without the need to rely on animal test methods.

  9. Diagnosis of penicillin allergy by skin testing: the Manitoba experience.

    PubMed Central

    Warrington, R. J.; Simons, F. E.; Ho, H. W.; Gorski, B. A.

    1978-01-01

    The reliability of skin testing in the diagnosis of penicillin allergy was studied in 86 adults and 167 children with a history of possible hypersensitivity reactions to penicillin. Skin testing was done with the major antigenic determinant of benzylpenicillin and minor determinants of benzylpenicillin, ampicillin, cloxacillin, methicillin and cephalothin. The overall frequency of positive skin reactions was 11.5%. Among the patients with positive skin reactions about half had a history of immediate or accelerated reactions to penicillins, but 2 of 11 adults and 50% of the children in this group had a history of maculopapular rash of delayed onset. There was a low frequency of positive skin reactions when there was a long interval between the times of clinical reaction and skin testing. Of 169 patients reacting negatively to skin testing who received a specific drug challenge only 2 manifested mild urticaria; this indicates the reliability of the skin tests in predicting penicillin allergy. The major and minor determinants of benzylpenicillin were the most useful reagents. One fifth of the patients with penicillin hypersensitivity would have been missed if the major determinant of benzylpenicillin alone had been used for skin testing. The additional use of the minor determinants of other penicillin derivatives, however, did not increase substantially the clinical reliability of the skin testing procedure. PMID:638909

  10. Zinc Cream and Reliability of Tuberculosis Skin Testing

    PubMed Central

    Rao, V. Bhargavi; Pelly, Tom F.; Gilman, Robert H.; Cabrera, Lilia; Delgado, Jose; Soto, Giselle; Friedland, Jon S.; Escombe, A. Roderick; Black, Robert E.

    2007-01-01

    In 50 healthy Peruvian shantytown residents, zinc cream applied to tuberculosis skin-test sitescaused a 32% increase in induration compared with placebo cream. Persons with lower plasma zinc had smaller skin-test reactions and greater augmentation with zinc cream. Zinc deficiency caused false-negative skin-test results, and topical zinc supplementation augmented antimycobacterial immune responses enough to improve diagnosis. PMID:18214192

  11. Quantitative skin prick and bronchial provocation tests with platinum salt.

    PubMed Central

    Merget, R; Schultze-Werninghaus, G; Bode, F; Bergmann, E M; Zachgo, W; Meier-Sydow, J

    1991-01-01

    Occupational asthma due to platinum salts is a frequent disease in platinum refineries. The diagnosis is based upon a history of work related symptoms and a positive skin prick test with platinum salts. Bronchial provocation tests have not been performed in epidemiological studies because the skin test is believed to be highly specific and sensitive. As no reliable data about this issue currently exist, this study assesses the use of skin prick and bronchial provocation tests with methacholine and platinum salt in platinum refinery workers. Twenty seven of 35 workers, who were referred to our clinic with work related symptoms and nine control subjects with bronchial hyperreactivity underwent a skin prick test and bronchial provocation with methacholine and platinum salt. For skin prick and bronchial provocation tests with platinum salt a 10(-2)-10(-8) mol/l hexachloroplatinic acid solution, in 10-fold dilutions was used. Four of the 27 subjects and all controls showed neither a bronchial reaction nor a skin reaction. Twenty three subjects were considered allergic to platinum salt; 22 of these showed a fall of 50% or more in specific airway conductance after inhalation of the platinum salt solution. Four workers experienced a positive bronchial reaction despite a negative skin prick test. No correlation of responsiveness to methacholine with responsiveness to platinum salt was found, but the skin prick test correlated with the bronchial reaction to platinum salt (rs = 0.50, p less than 0.023, n = 22). One dual reaction was seen in bronchial provocation tests. Side effects of both skin tests and bronchial provocation tests with platinum salt were rare and were not encountered in workers without a skin reaction to platinum salt. It is concluded that bronchial provocation tests with platinum salts should be performed on workers with work related symptoms but negative skin tests with platinum salts. PMID:1772797

  12. [A device for de-epithelization of the skin for skin scarification tests].

    PubMed

    Akhmedov, D R; Gadzhiev, A S

    1989-01-01

    The characteristic feature of the suggested device is the presence of a safety lock limiting a forward motion of the de-epithelializer into the depth of the epidermis; this rules out injuries of small vessels and provides the necessary depth of the epithelium removal. The device is recommended for skin allergic scarification tests and for Rebuck's skin fenestra test.

  13. [Bovine udder skin (BUS): testing of skin compatibility and skin protection].

    PubMed

    Pittermann, Wolfgang F; Kietzmann, Manfred

    2006-01-01

    New concepts of the horny layer as a metabolically active part of the epidermal permeability barrier elicited a re-evaluation of conventional mechanisms of occupational skin protection. Both skin protection products and noxae must penetrate the horny layer of the skin to be effective. The isolated perfused bovine udder skin (BUS) model reflects the natural penetration pattern; hence skin irritation, penetration and absorption can be investigated simultaneously. Using whole skin biopsies the degree of irritation in untreated (control), treated and pre-treated skin is measured by assessing the irritancy (PGE2-concentration) and cytotoxicity (MTT assay) after the exposure period of 0.5 h, 1.0 h and 5.0 h. Two types of skin protection studies were reported. One was a laboratory study using the water-soluble sodiumlaurylsulphate (10%, 15%) as noxa. The other study was initiated by a severely skin irritating water-soluble coolant (approx. 5%). This well documented case occurred in a metal working plant. In both studies different degrees of protective potential against the model noxae SLS and the coolant could be observed.

  14. Development of a forensic skin colour predictive test.

    PubMed

    Maroñas, Olalla; Phillips, Chris; Söchtig, Jens; Gomez-Tato, Antonio; Cruz, Raquel; Alvarez-Dios, José; de Cal, María Casares; Ruiz, Yarimar; Fondevila, Manuel; Carracedo, Ángel; Lareu, María V

    2014-11-01

    There is growing interest in skin colour prediction in the forensic field. However, a lack of consensus approaches for recording skin colour phenotype plus the complicating factors of epistatic effects, environmental influences such as exposure to the sun and unidentified genetic variants, present difficulties for the development of a forensic skin colour predictive test centred on the most strongly associated SNPs. Previous studies have analysed skin colour variation in single unadmixed population groups, including South Asians (Stokowski et al., 2007, Am. J. Hum. Genet, 81: 1119-32) and Europeans (Jacobs et al., 2013, Hum Genet. 132: 147-58). Nevertheless, a major challenge lies in the analysis of skin colour in admixed individuals, where co-ancestry proportions do not necessarily dictate any one person's skin colour. Our study sought to analyse genetic differences between African, European and admixed African-European subjects where direct spectrometric measurements and photographs of skin colour were made in parallel. We identified strong associations to skin colour variation in the subjects studied from a pigmentation SNP discovery panel of 59 markers and developed a forensic online classifier based on naïve Bayes analysis of the SNP profiles made. A skin colour predictive test is described using the ten most strongly associated SNPs in 8 genes linked to skin pigmentation variation. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  15. Testing of Raman spectroscopy method for assessment of skin implants

    NASA Astrophysics Data System (ADS)

    Timchenko, E. V.; Timchenko, P. E.; Volova, L. T.; Pershutkina, S. V.; Shalkovskaya, P. Y.

    2016-11-01

    Results of studies of testing of Raman spectroscopy (RS) method for assessment of skin implants are presented. As objects of study were used samples of rat's skin material. The main spectral differences of implants using various types of their processing appear at wavenumbers 1062 cm-1, 1645 cm-1, 1553 cm-1, 851 cm-1, 863 cm-1, 814 cm-1 and 1410 cm-1. Optical coefficients for assessment of skin implants were introduced. The research results are confirmed by morphological analysis.

  16. Tuberculin skin test and QuantiFERON in children.

    PubMed

    Bua, Alessandra; Molicotti, Paola; Cannas, Sara; Ruggeri, Melania; Olmeo, Paolina; Zanetti, Stefania

    2013-04-01

    Until some time ago, the tuberculin skin test was the only available screening test for the diagnosis of tubercular infection. Now the new interferon-? release assay QuantiFERON-TB Gold shows promise of greater accuracy in the detection of Mycobacterium tuberculosis-infected subjects. The aim of our study was to evaluate the use of QuantiFERONTB Gold in children and to verify its agreement with the tuberculin skin test. A total of 27 children had a positive tuberculin skin test, 76 subjects were negative and the remaining 2 had a dubious Mantoux test. A positive QuantiFERONTB Gold result was obtained in 21 children while in 84 it was negative. No statistically significant difference was detected between the two assays, which showed a concordance of 90.57%. Our results demonstrated a good concordance between the tuberculin skin test and the interferon-? release assay, though the QuantiFERON-TB may have several advantages over the Mantoux test.

  17. Elective penicillin skin testing in a pediatric outpatient setting.

    PubMed

    Jost, Barbara Capes; Wedner, H James; Bloomberg, Gordon R

    2006-12-01

    Adverse reactions associated with penicillin-type antibiotics are common in pediatric practice, leading to the subsequent unnecessary use of alternative antibiotics. IgE-mediated penicillin allergy represents only a fraction of these adverse reactions. To examine (1) the trend of penicillin skin test reactivity during a recent 10-year interval, (2) the relative distribution of specific reagents related to a positive skin test result, and (3) skin test reactivity as a function of reaction history. Penicillin testing using 3 reagents--benzylpenicilloyl polylysine, penicillin G, and sodium penicilloate (penicillin A)--was conducted in a prospective study of 359 consecutive patients referred to an outpatient pediatric allergy clinic between January 1, 1993, and May 31, 2003. We also retrospectively reviewed penicillin skin test results for 562 children previously tested between January 1, 1979, and December 31, 1992. Between 1993 and 2003, the prevalence of penicillin skin test sensitivity markedly declined. Of all the positive skin test results between 1979 and 2002, either penicillin G or sodium penicilloate or both identified 34%, with sodium penicilloate alone responsible for 8.5%. The rate of positive skin test reactions was not significantly different between patients with vs without a history of suggestive IgE-mediated reactions. A marked decline in penicillin skin test sensitivity in the pediatric age group is identified. The minor determinant reagents penicillin G and sodium penicilloate are both necessary for determining potential penicillin allergy. Relating history alone to potential penicillin sensitivity is unreliable in predicting the presence or absence of a positive skin test result.

  18. Cutaneous tuberculosis with nonreactive PPD skin test: a diagnostic challenge.

    PubMed

    Nassif, Priscila Wolf; Rosa, Ana Paula Zanatta; Gurgel, Ana Cristina Medeiros; Campanerut, Paula Aline Zanetti; Fillus Neto, José; Cardoso, Rosilene Fressatti

    2015-01-01

    The authors report a case of cutaneous tuberculosis in a 63-year-old female patient, who had an infiltrated, erythematous-ferruginous plaque of indurated aspect on her right leg and a nonreactive PPD skin test. Diagnosis was made by tissue culture and PCR of skin biopsy material. The treatment was performed with pyrazinamide, rifampicin, isoniazid and ethambutol, with good response.

  19. Cutaneous tuberculosis with nonreactive PPD skin test: a diagnostic challenge*

    PubMed Central

    Nassif, Priscila Wolf; Rosa, Ana Paula Zanatta; Gurgel, Ana Cristina Medeiros; Campanerut, Paula Aline Zanetti; Fillus Neto, José; Cardoso, Rosilene Fressatti

    2015-01-01

    The authors report a case of cutaneous tuberculosis in a 63-year-old female patient, who had an infiltrated, erythematous-ferruginous plaque of indurated aspect on her right leg and a nonreactive PPD skin test. Diagnosis was made by tissue culture and PCR of skin biopsy material. The treatment was performed with pyrazinamide, rifampicin, isoniazid and ethambutol, with good response. PMID:25672314

  20. Skin Testing for Allergic Rhinitis: A Health Technology Assessment

    PubMed Central

    Kabali, Conrad; Chan, Brian; Higgins, Caroline; Holubowich, Corinne

    2016-01-01

    Background Allergic rhinitis is the most common type of allergy worldwide. The accuracy of skin testing for allergic rhinitis is still debated. This health technology assessment had two objectives: to determine the diagnostic accuracy of skin-prick and intradermal testing in patients with suspected allergic rhinitis and to estimate the costs to the Ontario health system of skin testing for allergic rhinitis. Methods We searched All Ovid MEDLINE, Embase, and Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, CRD Health Technology Assessment Database, Cochrane Central Register of Controlled Trials, and NHS Economic Evaluation Database for studies that evaluated the diagnostic accuracy of skin-prick and intradermal testing for allergic rhinitis using nasal provocation as the reference standard. For the clinical evidence review, data extraction and quality assessment were performed using the QUADAS-2 tool. We used the bivariate random-effects model for meta-analysis. For the economic evidence review, we assessed studies using a modified checklist developed by the (United Kingdom) National Institute for Health and Care Excellence. We estimated the annual cost of skin testing for allergic rhinitis in Ontario for 2015 to 2017 using provincial data on testing volumes and costs. Results We meta-analyzed seven studies with a total of 430 patients that assessed the accuracy of skin-prick testing. The pooled pair of sensitivity and specificity for skin-prick testing was 85% and 77%, respectively. We did not perform a meta-analysis for the diagnostic accuracy of intradermal testing due to the small number of studies (n = 4). Of these, two evaluated the accuracy of intradermal testing in confirming negative skin-prick testing results, with sensitivity ranging from 27% to 50% and specificity ranging from 60% to 100%. The other two studies evaluated the accuracy of intradermal testing as a stand-alone tool for diagnosing allergic rhinitis, with

  1. Skin Testing for Allergic Rhinitis: A Health Technology Assessment.

    PubMed

    2016-01-01

    Allergic rhinitis is the most common type of allergy worldwide. The accuracy of skin testing for allergic rhinitis is still debated. This health technology assessment had two objectives: to determine the diagnostic accuracy of skin-prick and intradermal testing in patients with suspected allergic rhinitis and to estimate the costs to the Ontario health system of skin testing for allergic rhinitis. We searched All Ovid MEDLINE, Embase, and Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, CRD Health Technology Assessment Database, Cochrane Central Register of Controlled Trials, and NHS Economic Evaluation Database for studies that evaluated the diagnostic accuracy of skin-prick and intradermal testing for allergic rhinitis using nasal provocation as the reference standard. For the clinical evidence review, data extraction and quality assessment were performed using the QUADAS-2 tool. We used the bivariate random-effects model for meta-analysis. For the economic evidence review, we assessed studies using a modified checklist developed by the (United Kingdom) National Institute for Health and Care Excellence. We estimated the annual cost of skin testing for allergic rhinitis in Ontario for 2015 to 2017 using provincial data on testing volumes and costs. We meta-analyzed seven studies with a total of 430 patients that assessed the accuracy of skin-prick testing. The pooled pair of sensitivity and specificity for skin-prick testing was 85% and 77%, respectively. We did not perform a meta-analysis for the diagnostic accuracy of intradermal testing due to the small number of studies (n = 4). Of these, two evaluated the accuracy of intradermal testing in confirming negative skin-prick testing results, with sensitivity ranging from 27% to 50% and specificity ranging from 60% to 100%. The other two studies evaluated the accuracy of intradermal testing as a stand-alone tool for diagnosing allergic rhinitis, with sensitivity ranging from 60

  2. An in vitro human skin test for assessing sensitization potential.

    PubMed

    Ahmed, S S; Wang, X N; Fielding, M; Kerry, A; Dickinson, I; Munuswamy, R; Kimber, I; Dickinson, A M

    2016-05-01

    Sensitization to chemicals resulting in an allergy is an important health issue. The current gold-standard method for identification and characterization of skin-sensitizing chemicals was the mouse local lymph node assay (LLNA). However, for a number of reasons there has been an increasing imperative to develop alternative approaches to hazard identification that do not require the use of animals. Here we describe a human in-vitro skin explant test for identification of sensitization hazards and the assessment of relative skin sensitizing potency. This method measures histological damage in human skin as a readout of the immune response induced by the test material. Using this approach we have measured responses to 44 chemicals including skin sensitizers, pre/pro-haptens, respiratory sensitizers, non-sensitizing chemicals (including skin-irritants) and previously misclassified compounds. Based on comparisons with the LLNA, the skin explant test gave 95% specificity, 95% sensitivity, 95% concordance with a correlation coefficient of 0.9. The same specificity and sensitivity were achieved for comparison of results with published human sensitization data with a correlation coefficient of 0.91. The test also successfully identified nickel sulphate as a human skin sensitizer, which was misclassified as negative in the LLNA. In addition, sensitizers and non-sensitizers identified as positive or negative by the skin explant test have induced high/low T cell proliferation and IFNγ production, respectively. Collectively, the data suggests the human in-vitro skin explant test could provide the basis for a novel approach for characterization of the sensitizing activity as a first step in the risk assessment process. Copyright © 2015 John Wiley & Sons, Ltd.

  3. Predicting which medication classes interfere with allergy skin testing.

    PubMed

    Shah, Kunal M; Rank, Matthew A; Davé, Shoban A; Oslie, Corrine L; Butterfield, Joseph H

    2010-01-01

    Medications often interfere with allergy skin test interpretation. This study was performed to determine which medications interfere with allergy skin tests. We retrospectively reviewed skin-prick test results from patients who had discontinued H(1)-antagonists, tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), selective norepinephrine reuptake inhibitors (SNRIs), benzodiazepines, atypical antidepressants, antipsychotics, hypnotics, sedatives, proton pump inhibitors (PPIs), and H(2)-antagonists between 0 and 7 days before allergy skin testing. Ninety-seven subjects had taken second-generation H(1)-antihistamines within 7 days of skin testing; all patients who had stopped 3 days before testing had positive histamine controls. Two hundred sixty-eight skin tests performed on patients taking a single medication of interest showed that patients had the following percentages of a positive histamine control: TCAs, 56.5%; SNRIs, 100%; H(2)-blockers, 100%; SSRIs, 97%; PPIs, 97%; benzodiazepines, 85.7%; and atypical antidepressants/sedatives, 92.6%. The 580 patients taking multiple medications of interest showed that the odds ratio and 95% confidence intervals of a negative histamine test for patients taking TCAs were 6.33 (2.11-20.5), for H(1)-blockers were 4.95 (1.78-15.1), for benzodiazepines were 5.01 (1.72-15.80), for atypical antidepressants/sedatives were 3.11 (1.09-9.61), and for H(2)-blockers were 2.91 (0.97-9.37). The odds of a negative histamine test for SSRIs, SNRIs, or PPIs were not significantly increased. SSRIs, SNRIs, and PPIs are unlikely to interfere with skin testing. TCAs, H(1)-blockers, benzodiazepines, quetiapine, and mirtazapine should be discontinued temporarily if clinically able. H(2)-antagonists, bupropion, eszopiclone, trazodone, or zolpidem showed minimal interference with immediate hypersensitivity skin test histamine response.

  4. Reactivity of allergy skin test in healthy volunteers.

    PubMed

    Supakthanasiri, Phisit; Klaewsongkram, Jettanong; Chantaphakul, Hiroshi

    2014-01-01

    Healthy individuals may be exposed and sensitised to allergens, and have a positive response to a skin prick test despite being asymptomatic. The objectives of this study were to evaluate the prevalence of atopic sensitisation and identify the reactivity of healthy volunteers to common aeroallergens. Healthy volunteers with no known allergic symptoms were recruited in this study. All volunteers were scheduled to undergo a skin prick test with 16 common aeroallergens that were previously identified among atopic patients. A total of 100 volunteers (mean age 28 years) were enrolled in this study. 42 volunteers had positive skin prick tests for at least one allergen. The median number of sensitised allergen was 2 (range 1-7). Volunteers with positive skin tests (n = 42) were younger than those with negative skin tests (n = 58) (mean age 25.5 vs. 29.2 years; p < 0.05). The group with positive skin tests also had a higher proportion of males (57.1% vs. 31.0%; p < 0.01) and first-degree relatives with a history of atopic diseases (31.0% vs. 10.3%; p < 0.05). The most common sensitised allergens in these healthy asymptomatic volunteers were mite (n = 33), house dust (n = 23) and American cockroach (n = 20). In this study, up to 42% of healthy volunteers, particularly those with a family history of atopy, were sensitised to allergens. Reactivity of the skin test without allergic symptoms, however, does not indicate allergic disease. Therefore, the skin test should only be indicated in atopic symptomatic individuals.

  5. Cumulative irritation patch test of sanitary pads on sensitive skin.

    PubMed

    Farage, Miranda; Stadler, Angela

    2005-09-01

    Tools are needed to assess the effects of various products on sensitive skin. To investigate the cutaneous compatibility of various sanitary pads in people with self-declared sensitive skin. Eight subjects, who considered their skin to be sensitive and who reported adverse skin responses to everyday products or clothing, were patch tested on the arm with two, low-irritancy sanitary pads for four consecutive 24-hour periods. Test products differed only in their surface covering. Sodium lauryl sulfate solution (0.1% w/v) and physiological saline served as standard irritant and nonirritant controls, respectively. Skin irritation (erythema) was graded after each 24-hour period. No significant difference in skin erythema scores was observed between groups (scores on day 4: 1.06 +/- 0.11 vs. 1.25 +/- 0.13, on a five-point scale, P < 0.05). The temporal development of cumulative irritation associated with the pads was comparable to that observed with the nonirritant control (a plateau in maximal group scores) and distinct from that of the irritant control (continuously rising scores). Sanitary pads under investigation elicited negligible cumulative irritation in a four-day patch test on subjects with self-declared sensitive skin. The temporal pattern of cumulative response was consistent with the inherently low irritation potential of the products.

  6. Early skin and challenge testing after rocuronium anaphylaxis.

    PubMed

    Schulberg, E M; Webb, A R; Kolawole, H

    2016-05-01

    We present a case of early skin and challenge testing in a patient following severe anaphylaxis to rocuronium. The patient presented for semi-elective laparoscopic cholecystectomy and developed anaphylaxis with severe cardiovascular collapse after induction of anaesthesia. Surgery was cancelled but was considered necessary before the recommended four to six weeks for formal allergy testing. Limited skin and challenge testing was performed to rocuronium and cisatracurium while the patient was in the intensive care unit to identify a safe neuromuscular blocking drug for subsequent early surgery. The subsequent surgery, 48 hours after the initial reaction, was uneventful. The case highlights the difficulties when anaesthetising patients with recent anaphylaxis who have not yet had formal allergy testing and presents a potential management strategy involving early skin testing.

  7. Cutaneous Adverse Drug Reactions with Antimalarials and Allergological Skin Tests.

    PubMed

    Soria, Angèle; Barbaud, Annick; Assier, Haudrey; Avenel-Audran, Martine; Tétart, Florence; Raison-Peyron, Nadia; Amarger, Stéphanie; Girardin, Pascal; Francès, Camille

    2015-01-01

    Currently used antimalarial drugs (AM) are hydroxychloroquine and chloroquine, which are prescribed for many autoimmune disorders. The value of skin tests on cutaneous adverse drug reactions (CADR) with AM remains unknown. The main objective of this retrospective study is to know whether skin tests for AM are useful and how to manage the recovery of AM therapy in these patients. All patients referred for suspected CADR secondary to AM between 2001 and 2014 in eight French dermatology centers were retrospectively reviewed. We report herein a retrospective series of 20 patients with CADR and AM involvement. Skin tests, performed in 14/20 patients, were negative in all cases. Six patients had an oral provocation test with recurrence of CADR in 1 case. We encourage dermatologists to perform oral provocation tests in nonsevere CADR in order to allow AM rechallenge at progressive doses. © 2015 S. Karger AG, Basel.

  8. The lupus band test in oral mucosa, conjunctiva and skin.

    PubMed

    Burge, S M; Frith, P A; Millard, P R; Wojnarowska, F

    1989-12-01

    The prevalence and clinical significance of subepithelial immunoglobulin and complement deposition (the lupus band) were examined in the uninvolved sun-protected skin of the forearm, the uninvolved sun-protected lip mucosa and sun-protected bulbar conjunctival mucosa in systemic lupus erythematosus (SLE) and chronic cutaneous lupus erythematosus (CCLE). In SLE, linear deposition of an immunoreactant at the BMZ was detected in 32% (6/19) of skin biopsies; 21% (4/19) of lip mucosal biopsies and 42% (5/12) of conjunctival biopsies. There was no significant difference in the sensitivity of the test at different sites in SLE and no correlation between a positive test in skin, lip or conjunctiva and clinical mucosal involvement. In CCLE, linear deposition of an immunoreactant at the BMZ was found in 3% (1/32) of skin biopsies; 3% (1/29) of lip mucosal biopsies and 50% (10/20) of conjunctiva and clinical mucosal involvement. In the conjunctiva, IgG was present in all but one of the biopsies and was the only immunoreactant in 90% (9/10) of positive CCLE biopsies and 60% (3/5) of positive SLE biopsies. In lupus erythematosus immunoreactants may be deposited in the basement membrane zone beneath non-keratinizing mucosal surfaces of the lip and the eye as well as the skin. In CCLE, the test may be positive in conjunctiva when skin and lip are negative.

  9. Estimating Skin Cancer Risk: Evaluating Mobile Computer-Adaptive Testing

    PubMed Central

    Djaja, Ngadiman; Janda, Monika; Olsen, Catherine M; Whiteman, David C

    2016-01-01

    Background Response burden is a major detriment to questionnaire completion rates. Computer adaptive testing may offer advantages over non-adaptive testing, including reduction of numbers of items required for precise measurement. Objective Our aim was to compare the efficiency of non-adaptive (NAT) and computer adaptive testing (CAT) facilitated by Partial Credit Model (PCM)-derived calibration to estimate skin cancer risk. Methods We used a random sample from a population-based Australian cohort study of skin cancer risk (N=43,794). All 30 items of the skin cancer risk scale were calibrated with the Rasch PCM. A total of 1000 cases generated following a normal distribution (mean [SD] 0 [1]) were simulated using three Rasch models with three fixed-item (dichotomous, rating scale, and partial credit) scenarios, respectively. We calculated the comparative efficiency and precision of CAT and NAT (shortening of questionnaire length and the count difference number ratio less than 5% using independent t tests). Results We found that use of CAT led to smaller person standard error of the estimated measure than NAT, with substantially higher efficiency but no loss of precision, reducing response burden by 48%, 66%, and 66% for dichotomous, Rating Scale Model, and PCM models, respectively. Conclusions CAT-based administrations of the skin cancer risk scale could substantially reduce participant burden without compromising measurement precision. A mobile computer adaptive test was developed to help people efficiently assess their skin cancer risk. PMID:26800642

  10. Estimating Skin Cancer Risk: Evaluating Mobile Computer-Adaptive Testing.

    PubMed

    Djaja, Ngadiman; Janda, Monika; Olsen, Catherine M; Whiteman, David C; Chien, Tsair-Wei

    2016-01-22

    Response burden is a major detriment to questionnaire completion rates. Computer adaptive testing may offer advantages over non-adaptive testing, including reduction of numbers of items required for precise measurement. Our aim was to compare the efficiency of non-adaptive (NAT) and computer adaptive testing (CAT) facilitated by Partial Credit Model (PCM)-derived calibration to estimate skin cancer risk. We used a random sample from a population-based Australian cohort study of skin cancer risk (N=43,794). All 30 items of the skin cancer risk scale were calibrated with the Rasch PCM. A total of 1000 cases generated following a normal distribution (mean [SD] 0 [1]) were simulated using three Rasch models with three fixed-item (dichotomous, rating scale, and partial credit) scenarios, respectively. We calculated the comparative efficiency and precision of CAT and NAT (shortening of questionnaire length and the count difference number ratio less than 5% using independent t tests). We found that use of CAT led to smaller person standard error of the estimated measure than NAT, with substantially higher efficiency but no loss of precision, reducing response burden by 48%, 66%, and 66% for dichotomous, Rating Scale Model, and PCM models, respectively. CAT-based administrations of the skin cancer risk scale could substantially reduce participant burden without compromising measurement precision. A mobile computer adaptive test was developed to help people efficiently assess their skin cancer risk.

  11. A new alternative method for testing skin irritation using a human skin model: a pilot study.

    PubMed

    Miles, A; Berthet, A; Hopf, N B; Gilliet, M; Raffoul, W; Vernez, D; Spring, P

    2014-03-01

    Studies assessing skin irritation to chemicals have traditionally used laboratory animals; however, such methods are questionable regarding their relevance for humans. New in vitro methods have been validated, such as the reconstructed human epidermis (RHE) model (Episkin®, Epiderm®). The comparison (accuracy) with in vivo results such as the 4-h human patch test (HPT) is 76% at best (Epiderm®). There is a need to develop an in vitro method that better simulates the anatomo-pathological changes encountered in vivo. To develop an in vitro method to determine skin irritation using human viable skin through histopathology, and compare the results of 4 tested substances to the main in vitro methods and in vivo animal method (Draize test). Human skin removed during surgery was dermatomed and mounted on an in vitro flow-through diffusion cell system. Ten chemicals with known non-irritant (heptylbutyrate, hexylsalicylate, butylmethacrylate, isoproturon, bentazon, DEHP and methylisothiazolinone (MI)) and irritant properties (folpet, 1-bromohexane and methylchloroisothiazolinone (MCI/MI)), a negative control (sodiumchloride) and a positive control (sodiumlaurylsulphate) were applied. The skin was exposed at least for 4h. Histopathology was performed to investigate irritation signs (spongiosis, necrosis, vacuolization). We obtained 100% accuracy with the HPT model; 75% with the RHE models and 50% with the Draize test for 4 tested substances. The coefficients of variation (CV) between our three test batches were <0.1, showing good reproducibility. Furthermore, we reported objectively histopathological irritation signs (irritation scale): strong (folpet), significant (1-bromohexane), slight (MCI/MI at 750/250ppm) and none (isoproturon, bentazon, DEHP and MI). This new in vitro test method presented effective results for the tested chemicals. It should be further validated using a greater number of substances; and tested in different laboratories in order to suitably

  12. The effect of venom skin testing on venom RAST titers.

    PubMed

    Green, R L; Levine, M I

    1982-03-01

    Venom RAST titers were measured in 20 insect-sensitive patients before and two to three weeks after skin testing with insect venoms to determine whether venom testing might cause a rise in venom IgE titers. No significant rise in venom-specific RAST titers for honey bee, wasp and yellow jacket venoms was observed.

  13. Artificial microfluidic skin for in vitro perspiration simulation and testing.

    PubMed

    Hou, Linlin; Hagen, Joshua; Wang, Xiao; Papautsky, Ian; Naik, Rajesh; Kelley-Loughnane, Nancy; Heikenfeld, Jason

    2013-05-21

    To expedite development of any skin wearable material, product, or device, an artificial perspiration (sweat) simulator can provide improved ease, cost, control, flexibility, and reproducibility in comparison to human or animal tests. Reported here is a human perspiration mimicking device including microreplicated skin-texture. A bottom 0.2 μm track etched polycarbonate membrane layer provides flow-rate control while a top photo-curable layer provides skin-like features such as sweat pore density, hydrophobicity, and wetting hysteresis. Key capabilities of this sweat simulator include: constant 'sweat' rate density without bubble-point variation even down to ~1 L h(-1) m(-2); replication of the 2 pores mm(-2) pore-density and the ~50 μm texture of human skin; simple gravity-fed flow control; low-cost and disposable construction.

  14. Penicillin skin testing: potential implications for antimicrobial stewardship.

    PubMed

    Unger, Nathan R; Gauthier, Timothy P; Cheung, Linda W

    2013-08-01

    As the progression of multidrug-resistant organisms and lack of novel antibiotics move us closer toward a potential postantibiotic era, it is paramount to preserve the longevity of current therapeutic agents. Moreover, novel interventions for antimicrobial stewardship programs are integral to combating antimicrobial resistance worldwide. One unique method that may decrease the use of second-line antibiotics (e.g., fluoroquinolones, vancomycin) while facilitating access to a preferred β-lactam regimen in numerous health care settings is a penicillin skin test. Provided that up to 10% of patients have a reported penicillin allergy, of whom ~10% have true IgE-mediated hypersensitivity, significant potential exists to utilize a penicillin skin test to safely identify those who may receive penicillin or a β-lactam antibiotic. In this article, we provide information on the background, associated costs, currently available literature, pharmacists' role, antimicrobial stewardship implications, potential barriers, and misconceptions, as well as future directions associated with the penicillin skin test.

  15. Reliability of skin testing as a measure of nutritional state

    SciTech Connect

    Forse, R.A.; Christou, N.; Meakins, J.L.; MacLean, L.D.; Shizgal, H.M.

    1981-10-01

    The reliability of skin testing to assess the nutritional state was evaluated in 257 patients who received total parenteral nutrition (TPN). The nutritional state was assessed by determining body composition, by multiple-isotope dilution. Immunocompetence was simultaneously evaluated by skin testing with five recall antigens. These measurements were carried out before and at two-week intervals during TPN. A statistically significant relationship existed between the response to skin testing and the nutritional state. A body composition consistent with malnutrition was present in the anergic patients, while body composition was normal in the patients who reacted normally to skin testing. However, a considerable overlap existed as 43% of the reactive patients were malnourished, and 21% of the anergic patients were normally nourished. Thirty-seven (43%) of the 86 anergic patients converted and became reactive during TPN, and their body composition improved significantly. The remaining 49 anergic patients (57%) did not convert, and their body composition did not change despite similar nutritional support. The principal difference between the two groups of anergic patients was the nature of the therapy administered. In the anergic patients who converted, therapy was aggressive and appropriate, and clinical improvement occurred in 23 (62.2%) of the patients, with a mortality of 5.4%. In the 49 patients who remained anergic, therapy was often inappropriate or unsuccessful, with clinical improvement in only three (6.1%) of the patients and a mortality of 42.8%. The data demonstrated a significant relationship between the response to skin testing and the nutritional state. However, because of the wide overlap, skin testing does not accurately assess a person's nutritional state. The persistence of the anergic state is indicative of a lack of response to therapy.

  16. Improved wheal detection from skin prick test images

    NASA Astrophysics Data System (ADS)

    Bulan, Orhan

    2014-03-01

    Skin prick test is a commonly used method for diagnosis of allergic diseases (e.g., pollen allergy, food allergy, etc.) in allergy clinics. The results of this test are erythema and wheal provoked on the skin where the test is applied. The sensitivity of the patient against a specific allergen is determined by the physical size of the wheal, which can be estimated from images captured by digital cameras. Accurate wheal detection from these images is an important step for precise estimation of wheal size. In this paper, we propose a method for improved wheal detection on prick test images captured by digital cameras. Our method operates by first localizing the test region by detecting calibration marks drawn on the skin. The luminance variation across the localized region is eliminated by applying a color transformation from RGB to YCbCr and discarding the luminance channel. We enhance the contrast of the captured images for the purpose of wheal detection by performing principal component analysis on the blue-difference (Cb) and red-difference (Cr) color channels. We finally, perform morphological operations on the contrast enhanced image to detect the wheal on the image plane. Our experiments performed on images acquired from 36 different patients show the efficiency of the proposed method for wheal detection from skin prick test images captured in an uncontrolled environment.

  17. Non-animal testing strategies for assessment of the skin corrosion and skin irritation potential of ingredients and finished products.

    PubMed

    Robinson, M K; Cohen, C; de Fraissinette, A de Brugerolle; Ponec, M; Whittle, E; Fentem, J H

    2002-05-01

    The dermatotoxicologist today is faced with a dilemma. Protection of workers and consumers from skin toxicities (irritation and allergy) associated with exposure to products, and the ingredients they contain, requires toxicological skin testing prior to manufacture, transport, or marketing. Testing for skin corrosion or irritation has traditionally been conducted in animals, particularly in rabbits via the long established Draize test method. However, this procedure, among others, has been subject to criticism, both for its limited predictive capacity for human toxicity, as well as for its use of animals. In fact, legislation is pending in the European Union which would ban the sale of cosmetic products, the ingredients of which have been tested in animals. These considerations, and advancements in both in vitro skin biology and clinical testing, have helped drive an intensive effort among skin scientists to develop alternative test methods based either on in vitro test systems (e.g. using rat, pig or human skin ex vivo, or reconstructed human skin models) or ethical clinical approaches (human volunteer studies). Tools are now in place today to enable a thorough skin corrosion and irritation assessment of new ingredients and products without the need to test in animals. Herein, we describe general testing strategies and new test methods for the assessment of skin corrosion and irritation. The methods described, and utilized within industry today, provide a framework for the practicing toxicologist to support new product development initiatives through the use of reliable skin safety testing and risk assessment tools and strategies.

  18. Human skin equivalent as an alternative to animal testing.

    PubMed

    Mertsching, Heike; Weimer, Michaela; Kersen, Silke; Brunner, Herwig

    2008-03-11

    The 3-D skin equivalent can be viewed as physiologically comparable to the natural skin and therefore is a suitable alternative for animal testing. This highly differentiated in vitro human skin equivalent is used to assess the efficacy and mode of action of novel agents. This model is generated from primary human keratinocytes on a collagen substrate containing human dermal fibroblasts. It is grown at the air-liquid interface which allows full epidermal stratification and epidermal-dermal interactions to occur. Future emphasis is the establishment of different test systems to investigate wound healing, melanoma research and infection biology. Key features of this skin model are that it can be used as an alternative for in vivo studies, donor tissue can be tailored to the needs of the study and multiple analyses can be carried out at mRNA and protein level. Driven by both ethical and economical incentives, this has already resulted in a shift of the test strategies used by the Pharmaceutical Industry in the early drug development process as reflected by the increased demand for application of cell based assays. It is also a suitable model for testing a wide variety of endpoints including cell viability, the release of proinflammatory mediators, permeation rate, proliferation and biochemical changes.

  19. Non-animal test methods for predicting skin sensitization potentials.

    PubMed

    Mehling, Annette; Eriksson, Tove; Eltze, Tobias; Kolle, Susanne; Ramirez, Tzutzuy; Teubner, Wera; van Ravenzwaay, Bennard; Landsiedel, Robert

    2012-08-01

    Contact allergies are complex diseases, and it is estimated that 15-20 % of the general population suffers from contact allergy, with increasing prevalence. Evaluation of the sensitization potential of a substance is usually carried out in animal models. Nowadays, there is much interest in reducing and ultimately replacing current animal tests. Furthermore, as of 2013, the EU has posed a ban on animal testing of cosmetic ingredients that includes skin sensitization. Therefore, predictive and robust in vitro tests are urgently needed. In order to establish alternatives to animal testing, the in vitro tests must mimic the very complex interactions between the sensitizing chemical and the different parts of the immune system. This review article summarizes recent efforts to develop in vitro tests for predicting skin sensitizers. Cell-based assays, in chemico methods and, to a lesser extent, in silico methods are presented together with a discussion of their current status. With considerable progress having been achieved during the last years, the rationale today is that data from different non-animal test methods will have to be combined in order to obtain reliable hazard and potency information on potential skin sensitizers.

  20. Oxaliplatin hypersensitivity: evaluation, implications of skin testing, and desensitization.

    PubMed

    Wong, Johnson T; Ling, Morris; Patil, Sarita; Banerji, Aleena; Long, Aidan

    2014-01-01

    Oxaliplatin hypersensitivity (OXS) presents a challenge in the treatment of oxaliplatin-sensitive malignancies. To analyze patient characteristics of patients with OXS, skin test results, and desensitization outcomes to optimize management. Over 5 years, 48 patients with OXS were referred to the allergy/immunology unit at Massachusetts General Hospital. Their clinical reaction patterns were analyzed. Immediate hypersensitivity skin testing was used for risk stratification, and drug desensitizations were performed by using 3 related continuous intravenous protocols that were chosen based on clinical history, skin test reactivity, and the patients' previous desensitization outcomes. OXS occurred in both sexes, with mostly gastrointestinal-related tumors. Hypersensitivity reaction (HSR) onset had occurred during any course of therapy (course nos. 1-28), with a median onset at course no. 8. HSR to oxaliplatin was similar to those observed with cisplatin and carboplatin, including cutaneous, cardiovascular, pulmonary, and gastrointestinal symptoms. However, neurologic symptoms, including tingling, and systemic symptoms, including fever and chills, occurred more often in patients with OXS. Unique to OXS, 2 patients developed drug-induced thrombocytopenia; 1 patients also developed drug-induced hemolytic anemia. Skin testing was positive for the majority of patients with OXS (27/46 [59%]) and correlated with a greater likelihood of developing an HSR during subsequent desensitizations. We safely performed 200 desensitizations in 48 patients with OXS. OXS is common with much similarity to other platin agents but also have distinct differences in the onset of hypersensitivity, sex, tumor type, drug-induced hemolytic anemia, and drug-induced thrombocytopenia. Skin testing was helpful for risk stratification. All of the desensitizations were completed successfully. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights

  1. The predictive value of skin testing in the diagnosis of local anesthetic allergy.

    PubMed

    McClimon, Brad; Rank, Matthew; Li, James

    2011-01-01

    Local anesthetics are commonly used medications and can result in adverse reactions. The diagnostic workup of local anesthetic reactions remains controversial. This study was designed to determine the effectiveness of skin testing for local anesthetic allergy evaluation. A retrospective chart review was performed on patients undergoing local anesthetic skin testing. Patients were included if they underwent prick and intradermal skin testing followed by incremental subcutaneous challenge. Charts were further systematically reviewed to evaluate response to local anesthetics in the clinical setting after open subcutaneous challenge. One hundred seventy-eight patients underwent 227 local anesthetic skin tests. Two hundred twenty (97%) of the skin tests were negative. Of the negative skin tests results, 214 (97%) had negative challenge or probable non-IgE-mediated events during challenge. Three patients with six negative skin tests had a local reaction during the open subcutaneous challenge. Seven skin tests on five patients met the criteria for a positive skin test with local anesthetics. One patient had an equivocal local skin reaction with subcutaneous challenge without systemic effects. Three patients had a negative subcutaneous challenge and one patient did not undergo a challenge. Ninety-eight percent of patients receiving local anesthetics in the clinical setting after open subcutaneous challenge tolerated the medications. The negative predictive value of the local anesthetic skin test was 97% with few positive skin tests. Positive local anesthetic skin tests are uncommon and the local anesthetic skin tests have an excellent negative predictive value. Additional study with skin test-only protocols is warranted.

  2. Pumpless microfluidic platform for drug testing on human skin equivalents

    PubMed Central

    Abaci, Hasan Erbil; Gledhill, Karl; Guo, Zongyou; Christiano, Angela M.; Shuler, Michael L.

    2014-01-01

    Advances in bio-mimetic in vitro human skin models increase the efficiency of drug screening studies. In this study, we designed and developed a microfluidic platform that allows for long-term maintenance of full thickness human skin equivalents (HSE) which are comprised of both the epidermal and dermal compartments. The design is based on the physiologically relevant blood residence times in human skin tissue and allows for the establishment of an air-epidermal interface which is crucial for maturation and terminal differentiation of HSEs. The small scale of the design reduces the amount of culture medium and the number of cells required by 36 fold compared to conventional transwell cultures. Our HSE-on-a-chip platform has the capability to recirculate the medium at desired flow rates without the need for pump or external tube connections. We demonstrate that the platform can be used to maintain HSEs for three weeks with proliferating keratinocytes similar to conventional HSE cultures. Immunohistochemistry analyses show that the differentiation and localization of keratinocytes was successfully achieved, establishing all sub-layers of the epidermis after one week. Basal keratinocytes located at the epidermal-dermal interface remain in a proliferative state for three weeks. We use a transdermal transport model to show that the skin barrier function is maintained for three weeks. We also validate the capability of the HSE-on-a-chip platform to be used for drug testing purposes by examining the toxic effects of doxorubucin on skin cells and structure. Overall, the HSE-on-a-chip is a user-friendly and cost-effective in vitro platform for drug testing of candidate molecules for skin disorders. PMID:25490891

  3. Pumpless microfluidic platform for drug testing on human skin equivalents.

    PubMed

    Abaci, Hasan Erbil; Gledhill, Karl; Guo, Zongyou; Christiano, Angela M; Shuler, Michael L

    2015-02-07

    Advances in bio-mimetic in vitro human skin models increase the efficiency of drug screening studies. In this study, we designed and developed a microfluidic platform that allows for long-term maintenance of full thickness human skin equivalents (HSE) which are comprised of both the epidermal and dermal compartments. The design is based on the physiologically relevant blood residence times in human skin tissue and allows for the establishment of an air-epidermal interface which is crucial for maturation and terminal differentiation of HSEs. The small scale of the design reduces the amount of culture medium and the number of cells required by 36 fold compared to conventional transwell cultures. Our HSE-on-a-chip platform has the capability to recirculate the medium at desired flow rates without the need for pump or external tube connections. We demonstrate that the platform can be used to maintain HSEs for three weeks with proliferating keratinocytes similar to conventional HSE cultures. Immunohistochemistry analyses show that the differentiation and localization of keratinocytes was successfully achieved, establishing all sub-layers of the epidermis after one week. Basal keratinocytes located at the epidermal-dermal interface remain in a proliferative state for three weeks. We use a transdermal transport model to show that the skin barrier function is maintained for three weeks. We also validate the capability of the HSE-on-a-chip platform to be used for drug testing purposes by examining the toxic effects of doxorubucin on skin cells and structure. Overall, the HSE-on-a-chip is a user-friendly and cost-effective in vitro platform for drug testing of candidate molecules for skin disorders.

  4. Functional testing of topical skin formulations using an optimised ex vivo skin organ culture model.

    PubMed

    Sidgwick, G P; McGeorge, D; Bayat, A

    2016-07-01

    A number of equivalent-skin models are available for investigation of the ex vivo effect of topical application of drugs and cosmaceuticals onto skin, however many have their drawbacks. With the March 2013 ban on animal models for cosmetic testing of products or ingredients for sale in the EU, their utility for testing toxicity and effect on skin becomes more relevant. The aim of this study was to demonstrate proof of principle that altered expression of key gene and protein markers could be quantified in an optimised whole tissue biopsy culture model. Topical formulations containing green tea catechins (GTC) were investigated in a skin biopsy culture model (n = 11). Punch biopsies were harvested at 3, 7 and 10 days, and analysed using qRT-PCR, histology and HPLC to determine gene and protein expression, and transdermal delivery of compounds of interest. Reduced gene expression of α-SMA, fibronectin, mast cell tryptase, mast cell chymase, TGF-β1, CTGF and PAI-1 was observed after 7 and 10 days compared with treated controls (p < 0.05). Histological analysis indicated a reduction in mast cell tryptase and chymase positive cell numbers in treated biopsies compared with untreated controls at day 7 and day 10 (p < 0.05). Determination of transdermal uptake indicated that GTCs were detected in the biopsies. This model could be adapted to study a range of different topical formulations in both normal and diseased skin, negating the requirement for animal models in this context, prior to study in a clinical trial environment.

  5. Is there a need for repetition of skin test in childhood allergic diseases? Repetition of skin test and allergic diseases.

    PubMed

    Dogru, Mahmut; Bostanci, Ilknur; Ozmen, Serap; Ginis, Tayfur; Duman, Handan

    2014-06-01

    Skin prick tests are widely used to determine sensitivity in allergic diseases. There is limited information about the natural history of skin sensitization tests and factors that affect them. It was aimed to determine the changes in skin test results and the factors affecting the reactivity of skin tests after a period of approximately four years in children with allergic disease. SPT of 170 patients among 2485 children with asthma and/or allergic rhinitis and/or atopic dermatitis, who underwent SPT between 2005 and 2007, were repeated after an interval of at least 3 years. The mean age was 10.7 ± 3.1 (5-18) years and 70% of the patients were male. In total 66 (39.0% of the study population) had a different skin tests result in follow-up. Alterations: loss of sensitivity in 18 (11%) patients, the formation of a new sensitivity in 37 (22%) patients, and 11 (6%) both gained and lost sensitization. The presence of atopy in the family, the presence of allergic rhinitis and IgE elevation significantly predicted the incidence of new sensitization. The presence of sensitization to multiple allergens significantly predicted the incidence of loss of sensitization. It is found that there was an alteration of sensitization in 4/10 children at the end of the average 4-year period. The presence of family atopy, the presence of allergic rhinitis and serum total IgE elevation were risk factors for the development of new sensitization. On the other hand sensitization to multiple allergens was risk factors for the loss of sensitization.

  6. Validation of artificial skin equivalents as in vitro testing systems

    NASA Astrophysics Data System (ADS)

    Schmitt, Robert; Marx, Ulrich; Walles, Heike; Schober, Lena

    2011-03-01

    With the increasing complexity of the chemical composition of pharmaceuticals, cosmetics and everyday substances, the awareness of potential health issues and long term damages for humanoid organs is shifting into focus. Artificial in vitro testing systems play an important role in providing reliable test conditions and replacing precarious animal testing. Especially artificial skin equivalents ASEs are used for a broad spectrum of studies like penetration, irritation and corrosion of substances. One major challenge in tissue engineering is the qualification of each individual ASE as in vitro testing system. Due to biological fluctuations, the stratum corneum hornified layer of some ASEs may not fully develop or other defects might occur. For monitoring these effects we developed an fully automated Optical Coherence Tomography device. Here, we present different methods to characterize and evaluate the quality of the ASEs based on image and data processing of OCT B-scans. By analysing the surface structure, defects, like cuts or tears, are detectable. A further indicator for the quality of the ASE is the morphology of the tissue. This allows to determine if the skin model has reached the final growth state. We found, that OCT is a well suited technology for automatically characterizing artificial skin equivalents and validating the application as testing system.

  7. Comparison of the brucellin skin test with the lymphocyte transformation test in bovine brucellosis.

    PubMed Central

    Chukwu, C. C.

    1986-01-01

    The brucellin skin test and the lymphocyte transformation test were compared in heifers infected with virulent Brucella abortus strain 544, heifers vaccinated against brucellosis and unexposed cattle. Results of the in vitro lymphocyte transformation test were consistently positive for all 9 Brucella-infected heifers while the skin test was consistently positive for 6 of the 9 heifers. In 7 heifers repeatedly vaccinated with B. abortus strain-19 vaccine the in vitro test classified 3 animals as positive whereas the skin test identified all the animals as infected during most of the experimental period. Four heifers injected with a single dose of B. abortus strain 19 were consistently negative to the lymphocyte transformation test while the skin test classified all the animals as infected during most of the experimental period. The skin test gave strong reactions indicative of Brucella infection in heifers vaccinated with 'Duphavac' and 'Abortox' vaccines whereas the lymphocyte transformation test was consistently negative with these vaccines. The two tests were negative in unexposed cattle. It was concluded that the in vitro test correlated better with Brucella isolation than the in vivo test did and that the lack of agreement between the results of the two tests is likely to be due to the different antigens used in the assays. PMID:3734426

  8. MONTENEGRO SKIN TEST AND AGE OF SKIN LESION AS PREDICTORS OF TREATMENT FAILURE IN CUTANEOUS LEISHMANIASIS

    PubMed Central

    Antonio, Liliane de Fátima; Fagundes, Aline; Oliveira, Raquel Vasconcellos Carvalhaes; Pinto, Priscila Garcia; Bedoya-Pacheco, Sandro Javier; Vasconcellos, Érica de Camargo Ferreira e; Valete-Rosalino, Maria Cláudia; Lyra, Marcelo Rosandiski; Passos, Sônia Regina Lambert; Pimentel, Maria Inês Fernandes; Schubach, Armando de Oliveira

    2014-01-01

    A case-control study was conducted to examine the association among the Montenegro skin test (MST), age of skin lesion and therapeutic response in patients with cutaneous leishmaniasis (CL) treated at Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil. For each treatment failure (case), two controls showing skin lesion healing following treatment, paired by sex and age, were randomly selected. All patients were treated with 5 mg Sb5+/kg/day of intramuscular meglumine antimoniate (Sb5+) for 30 successive days. Patients with CL were approximately five times more likely to fail when lesions were less than two months old at the first appointment. Patients with treatment failure showed less intense MST reactions than patients progressing to clinical cure. For each 10 mm of increase in MST response, there was a 26% reduction in the chance of treatment failure. An early treatment - defined as a treatment applied for skin lesions, which starts when they are less than two months old at the first appointment -, as well as a poor cellular immune response, reflected by lower reactivity in MST, were associated with treatment failure in cutaneous leishmaniasis. PMID:25229216

  9. Construction of three-dimensional dermo-epidermal skin equivalents using cell coating technology and their utilization as alternative skin for permeation studies and skin irritation tests.

    PubMed

    Akagi, Takami; Nagura, Mayuka; Hiura, Ayami; Kojima, Hajime; Akashi, Mitsuru

    2017-03-23

    In vitro generated human skin equivalents are generating interest as promising tools in basic research, as alternatives to animal testing and for clinical applications in regenerative medicine. For prediction of skin irritation and corrosion, three-dimensional (3D) human skin equivalents consisting of differentiated human keratinocytes have been developed and some models have been internationally accepted. However, more delicate assessments using full-thickness skin models, such as skin sensitization tests cannot be performed because of the lack of a dermis containing fibroblasts or appendages. In a previous study, we developed dermo-epidermal human skin equivalents (DESEs) using a cell coating technique, which employs cell surface coating by layer-by-layer (LbL) assembled extracellular matrix (ECM) films. The DESEs with dermis consisting of normal human dermal fibroblasts (NHDF) and epidermis consisting of human keratinocytes (KC) were easily fabricated by using this technology. In this study, the constructed DESEs were evaluated as an alternative skin for skin permeation and irritation tests. A good relationship of permeability coefficient of chemicals was observed between the DESEs and human skin data. We investigated whether the DESEs, a new in vitro skin model, are able to identify skin irritant and non-irritant substances among 20 reference chemicals. It was confirmed that the DESEs are applicable to skin irritation testing as defined in the European Centre for the Validation of Alternative Methods (ECVAM) Performance Standard (OECD Test Guideline 439). We further studied the construction of the DESEs with density-controlled blood capillary networks using human umbilical vein endothelial cells (HUVEC). The results suggest that DESEs allowing incorporation of skin appendages are more promising alternatives to animal testing, and can be applied to the design of physiologically relevant in vitro skin models.

  10. Isolation of glycopeptides with skin test activity from dermatophytes.

    PubMed Central

    Moser, S A; Pollack, J D

    1978-01-01

    By using ethylene glycol extraction of whole submerged cultures followed by Sephadex G-200 and diethylaminoethyl-Sephadex chromatography, we isolated four distinct glycopeptides from Trichophyton mentagrophytes, T. rubrum, and Microsporum canis. Chemical analyses revealed that these glycopeptides contained mostly carbohydrate (42.5 to 81.6%) and protein (4.3 to 11.3%), with lesser amounts of phosphorus (0.4 to 6.0%) and hexosamines (0.3 to 0.6%). Based upon total carbohydrate and monosaccharide content, these dermatophyte glycopeptides could be divided into two chemical groups: glucopeptides (DSI1) and mannopeptides (DSI2, DSII1, and DSII2). The mannopeptides and glucopeptides of each species of dermatophyte were not significantly different chemically from those derived from the other two dermatophyte species studied. Skin testing of DSI1-glycopeptides or DSI2-mannopeptides in immunized guinea pigs indicated that only the DSI2-mannopeptides elicited a delayed hypersensitivity reaction. Skin testing T. mentagrophytes 62-infected guinea pigs with the four purified DS-glycopeptides, as well as earlier fractions from the purification scheme, derived from T. mentagrophytes, T. rubrum, and M. canis, again indicated that only the DSI2-mannopeptides of the two Trichophyton species elicited a delayed hypersensitivity reaction. The number of infections or duration of infection had no effect on the size of the skin test response. DSI2-mannopeptides were non-cross-reactive between genera when tested in Trichophyton-immunized or -infected guinea pigs and Microsporum-immunized guinea pigs. Images PMID:640721

  11. Comparison of different diagnostic products for skin prick testing.

    PubMed

    Pagani, M; Antico, A; Cilia, M; Calabrò, D; Poto, S; Pecora, S; Burastero, S E

    2009-02-01

    Different in vivo methods are used to quantify the amount of allergens in products for skin prick testing. It is unclear how this impacts on the correct diagnosis of allergies. We compared the allergenic potency of three commercial extracts for skin prick testing and evaluated batch-to-batch differences within each product. Patients with a mono-sensitization (specific IgE level > 0,70 KU/L, ImmunoCAP, Phadia) to Phleum pratense (N=21), Parietaria judaica (N=20) or Dermatophagoides pteronyssinus (N=28) were evaluated by standard skin prick testing and with the end-point dilution technique using commercial products from Stallergenes (A) (Antony, France), Lofarma Allergeni (B) (Milan, Italy) and ALK Abellò (C) (Hoersholm, Denmark). Results were expressed as mean areas of the wheal (cut-off for positive reactions: 7 mm2). With standard prick testing, the following differences in wheal areas were found: Phleum, C higher than B (p=0.0454); Parietaria, C higher than A (p=0.094); Dermatophagoides, C higher than A (p=0.021). With limiting dilution testing, the following differences in dilutions yielding positive skin prick tests were found: Phleum, C and B higher than A (p=0.0391 and 0.0039, respectively); Dermatophagoides, C higher than A and B (p=0.0010 and 0.0156, respectively). In the batch-to-batch comparison, mean differences between wheal areas of compared undiluted solutions did not significantly differ in any allergen tested, although in single cases large differences were observed. At the 1 to 64 dilution, agreement was significant only with Dermatophagoides from Manufacturer C (p= 0.262). At the 1 to 16 dilution, agreement was significant with Phleum from Manufacturer C (p=0.0116) and with Dermatophagoides from Manufacturer B and C (p=0.0239 and 0.0001, respectively). At the 1 to 4 dilution agreement was significant with Dermatophagoides from the three considered Manufacturers (p=0.0189, 0.0052 and 0.0077, respectively) and with Phleum from Manufacturer B and C

  12. Advanced Development of Leishmania Topical Skin Test Antigen

    DTIC Science & Technology

    2012-09-28

    Qualification of Cell Substrates and Other Biological Materials Used in the Production of Viral Vaccines for Infectious Disease Indications"(2010). The tests...product formulation was a phosphate buffer system as formulated below: 12.5mM Na2HPO4 12.5mM NaH2PO4 8.5% NaCl 0.4% Phenol 1.0% Glycerol 0.01...prior infection with the parasite. The test is commonly used to screen candidates in Leishmania vaccine trials. The skin test also has been used as a

  13. [Aeroallergens, skin tests and allergic diseases in 1091 patients].

    PubMed

    Enríquez Palomec, O; Hernández Chávez, L; Sarrazola Sanjuan, D M; Segura Méndez, N H; Hernández Colín, D D; Martínez-Cairo, S

    1997-01-01

    To know the frequency of positively of several skin tests, data cards from patients, of the Allergy and Clinic Immunology Service of the Hospital de Especialidades del Centro Medico Nacional Siglo XXI (Mexico City), between January, 1989 and March, 1995, were reviewed. Aqueous extracts manufactures by our laboratory were applied, in a dilution of 1:1000 weight-volume. 1091 from 5,651 skin tests patients were positive. Asthma and rhinitis were diagnosed in 492, allergic rhinitis in 289, allergic asthma in 111, and other diagnosis in 199 cases. The most frequent inhalable aeroallergens were house dust and perennial Dermatophagoides p and f1 with predominance in the rainy season, followed by pollens from Fraxinus a. Quercus a and Capriola, with predominance in the rainy season. The most frequent fungi were Candida and Fusarium, with predominance in the dry season.

  14. Antimicrobial efficacy of biocides tested on skin using an ex-vivo test.

    PubMed

    Maillard, J Y; Messager, S; Veillon, R

    1998-12-01

    An ex-vivo test was used to evaluate the activity of antimicrobials against three microorganisms, Escherichia coli, Pseudomonas aeruginosa and Staphylococcus aureus. The ex-vivo test is a carrier test using freshly excised animal skin samples maintained in viable conditions for a short period of time. Skin samples came from a veterinary practice and were excised from either dogs or cats. The antimicrobial activity of povidone iodine, chlorhexidine diacetate, cetrimide and benzalkonium chloride was also evaluated with suspension and glass-carrier tests. Generally, the activity of the antimicrobials tested was reduced when applied to the skin surface. Apart from povidone iodine (2%) against S. aureus, the biocides investigated failed to achieve a 5 log10 reduction in bacterial titre when tested with the ex-vivo method. There was no significant difference in reduction of bacterial titres after treatment with antimicrobials between the glass-carrier and the suspension tests. Furthermore, the drying process of bacterial inoculum was less detrimental on skin than on glass surfaces. This study confirmed that the activity of a biocide tested in suspension or on an inanimate surface did not reflect its activity when tested on skin. Further development of the ex-vivo test may be useful, especially for testing the antimicrobial activity of formulations with antiseptic properties.

  15. Development and Production of a Leishmania Skin Test

    DTIC Science & Technology

    2009-03-01

    indurated border will be outlined as a solid line with a ballpoint pen . Erythema will be outlined with a broken (dotted) line. The tracing will be...shall be reported as mm edema/mm erythema. Skin tests read at 48 ± 6 hours shall be recorded in mm induration using the ballpoint pen method. (19...10.6.2.4 Measuring and Recording Induration The area of induration (firmness) shall be outlined with a ballpoint pen . A permanent record of the reaction

  16. Investigation of dental materials as skin simulants for forensic skin/skull/brain model impact testing.

    PubMed

    Falland-Cheung, Lisa; Pittar, Nicholas; Tong, Darryl; Waddell, J Neil

    2015-12-01

    The purpose of this study was to measure the tear strength and hardness of four different dental silicones in comparison to that of porcine skin. Specimens were prepared (n = 20/group) according to ASTM D624-00, using three hydrophilic vinyl polysiloxane impression materials, one duplication silicone, and fresh porcine skin. A universal testing machine was used to strain each test specimen until complete rupture and calculate its tear strength (kNm(-1)). Failure analysis was then conducted using a stereoscopic zoom light microscope, as well as a scanning electron microscope (SEM). A shore A-type durometer was used to measure the hardness of all specimens. The tear strength for the silicones ranged from 1.75 to 9.58 kNm(-1) and the pigskin from 3.65 to 56.40 kNm(-1). The mean shore hardness for the silicones ranged from 16.275 to 62.65DU and the pigskin had a mean shore hardness of 22.65DU, with p values <0.0125 (0.05/4). Failure analysis of the silicone materials showed the origin of failure being in the tension side of the specimens and typical failure patterns were observed. Examining the materials under a SEM revealed that materials with higher viscosity presented with a larger amount of filler particle content than silicones with low viscosity, with the duplication silicone having no filler content. Dental silicones are a good alternative for skin in studies that require a skin simulant.

  17. Oral Toxicity Study and Skin Sensitization Test of a Cricket

    PubMed Central

    Ryu, Hyeon Yeol; Lee, Somin; Ahn, Kyu Sup; Kim, Hye Jin; Lee, Sang Sik; Ko, Hyuk Ju; Lee, Jin Kyu; Cho, Myung-Haing; Ahn, Mi Young; Kim, Eun Mi; Lim, Jeong Ho; Song, Kyung Seuk

    2016-01-01

    Crickets have been attracting considerable interest in the field of nutrition and toxicology due to the global exhaustion of food resulting from a growing population. The cricket is normally eaten in several countries after roasting, similar to the grasshopper; however, safety evaluation data on cricket powder is limited. Here, we performed general toxicity studies of cricket powder including a single, 2-week repeated dose range evaluation test, a 13-week repeated oral dose toxicity test in Sprague-Dawley rats, a single oral dose toxicity test in Beagle dogs, and a skin sensitization test in guinea pigs following the Organization for Economic Cooperation and Development test guidelines 406 and 408 in addition to Good Laboratory Practice. To investigate the NOAEL and target organs of cricket powder, Sprague-Dawley rats were allocated to 4 groups: vehicle control, 1,250 mg/kg, 2,500 mg/kg, 5,000 mg/kg dose test groups and cricket powder was administered over 13 weeks after single dose and dose range finding studies in rats based on the results of the single oral administration toxicity study in rats and Beagle dogs. The results of the study showed that the NOAEL of cricket powder was over 5,000 mg/kg for both sexes of rats without adverse effects in a 13-week repeated oral toxicity study and there was no skin hypersensitivity reaction. Therefore, our results reveal that crickets can be widely used as a new substitute food or nutrient resource. PMID:27123167

  18. Apparatus for testing skin samples or the like

    DOEpatents

    Holland, J.M.

    1982-08-31

    An apparatus for testing the permeability of living skin samples has a flat base with a plurality of sample-holding cavities formed in its upper surface, the samples being placed in counterbores in the cavities with the epidermis uppermost. O-rings of Teflon washers are respectively placed on the samples and a flat cover is connected to the base to press the rings against the upper surfaces of the samples. Media to maintain tissue viability and recovery of metabolites is introduced into the lower portion of the sample-holding cavities through passages in the base. Test materials are introduced through holes in the cover plate after assembly of the chamber.

  19. Plasmacytoid dendritic cells infiltrate the skin in positive tuberculin skin test indurations.

    PubMed

    Bond, Emily; Liang, Frank; Sandgren, Kerrie J; Smed-Sörensen, Anna; Bergman, Peter; Brighenti, Susanna; Adams, William C; Betemariam, Senait A; Rangaka, Molebogeng X; Lange, Christoph; Wilkinson, Robert J; Andersson, Jan; Loré, Karin

    2012-01-01

    Plasmacytoid dendritic cells (pDCs) are rarely present in normal skin but have been shown to infiltrate lesions of infections or autoimmune disorders. Here, we report that several DC subsets including CD123(+) BDCA-2/CD303(+) pDCs accumulate in the dermis in indurations induced by the tuberculin skin test (TST), used to screen immune sensitization by Mycobacterium tuberculosis. Although the purified protein derivate (PPD) used in the TST did not itself induce pDC recruitment or IFN-α production, the positive skin reactions showed high expression of the IFN-α-inducible protein MxA. In contrast, the local immune response to PPD was associated with substantial cell death and high expression of the cationic antimicrobial peptide LL37, which together can provide a means for pDC activation and IFN-α production. In vitro, pDCs showed low uptake of PPD compared with CD11c(+) and BDCA-3/CD141(+) myeloid DC subsets. Furthermore, supernatants from pDCs activated with LL37-DNA complexes reduced the high PPD uptake in myeloid DCs, as well as decreased their capacity to activate T-cell proliferation. Infiltrating pDCs in the TST reaction site may thus have a regulatory effect upon the antigen processing and presentation functions of surrounding potent myeloid DC subsets to limit potentially detrimental and excessive immune stimulation.

  20. [Characteristics of allergic conjunctivitis with positive skin prick test].

    PubMed

    Yang, S; Jiang, Y; Jin, Y M; Zhang, J Y; Li, Y

    2017-09-11

    Objective: To observe the clinical characteristics of allergic conjunctivitis, and the correlations with skin prick test results. Methods: A retrospective study. Forty patients with positive skin prick test result were included. Patients underwent an ophthalmologic examination to identify their primary presenting signs and symptoms. The allergy types were divided into 5 groups. All dates were analyzed for the dependence, normality and homogeneity of variance. Chi-square test, Mann-Whitney U test, Kruskal-Wallis H test and Spearman correlation analysis were performed accordingly. Results: Among 40 patients, 18(45.0%) had a clinical diagnosis of seasonal allergic conjunctivitis, 14(35.0%) had perennial allergic conjunctivitis, 5(12.5%) had vernal keratoconjunctivitis, and 2(5.0%) had atopic keratoconjunctivits, and 1(2.5%) had giant papillary conjunctivitis. There was no significant difference in the number of symptoms and signs score among different types of allergic conjunctivitis, the score of itching and hyperemia had a positive relationship with the number of positive allergens (r=0.74, P<0.05. r=0.96, P<0.05). The primary symptoms and signs are itching and hyperemia; dust and pollens are the most common allergens. The more positive result of the test of the allergen, the more symptoms and signs encountered in terms of severity. Conclusion: Seasonal allergic conjunctivitis was the most prevalent disorder, the most important clinical characteristics of allergic conjunctivitis are itching and conjunctival congestion, the main allergens are dust and pollens, patients may be sensitive to multiple allergens. (Chin J Ophthalmol, 2017, 53: 689-693).

  1. 78 FR 68076 - Request for Information on Alternative Skin Sensitization Test Methods and Testing Strategies and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-13

    ... require the use of animals. Specific ICCVAM or NICEATM activities include the following: ICCVAM... international efforts to replace the use of animals in skin sensitization testing for hazard and potency... (OECD) and the European Union Reference Laboratory for Alternatives to Animal Testing (EURL ECVAM), and...

  2. Skin Testing in the Evaluation and Management of Carboplatin-Related Hypersensitivity Reactions.

    PubMed

    Lax, Timothy; Long, Aidan; Banerji, Aleena

    2015-01-01

    Carboplatin-induced hypersensitivity reactions (HSRs) are a frequent occurrence in patients being retreated for malignancy. The most common and severe reactions are thought to be IgE mediated. Currently, skin testing is the only method used clinically to identify individuals sensitized to carboplatin. Despite almost 20 years of clinical use, a standardized approach to skin testing and its use in the management of carboplatin HSRs has not been well established. We review the utility of carboplatin skin testing and discuss factors that influence the interpretation of skin testing results. A risk stratification strategy using skin testing and desensitization to manage patients with carboplatin HSRs is proposed.

  3. Practical guide to skin prick tests in allergy to aeroallergens.

    PubMed

    Bousquet, J; Heinzerling, L; Bachert, C; Papadopoulos, N G; Bousquet, P J; Burney, P G; Canonica, G W; Carlsen, K H; Cox, L; Haahtela, T; Lodrup Carlsen, K C; Price, D; Samolinski, B; Simons, F E R; Wickman, M; Annesi-Maesano, I; Baena-Cagnani, C E; Bergmann, K C; Bindslev-Jensen, C; Casale, T B; Chiriac, A; Cruz, A A; Dubakiene, R; Durham, S R; Fokkens, W J; Gerth-van-Wijk, R; Kalayci, O; Kowalski, M L; Mari, A; Mullol, J; Nazamova-Baranova, L; O'Hehir, R E; Ohta, K; Panzner, P; Passalacqua, G; Ring, J; Rogala, B; Romano, A; Ryan, D; Schmid-Grendelmeier, P; Todo-Bom, A; Valenta, R; Woehrl, S; Yusuf, O M; Zuberbier, T; Demoly, P

    2012-01-01

    This pocket guide is the result of a consensus reached between members of the Global Allergy and Asthma European Network (GA(2) LEN) and Allergic Rhinitis and its Impact on Asthma (ARIA). The aim of the current pocket guide is to offer a comprehensive set of recommendations on the use of skin prick tests in allergic rhinitis-conjunctivitis and asthma in daily practice. This pocket guide is meant to give simple answers to the most frequent questions raised by practitioners in Europe, including 'practicing allergists', general practitioners and any other physicians with special interest in the management of allergic diseases. It is not a long or detailed scientific review of the topic. However, the recommendations in this pocket guide were compiled following an in-depth review of existing guidelines and publications, including the 1993 European Academy of Allergy and Clinical Immunology position paper, the 2001 ARIA document and the ARIA update 2008 (prepared in collaboration with GA(2) LEN). The recommendations cover skin test methodology and interpretation, allergen extracts to be used, as well as indications in a variety of settings including paediatrics and developing countries.

  4. Predicting the Development of Tuberculosis with the Tuberculin Skin Test and QuantiFERON Testing.

    PubMed

    Altet, Neus; Dominguez, José; Souza-Galvão, Maria-Luiza de; Jiménez-Fuentes, M Ángeles; Milà, Célia; Solsona, Jordi; Soriano-Arandés, Antonio; Latorre, Irene; Lara, Elisa; Cantos, Adela; Ferrer, María Dolores; Orcau, Àngels; Ruiz-Manzano, Juan; Caylà, Joan

    2015-05-01

    The identification of patients with latent tuberculosis infection, who are at higher risk to develop active disease, is an important component of disease control. We aim to compare the usefulness of the QuantiFERON-TB Gold in-tube assay and the tuberculin skin test to predict the development of active tuberculosis during follow-up, using positive and negative predictive values, positive likelihood ratios, and stratified level of risk. The study included contacts of tuberculosis cases diagnosed between 2007 and 2009. All contacts included were from the first circle of exposure. Tuberculin skin test and QuantiFERON test were performed and a chest radiograph was obtained during the contact's study. A total of 1,335 contacts were followed up for 4 years: a smear-positive index case was identified for 937 contacts, of whom 15 developed active tuberculosis and had initially presented with positive tuberculin skin test/QuantiFERON results, a normal chest radiograph, and no symptoms. The positive predictive value was 4% for QuantiFERON and 2% for the tuberculin skin test (when ≥5 mm). The probability of developing active disease was 2.36 times higher with a positive QuantiFERON, and 1.3 times higher with a positive tuberculin skin test. The positive predictive value was 17%, and the positive likelihood ratio was 7.53 for untreated contacts with a positive QuantiFERON. Stratifying according to initial QuantiFERON results showed a 6.36 times higher risk of developing active tuberculosis for patients with a QuantiFERON result greater than or equal to 10 IU/ml. Among bacillus Calmette-Guérin-vaccinated patients, a tuberculin skin test induration greater than or equal to 15 mm correlated better with a positive QuantiFERON. QuantiFERON results were more accurate than tuberculin skin test results in predicting tuberculosis. Although all contacts with QuantiFERON-positive results are at risk of developing tuberculosis, those with a tuberculin skin test induration greater than

  5. State of the art in non-animal approaches for skin sensitization testing: from individual test methods towards testing strategies.

    PubMed

    Ezendam, Janine; Braakhuis, Hedwig M; Vandebriel, Rob J

    2016-12-01

    The hazard assessment of skin sensitizers relies mainly on animal testing, but much progress is made in the development, validation and regulatory acceptance and implementation of non-animal predictive approaches. In this review, we provide an update on the available computational tools and animal-free test methods for the prediction of skin sensitization hazard. These individual test methods address mostly one mechanistic step of the process of skin sensitization induction. The adverse outcome pathway (AOP) for skin sensitization describes the key events (KEs) that lead to skin sensitization. In our review, we have clustered the available test methods according to the KE they inform: the molecular initiating event (MIE/KE1)-protein binding, KE2-keratinocyte activation, KE3-dendritic cell activation and KE4-T cell activation and proliferation. In recent years, most progress has been made in the development and validation of in vitro assays that address KE2 and KE3. No standardized in vitro assays for T cell activation are available; thus, KE4 cannot be measured in vitro. Three non-animal test methods, addressing either the MIE, KE2 or KE3, are accepted as OECD test guidelines, and this has accelerated the development of integrated or defined approaches for testing and assessment (e.g. testing strategies). The majority of these approaches are mechanism-based, since they combine results from multiple test methods and/or computational tools that address different KEs of the AOP to estimate skin sensitization potential and sometimes potency. Other approaches are based on statistical tools. Until now, eleven different testing strategies have been published, the majority using the same individual information sources. Our review shows that some of the defined approaches to testing and assessment are able to accurately predict skin sensitization hazard, sometimes even more accurate than the currently used animal test. A few defined approaches are developed to provide an

  6. Skin test-positive immediate hypersensitivity reaction to iodinated contrast media: the role of controlled challenge testing.

    PubMed

    Prieto-García, A; Tomás, M; Pineda, R; Tornero, P; Herrero, T; Fuentes, V; Zapatero, L; de Barrio, M

    2013-01-01

    Immediate hypersensitivity reactions (IHR) to iodinated contrast media (ICM) have traditionally been considered nonallergic; however, the increasingly frequent reporting of positive skin test and basophil activation test results suggests a specific allergic mechanism in some patients. Skin tests have been proposed as a useful tool for diagnosis, although their sensitivity and predictive values remain to be determined. The role of controlled challenge testing has not been assessed. We aimed to evaluate the role of controlled challenge testing in skin test-positive IHR to ICM. We evaluated 106 patients with IHR to ICM by performing skin tests with the agent that caused the reaction. Patients with a positive result were selected. Skin tests were extended to a series of 8 ICMs; 5 patients underwent controlled challenge test with an alternative skin test-negative ICM; a further 2 patients underwent computed tomography with an alternative skin test-negative ICM. No premedication was administered. Intradermal test results were positive to the ICM that caused the reaction in 11 out of 106 patients (10.4%). Five of the 11 patients tolerated a controlled challenge test with an alternative skin test-negative ICM. The 2 patients who underwent computed tomography with an alternative skin test-negative ICM tolerated the medium. Skin tests are useful for the diagnostic workup in patients with an allergic IHR to ICM. Since ICM cannot be avoided in many patients because they are irreplaceable in some diagnostic or therapeutic techniques, an alternative safe ICM should be investigated for future procedures. We propose the use of controlled challenge tests based on skin test results to address this need in skin test-positive reactions in order to identify an alternative non-cross-reactive ICM.

  7. Simplification of intradermal skin testing in Hymenoptera venom allergic children.

    PubMed

    Cichocka-Jarosz, Ewa; Stobiecki, Marcin; Brzyski, Piotr; Rogatko, Iwona; Nittner-Marszalska, Marita; Sztefko, Krystyna; Czarnobilska, Ewa; Lis, Grzegorz; Nowak-Węgrzyn, Anna

    2017-03-01

    The direct comparison between children and adults with Hymenoptera venom anaphylaxis (HVA) has never been extensively reported. Severe HVA with IgE-documented mechanism is the recommendation for venom immunotherapy, regardless of age. To determine the differences in the basic diagnostic profile between children and adults with severe HVA and its practical implications. We reviewed the medical records of 91 children and 121 adults. Bee venom allergy was exposure dependent, regardless of age (P < .001). Atopy was more common in children (P = .01), whereas cardiovascular comorbidities were present almost exclusively in adults (P = .001). In the bee venom allergic group, specific IgE levels were significantly higher in children (29.5 kUA/L; interquartile range, 11.30-66.30 kUA/L) compared with adults (5.10 kUA/L; interquartile range, 2.03-8.30 kUA/L) (P < .001). Specific IgE levels for culprit insect venom were higher in bee venom allergic children compared with the wasp venom allergic children (P < .001). In adults, intradermal tests revealed higher sensitivity, accompanied by larger area of skin reactions, regardless of type of venom. At concentrations lower than 0.1 μg/mL, 16% of wasp venom allergic children and 39% of bee venom allergic children had positive intradermal test results. The median tryptase level was significantly higher in adults than in children for the entire study group (P = .002), as well as in bee (P = .002) and wasp venom allergic groups (P = .049). The basic diagnostic profile in severe HVA reactors is age dependent. Lower skin test reactivity to culprit venom in children may have practical application in starting the intradermal test procedure with higher venom concentrations. Copyright © 2016 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  8. Freeze-drying as a preserving preparation technique for in vitro testing of human skin.

    PubMed

    Franzen, Lutz; Vidlářová, Lucie; Kostka, Karl-Heinz; Schaefer, Ulrich F; Windbergs, Maike

    2013-01-01

    In vitro testing of drugs with excised human skin is a valuable prerequisite for clinical studies. However, the analysis of excised human skin presents several obstacles. Ongoing drug diffusion, microbial growth and changes in hydration state influence the results of drug penetration studies. In this work, we evaluate freeze-drying as a preserving preparation method for skin samples to overcome these obstacles. We analyse excised human skin before and after freeze-drying and compare these results with human skin in vivo. Based on comprehensive thermal and spectroscopic analysis, we demonstrate comparability to in vivo conditions and exclude significant changes within the skin samples due to freeze-drying. Furthermore, we show that freeze-drying after skin incubation with drugs prevents growth of drug crystals on the skin surface due to drying effects. In conclusion, we introduce freeze-drying as a preserving preparation technique for in vitro testing of human skin. © 2013 John Wiley & Sons A/S.

  9. Skin testing for immediate hypersensitivity to corticosteroids: a case series and literature review.

    PubMed

    Baker, A; Empson, M; The, R; Fitzharris, P

    2015-03-01

    Immediate hypersensitivity to corticosteroids is reported to occur with an incidence of 0.1%. The largest previous case series reporting corticosteroid skin testing has seven patients. We identified 23 patients (mean age 50 years, 65% female) from Auckland City Hospital who underwent skin testing (ST) for suspected corticosteroid hypersensitivity between July 2005 and April 2012. We performed a retrospective clinical case note review detailing clinical history of reaction, skin test results and subsequent management. Most patients (21/23) had a standard panel of testing with prednisolone, triamcinolone, methylprednisolone, hydrocortisone and dexamethasone. Skin tests used a 10% steroid stock concentration for skin prick tests (SPT) and dilutions of 1 : 1000, 1 : 100 and 1 : 10 for subsequent intradermal testing. A weal 3 mm greater than the negative control was considered positive. A total of 23 patients were identified who had skin testing for suspected acute hypersensitivity to corticosteroids, eight of which had a history of anaphylaxis. From 28 reactions (in 23 patients), the most common route of administration was intra-articular (13), followed by oral (7), intravenous (3) and other (5). Skin tests were positive in 8/23 patients, and 7/8 of these patients had a history of corticosteroid-associated anaphylaxis. Skin tests were positive at either the skin prick test or intradermal stages. There was evidence suggesting clinical and skin test cross-reactivity between corticosteroids in one patient. One patient had a positive skin test, but negative oral challenge suggesting the skin test was false positive. Skin tests were negative in 15/23 patients. One patient had a negative prednisolone skin test and positive unblinded oral challenge, suggesting a false-negative skin test. Skin testing can provide sufficient evidence to diagnose allergy in patients with a clear history of immediate hypersensitivity to corticosteroids such as anaphylaxis. Both skin prick

  10. Clinical patterns and results of radioallergosorbent test (RAST) and skin tests in penicillin allergy.

    PubMed

    Kraft, D; Wide, L

    1976-06-01

    Seventy-nine patients with acute or former reactions to penicillin were investigated by a benzylpenicilloyl (BPO)-specific RAST and/or by skin tests with penicilloyl-polylysine (PPL), benzylpenicillin and penicilloic acid and the results were correlated with the different clinical pictures. Positive RAST and skin test results could be found in patients with anaphylactic shock, urticaria and serum sickness-like reaction and sometimes in a special group of exanthems, which are characterized by the existence of many different lesions at the same time, therefore called 'polymorphic exanthems', and often observed after high-dosage penicillin therapy. In cases of scarlatiniform or morbilliform exanthems no positive results were found. The BPO-specific RAST showed an overall correlation of 95-I% with skin tests using PPL. However, some patients with positive skin tests to benzylpenicillin and penicilloic acid did no have detectable circulating IgE antibodies to BPO. This emphasizes the need for including these antigens in in vitro methods. The RAST was informative even at the allergic reaction or in the first 15 days afterwards and seems to be very valuable for early diagnosis of penicillin allergy especially in cases when many drugs have been given.

  11. Dialyzed venom skin tests for identifying yellow jacket-allergic patients not detected using standard venom.

    PubMed

    Golden, David B K; Kelly, Denise; Hamilton, Robert G; Wang, Nae-Yuh; Kagey-Sobotka, Anne

    2009-01-01

    The chance of a nonspecific intradermal skin test response at venom concentrations greater than 1.0 microg/mL limits the diagnostic range and can interfere with the diagnosis of some affected patients. To compare the diagnostic ranges and clinical detection rates of skin tests using dialyzed yellow jacket venom (DYJV) and undialyzed YJV (UYJV), particularly in patients who have had negative venom skin test results. Both DYJV and UYJV from the same original lot were diluted from 100 microg/mL to skin test concentrations of 0.01, 0.1, 1.0, 3.0, and 10 microg/mL. Participants included 10 nonallergic controls, 20 patients with a positive history and positive skin test results using UYJV, and 24 patients with a positive history but negative skin test results using UYJV (17 of whom had a positive IgE anti-YJV serology). Dialyzed venom skin test results were positive at 10 microg/mL or less in 79% of patients with a positive history but negative skin test reactions using UYJV. The dialyzed venom skin test results showed a half-log shift to the left from the undialyzed venom results in linear regression analysis, indicating a greater detection rate with skin tests using DYJV. Results of skin tests with dialyzed venom were positive in 3 of 4 patients who had negative undialyzed venom skin test results and who experienced a systemic reaction to challenge stings. The DYJV improves the ability of skin tests to detect yellow jacket allergy and should be subject to further study.

  12. In vitro skin irritation testing: Improving the sensitivity of the EpiDerm skin irritation test protocol.

    PubMed

    Kandárová, Helena; Hayden, Patrick; Klausner, Mitch; Kubilus, Joseph; Kearney, Paul; Sheasgreen, John

    2009-12-01

    A skin irritation test (SIT) utilising a common protocol for two in vitro reconstructed human epidermal (RhE) models, EPISKIN and EpiDerm, was developed, optimised and evaluated as a replacement for the in vivo rabbit skin irritation test in an ECVAM-sponsored validation study. In 2007, both RhE models were recognised by an independent peer-review panel and the ECVAM Scientific Advisory Committee (ESAC) as validated for use with the common SIT protocol. The EPISKIN SIT was endorsed as a full replacement of the in vivo rabbit test. Since the EpiDerm SIT proved to be less sensitive than the in vivo test and the EPISKIN SIT, the test was recognised as a validated component of a tiered testing strategy, in which positive results are accepted and negative results require further confirmation. The ESAC, in its April 2007 statement, also recommended increasing the sensitivity of the EpiDerm SIT, in order to gain the full acceptance. Analysis of the EpiDerm and EPISKIN data from the ECVAM validation study indicated that the lower sensitivity of the EpiDerm SIT might be linked to the more robust barrier properties of the EpiDerm model. This hypothesis was also in line with results published previously. To overcome the relatively low sensitivity of the EpiDerm protocol as a hindrance to full regulatory acceptance, a modification of exposure conditions was introduced into the protocol to achieve better agreement with the in vivo rabbit data. In the Modified EpiDerm SIT protocol, the test chemical exposure time was increased from 15 minutes to 60 minutes. In addition, part of the exposure was performed at 37 degrees C. When the 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide (MTT) viability assay endpoint was used for classification, a significant increase of sensitivity was obtained (86.1%), whilst maintaining the high specificity of the method (76.3%). With the change to the EU classification system, which now uses higher cut-off for the classification of

  13. Prospective multicentre study of the U-SENS test method for skin sensitization testing.

    PubMed

    Alépée, N; Piroird, C; Aujoulat, M; Dreyfuss, S; Hoffmann, S; Hohenstein, A; Meloni, M; Nardelli, L; Gerbeix, C; Cotovio, J

    2015-12-25

    The U-SENS™ is a test method based on the human myeloid U937 cell line to assess the skin sensitisation potential of substances. To demonstrate its robustness, a multicentre validation study with four laboratories testing 24 coded substances has been conducted according to internationally agreed principles. The primary objective of the study was to enlarge the U-SENS™'s reproducibility database. Secondary objectives were to provide additional evidence on its transferability and its predictive capability. Reproducibility within laboratories was approximately 92%, while the reproducibility between laboratories was 87.5%. Predictivity for the 24 validation substances was high, with sensitivity, specificity and accuracy being on average at least 93.8%. Similar performances are obtained for 38 substances when combining the study results with those of an earlier multicentre study, as well as with an automated version of the U-SENS™. With reliability and relevance similar to comparable non-animal skin sensitisation test methods, which have achieved regulatory acceptance, it is concluded that the U-SENS™ is a well reproducible and predictive test method. This profiles the U-SENS™ as a valuable addition to the suite of non-animal testing methods for skin sensitisation with the potential to significantly contribute to the development of integrated testing strategies.

  14. Diagnostic procedures of the skin. Part two: Skin biopsy and other tests.

    PubMed

    Krull, E A; Babel, D E

    1976-08-01

    The diagnosis of skin lesions involves the same principles and approaches required for other clinical problems. "Shotgun" therapy based on visual recognition alone is not an adequate clinical approach. A pertinent history and careful physical examination, supplemented by carefully selected diagnostic procedures, is usually necessary for skin diseases. The indications, limitations, interpretation, and techniques of diagnostic procedures must be well understood to obtain reliable and useful information. The selection of the specific method of skin biopsy, for example, may be based on cosmetic considerations, location and nature of the lesion, and the physician's understanding of the biology and histopathology of the suspected diagnosis. This is the second paper in a two-part series dealing with diagnostic procedures of the skin. Various kinds of skin biopsy, touch imprints, the Tzanck smear, and immunofluorescent studies are described as they relate to the everyday practice of the family physician.

  15. What is the clinical value of negative predictive values of skin tests to iodinated contrast media?

    PubMed

    Soyyigit, Sadan; Goksel, Ozlem; Aydin, Omur; Gencturk, Zeynep; Bavbek, Sevim

    2016-11-01

    Iodinated contrast media (ICM) can cause hypersensitivity reactions (HSR), yet data are scant about the negative predictive value (NPV) of ICM skin tests. To determine the NPV of skin tests to ICM Methods: We enrolled 73 patients with a history of HSRs to ICM, 136 subjects with no previous exposure to ICM, and, as controls, 47 subjects who had previously tolerated ICM. All the subjects had skin tests with the culprit and/or alternative ICM and were later questioned as to whether they were reexposed and/or reacted to the skin-test-negative ICM. Sixty (82.2%) and 13 (17.8%) patients had a history of immediate HSR and those with a history of nonimmediate HSR, respectively. The sensitivity and specificity of the skin tests were 18% and 97%, respectively, in patients with immediate HSR and were 23% and 99%, respectively, in patients with nonimmediate HSR. Of a total of 237 subjects with negative skin test results, 207 (87.3%) were asked about further ICM administration; 158 (84.9%) confirmed subsequent use either with (n = 15 [9.4%]) or without premedication (n = 143 [90.6%]). Of the 143 individuals, 140 tolerated skin-test-negative ICMs but three (1.9%) reacted to ICMs (two with mild nonimmediate reactions, one with a grade 1 immediate reaction). Of 20 patients who had previous HSR to ICM, 17 tolerated further skin-test-negative ICM without premedication. The NPV of ICM skin tests, therefore, was 97% (95% confidence interval, 7599%). The NPV of skin tests with ICM was high. None of the reactions in patients who had negative skin test results were severe, which may reassure physicians who hesitate to perform further evaluations in patients with negative skin test results.

  16. Comparison of pain during skin-prick testing, immunizations, and phlebotomy.

    PubMed

    Coop, Christopher A; Forester, Joseph P

    2016-09-01

    Allergy skin prick testing is a medical procedure that is very useful for assessing a patient's sensitization to specific allergens. Some patients are worried about pain associated with prick skin testing. To compare pain among different age groups, to look at pain during skin prick testing in younger children, and to compare the pain during skin prick testing to procedures including routine immunizations and phlebotomy. A survey was provided to patients undergoing allergy skin testing, immunizations or phlebotomy at the Wilford Hall Medical Center. There were 197 patients and 26 parents of patients aged 3-8 years who completed surveys during allergy skin testing. The average anticipated (pre procedure) pain score was 4.3 for the patients aged 3-8 years, 4.6 for the patients aged 9-17 years and 3.2 for the patients older than 17 years. The average actual pain score of the patients during skin testing was 3.1 for the patients aged 3-8 years, 2.2 for the patients aged 9-17 years and 1.4 for the patients older than 17 years. For the parents of patients aged 3-8 years, the average anticipated average pain score was 3.0 and the average actual pain score was 1.7. The actual pain experienced from skin prick testing is perceived to be much less than the anticipated pain. Patients and referring physicians should not have a fear of pain from allergy skin prick testing.

  17. Fractionation and Composition Studies of Skin Test-Active Components of Sensitins from Coccidioides immitis

    PubMed Central

    Anderson, Kenneth L.; Wheat, Robert W.; Conant, Norman F.

    1971-01-01

    Coccidioidin skin-test activities from mycelial culture filtrates and autolysates were partially purified. Major chemical constituents included 3-O-methylmannose, mannose, and amino acids. PMID:5119201

  18. Skin testing with β-lactam antibiotics for diagnosis of β-lactam hypersensitivity in children.

    PubMed

    Manuyakorn, Wiparat; Singvijarn, Prapasiri; Benjaponpitak, Suwat; Kamchaisatian, Wasu; Rerkpattanapipat, Ticha; Sasisakulporn, Cherapat; Jotikasthira, Wanlapa

    2016-09-01

    Skin testing with penicilloyl-polylysine (PPL) and a minor determinant mixture (MDM) were previously recommended for evaluating β-lactam hypersensitivity. However, PPL and MDM have not been commercially available. This study was to determine the negative predictive value (NPV) of skin testing with β-lactam antibiotics for the diagnosis of β-lactam hypersensitivity. Patients age 1-18 years old with a history of β-lactam hypersensitivity were evaluated by skin tests (a skin prick test, an intradermal test) with penicillin G, ampicillin, amoxicillin-clavulanic acid, and the suspect βlactam. The patients who had a negative skin test were performed with a drug provocation test (DPT) in a 3-dose-graded challenge. The hypersensitivity reactions were classified into immediate and non-immediate reactions. A total of 126 patients were evaluated for β-lactam hypersensitivity. Twenty two patients (17.4%) were confirmed with a ?-lactam hypersensitivity. 12 (54.54 %) of them were confirmed by a skin test. There was no systemic reaction occurring after the skin tests. Ten patients (9.6%) from 104 patients with a negative skin test showed reactions after a DPT providing the NPV of the skin test with a 91.2% value. Among those children with a history of β-lactam hypersensitivity, skin testing with penicillin G, ampicillin, amoxicillin-clavulanic acid, and the suspect β-lactam was safe and provided a good NPV when PPL and MDM were unavailable. However, a skin test with β-lactam antibiotics alone did not provide a high sensitivity, thus a DPT procedure was necessary in order to confirm the diagnosis of β-lactam hypersensitivity.

  19. ECVAM's activities in validating alternative tests for skin corrosion and irritation.

    PubMed

    Fentem, Julia H; Botham, Philip A

    2002-12-01

    ECVAM has funded and managed validation studies on in vitro tests for skin corrosion, resulting in the validities of four in vitro tests being endorsed by the ECVAM Scientific Advisory Committee: the rat skin transcutaneous electrical resistance (TER) assay, two tests based on the use of commercial reconstituted human skin equivalents, EPISKIN and EpiDerm, and another commercially-produced test, CORROSITEX. In the European Union (EU), a new test method on skin corrosion (B.40), incorporating the rat skin TER and human skin model assays, was included in Annex V of Directive 67/548/EEC in mid-2000, thereby making the use of in vitro alternatives for skin corrosion testing of chemicals mandatory in the EU. At the recommendation of its Skin Irritation Task Force, ECVAM has funded prevalidation studies on five in vitro tests for acute skin irritation: EpiDerm, EPISKIN, PREDISKIN, the pig-ear test, and the mouse-skin integrity function test (SIFT). However, none of the tests met the criteria (set by the Management Team for the studies) for inclusion in a large-scale formal validation study. Thus, to date, there are no validated in vitro tests for predicting the dermal irritancy of chemicals. Following further work on the EPISKIN, EpiDerm and SIFT test protocols and/or prediction models after the completion of the prevalidation studies, it appears that the modified tests could meet the performance criteria defined for progression to a validation study. This will now be assessed independently by the ECVAM Skin Irritation Task Force, with the objective of taking a decision before the end of 2002 on whether to conduct a formal validation study.

  20. The colour of blood in skin: a comparison of Allen's test and photonics simulations.

    PubMed

    Välisuo, Petri; Kaartinen, Ilkka; Kuokkanen, Hannu; Alander, Jarmo

    2010-11-01

    The colour of the skin reflects many physiological and pathological states of an individual. Usually, the skin colour is examined by the bare eye alone. Several scaling systems have been developed to quantify the sensory evaluation of skin colour. In this work, the reflectance of the skin is measured directly using an objective instrument. Haemoglobin inside the dermal circulation is one of the key factors of skin colour and it also has a major role in the appearance of many skin lesions and scars. To quantitatively measure and analyse such conditions, the relation between the skin colour and the haemoglobin concentration in the skin needs to be resolved. To examine the effect of blood concentration on the skin colour, five Allen's tests were performed on 20 persons. The skin colour change was measured using a spectrophotometer by changing the blood concentration by the Allen's test. Light interaction with the skin was simulated with a Monte Carlo model, tuning the blood concentration parameter until the simulated and the measured spectra matched, yielding the relationship between the skin colour and the blood concentration. The simulation produced spectra similar to those measured. The change in the blood concentration in the simulation model and in the skin produced changes similar to the spectra. The reflectance of the skin was found to be a nonlinear function of the blood concentration. The relationship found between skin colour and blood concentration makes it possible to quantify those skin conditions expressed by blood volume better than plain colour. © 2010 John Wiley & Sons A/S.

  1. [Anaphylactic shock following administration of lidocaine after negative skin test].

    PubMed

    Khokhlov, V D; Krut', M I; Sashko, S Iu

    2012-01-01

    A rare case of sudden fatal anaphylactic shock is described in a 50 year-old woman after secondary lidocaine blockade to relieve lumbar pain (the first blockade was performed 4 days before by the same physician after the negative skin test). The patient had the history of multiple allergic reactions to drugs, pollen, home dust, and citrus fruits (repeated Quincke's oedema). In the preceding period, lidocaine was several time administered without side effects during out-patient visits to a surgeon and dentist. The signs of anaphylactic shock appeared within 2 min after injection of 4 ml of 2% lidocaine solution (no other injections were made between the two blockades). Comprehensive emergency measures had no effect. The diagnosis was confirmed at autopsy; microscopic study of soft tissues revealed mast cell degranulation and characteristic changes in internal organs. A literature review of anaphylactic shock symptoms is presented. The fulminant development of this condition after lidocaine administration may be regarded as a fatal coincidence of circumstances that could not be foreseen by the physician. Caution is needed when prescribing medications to polyallergic patients.

  2. Skin Corrosion and Irritation Test of Nanoparticles Using Reconstructed Three-Dimensional Human Skin Model, EpiDermTM

    PubMed Central

    Kim, Hyejin; Choi, Jonghye; Lee, Handule; Park, Juyoung; Yoon, Byung-Il; Jin, Seon Mi; Park, Kwangsik

    2016-01-01

    Effects of nanoparticles (NPs) on skin corrosion and irritation using three-dimensional human skin models were investigated based on the test guidelines of Organization for Economic Co-operation and Development (OECD TG431 and TG439). EpiDermTM skin was incubated with NPs including those harboring iron (FeNPs), aluminum oxide (AlNPs), titanium oxide (TNPs), and silver (AgNPs) for a defined time according to the test guidelines. Cell viabilities of EpiDermTM skins were measured by the 3-(4, 5-dimethylthi-azol-2-yl)-2.5-diphenyltetrazolium bromide based method. FeNPs, AlNPs, TNPs, and AgNPs were non-corrosive because the viability was more than 50% after 3 min exposure and more than 15% after 60 min exposure, which are the non-corrosive criteria. All NPs were also non-irritants, based on viability exceeding 50% after 60 min exposure and 42 hr post-incubation. Release of interleukin 1-alpha and histopathological analysis supported the cell viability results. These findings suggest that FeNPs, AlNPs, TNPs, and AgNPs are ‘non-corrosive’ and ‘non-irritant’ to human skin by a globally harmonized classification system. PMID:27818733

  3. Skin models for the testing of transdermal drugs

    PubMed Central

    Abd, Eman; Yousef, Shereen A; Pastore, Michael N; Telaprolu, Krishna; Mohammed, Yousuf H; Namjoshi, Sarika; Grice, Jeffrey E; Roberts, Michael S

    2016-01-01

    The assessment of percutaneous permeation of molecules is a key step in the evaluation of dermal or transdermal delivery systems. If the drugs are intended for delivery to humans, the most appropriate setting in which to do the assessment is the in vivo human. However, this may not be possible for ethical, practical, or economic reasons, particularly in the early phases of development. It is thus necessary to find alternative methods using accessible and reproducible surrogates for in vivo human skin. A range of models has been developed, including ex vivo human skin, usually obtained from cadavers or plastic surgery patients, ex vivo animal skin, and artificial or reconstructed skin models. Increasingly, largely driven by regulatory authorities and industry, there is a focus on developing standardized techniques and protocols. With this comes the need to demonstrate that the surrogate models produce results that correlate with those from in vivo human studies and that they can be used to show bioequivalence of different topical products. This review discusses the alternative skin models that have been developed as surrogates for normal and diseased skin and examines the concepts of using model systems for in vitro–in vivo correlation and the demonstration of bioequivalence. PMID:27799831

  4. Chitin microneedles for an easy-to-use tuberculosis skin test.

    PubMed

    Jin, Jungho; Reese, Valerie; Coler, Rhea; Carter, Darrick; Rolandi, Marco

    2014-03-01

    An easy-to-use tuberculosis skin test is developed with chitin microneedles that deliver purified protein derivative at the correct skin depth and result in a positive test in BCG-immunized guinea pigs. © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  5. Skin testing in patients with hypersensitivity reactions to iodinated contrast media - a European multicenter study.

    PubMed

    Brockow, K; Romano, A; Aberer, W; Bircher, A J; Barbaud, A; Bonadonna, P; Faria, E; Kanny, G; Lerch, M; Pichler, W J; Ring, J; Rodrigues Cernadas, J; Tomaz, E; Demoly, P; Christiansen, C

    2009-02-01

    Iodinated contrast media cause both immediate and nonimmediate hypersensitivity reactions. The aim of this prospective study was to determine the specificity and sensitivity of skin tests in patients who have experienced such reactions. Skin prick, intradermal and patch tests with a series of contrast media were conducted in 220 patients with either immediate or nonimmediate reaction. Positive skin tests were defined according to internationally accepted guidelines. Seventy-one never-exposed subjects and 11 subjects who had tolerated contrast medium exposure, served as negative controls. Skin test specificity was 96-100%. For tests conducted within the time period from 2 to 6 months after the reaction, up to 50% of immediate reactors and up to 47% of nonimmediate reactors were skin test positive. For immediate reactors, the intradermal tests were the most sensitive, whereas delayed intradermal tests in combination with patch tests were needed for optimal sensitivity in nonimmediate reactors. Contrast medium cross-reactivity was more common in the nonimmediate than in the immediate group. Interestingly, 49% of immediate and 52% of nonimmediate symptoms occurred in previously unexposed patients. Many of these patients were skin test positive, indicating that they were already sensitized at the time of first contrast medium exposure. These data suggest that at least 50% of hypersensitivity reactions to contrast media are caused by an immunological mechanism. Skin testing appears to be a useful tool for diagnosis of contrast medium allergy and may play an important role in selection of a safe product in previous reactors.

  6. Comparison of human skin irritation patch test data with in vitro skin irritation assays and animal data.

    PubMed

    Jírová, Dagmar; Basketter, David; Liebsch, Manfred; Bendová, Hana; Kejlová, Kristina; Marriott, Marie; Kandárová, Helena

    2010-02-01

    Efforts to replace the rabbit skin irritation test have been underway for many years, encouraged by the EU Cosmetics Directive and REACH. Recently various in vitro tests have been developed, evaluated and validated. A key difficulty in confirming the validity of in vitro methods is that animal data are scarce and of limited utility for prediction of human effects, which adversely impacts their acceptance. This study examines whether in vivo or in vitro data most accurately predicted human effects. Using the 4-hr human patch test (HPT) we examined a number of chemicals whose EU classification of skin irritancy is known to be borderline, or where in vitro methods provided conflicting results. Of the 16 chemicals classified as irritants in the rabbit, only five substances were found to be significantly irritating to human skin. Concordance of the rabbit test with the 4-hr HPT was only 56%, whereas concordance of human epidermis models with human data was 76% (EpiDerm) and 70% (EPISKIN). The results confirm observations that rabbits overpredict skin effects in humans. Therefore, when validating in vitro methods, all available information, including human data, should be taken into account before making conclusions about their predictive capacity.

  7. Clinical value of radiocontrast media skin tests as a prescreening and diagnostic tool in hypersensitivity reactions.

    PubMed

    Kim, Sae-Hoon; Jo, Eun-Jung; Kim, Mi-Yeong; Lee, Seung-Eun; Kim, Min-Hye; Yang, Min-Suk; Song, Woo-Jung; Choi, Sang-Il; Kim, Jae-Hyoung; Chang, Yoon-Seok

    2013-04-01

    Some radiocontrast media (RCM) hypersensitivity reactions may have underlying IgE- or T-cell-mediated mechanisms. RCM skin testing may be useful for predicting future reactions. To investigate the clinical value of RCM skin testing before computed tomography and after RCM hypersensitivity reactions. Patients who underwent RCM skin testing were a prospective sample of convenience at a single medical center and were tested just before their pending nonionic RCM-enhanced computed tomogram. In addition, skin test data of patients who were referred to the allergy clinic because of their previous RCM hypersensitivity reactions were reviewed retrospectively. A total of 1048 patients enrolled in the study prospectively. Of these, 672 (64.1%) had never been exposed to RCM. Of the 376 previously exposed to RCM, 61 (16.2%) had a history of at least one mild RCM-associated reaction, 56 (91.8%) had immediate reactions, and 5 had no-immediate reactions. There was only 1 positive immediate hypersensitivity RCM skin test result (0.09%). There were 51 mild immediate reactions (4.9%), 1 moderate immediate reaction (0.09%), 8 mild nonimmediate reactions (0.76%), and 1 moderate nonimmediate reaction (0.09%). There was only 1 positive delayed hypersensitivity skin test result (0.09%), retrospectively determined, in 1 (11.1%) of the nonimmediate RCM-associated reactions. Sensitivity of RCM skin testing was significantly higher with severe immediate reactions (57.1%) than mild reactions (12.9%) and moderate reactions (25.0%) in the retrospective review of diagnostic skin test data (P = .03). RCM skin testing for screening is of no clinical utility in predicting hypersensitivity reactions. RCM skin testing may have modest utility in retrospectively evaluating severe adverse reactions. Copyright © 2013 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  8. Allergy history does not predict skin test reactivity in asthmatic children.

    PubMed

    Carter, E R; Pulos, E; Delaney, J; Matheson, E J; Moffitt, D R

    2000-12-01

    We prospectively assessed how well patient report of allergy to cat, dust mite, and grass predicted the results of skin prick testing to those allergens in 95 asthmatic children. Children between 4 and 18 years old with physician-documented asthma provided a detailed standardized allergy history and then underwent skin prick testing. The children were categorized by asthma severity. The diagnostic accuracy, which was the primary outcome measure, as well as sensitivity, specificity, and positive and negative predicted values were calculated for allergy history with regards to skin test reactivity. The diagnostic accuracy of allergy history in identifying skin test reactivity was 65%, 50%, and 56% for cat, dust mite, and grass, respectively. Asthma severity did not affect the diagnostic accuracy. Allergy history was a poor predictor of skin test reactivity in this group of asthmatic children.

  9. Development of Cutaneous Leishmaniasis after Leishmania Skin Test

    PubMed Central

    Machado, Paulo R.; Carvalho, Augusto M.; Machado, Gustavo U.; Dantas, Marina L.; Arruda, Sérgio

    2011-01-01

    Thirty-year-old female with a previous history of a cutaneous ulcer suspicious of leishmaniasis 20 years ago presented with a new complaint of a depressed papular lesion 8 × 7 mm in the right lower extremity. The lesion was of 10-day duration. Because early cutaneous leishmaniasis (CL) lesions may have a non-ulcerated appearance, a Leishmania skin test (LST) was performed on the forearm with a strong positive result (38 × 32 mm). After 8 days, the lesion in the leg, which was diagnosed as folliculitis, completely healed. However, a typical CL ulcer (26 × 24 mm) developed at the LST site. Histopathology of the new lesion did not identifiy parasites, but the findings were consistent with a diagnosis of CL. Further analysis identified amastigotes by immunohistochemical stain. Mononuclear cells harvested from the patient were stimulated with Leishmania antigen and showed high levels of production of both tumor necrosis factor-alpha (TNF-α) and interferon-gamma (IFN-γ): 2,943 pg/mL and 2,313 pg/mL, respectively. After 40 days of treatment with antimony and pentoxifylline, the ulcer resolved. The development of CL at the LST site suggests a strong Th1 immune response, and it is an in vivo documentation of the role of the host immune response in the pathology of CL. It teaches us that LST should be cautiously, if at all, used in patients with self-healing CL ulcers. PMID:22162702

  10. Development of cutaneous leishmaniasis after leishmania skin test.

    PubMed

    Machado, Paulo R; Carvalho, Augusto M; Machado, Gustavo U; Dantas, Marina L; Arruda, Sérgio

    2011-01-01

    Thirty-year-old female with a previous history of a cutaneous ulcer suspicious of leishmaniasis 20 years ago presented with a new complaint of a depressed papular lesion 8 × 7 mm in the right lower extremity. The lesion was of 10-day duration. Because early cutaneous leishmaniasis (CL) lesions may have a non-ulcerated appearance, a Leishmania skin test (LST) was performed on the forearm with a strong positive result (38 × 32 mm). After 8 days, the lesion in the leg, which was diagnosed as folliculitis, completely healed. However, a typical CL ulcer (26 × 24 mm) developed at the LST site. Histopathology of the new lesion did not identifiy parasites, but the findings were consistent with a diagnosis of CL. Further analysis identified amastigotes by immunohistochemical stain. Mononuclear cells harvested from the patient were stimulated with Leishmania antigen and showed high levels of production of both tumor necrosis factor-alpha (TNF-α) and interferon-gamma (IFN-γ): 2,943 pg/mL and 2,313 pg/mL, respectively. After 40 days of treatment with antimony and pentoxifylline, the ulcer resolved. The development of CL at the LST site suggests a strong Th1 immune response, and it is an in vivo documentation of the role of the host immune response in the pathology of CL. It teaches us that LST should be cautiously, if at all, used in patients with self-healing CL ulcers.

  11. Effect of nutritional status on Tuberculin skin testing.

    PubMed

    Piñeiro, Roi; Cilleruelo, María José; García-Hortelano, Milagros; García-Ascaso, Marta; Medina-Claros, Antonio; Mellado, María José

    2013-04-01

    To evaluate Tuberculin skin test (TST) results in a population of immigrants and internationally adopted children from several geographical areas; to analyze whether nutritional status can modify TST results. This cross-sectional observational study included adopted children and immigrants evaluated in the authors' unit between January 2003 and December 2008. Children diagnosed with tuberculosis, or vaccinated with live attenuated virus 2 mo earlier, HIV-infected, chronically ill or under treatment with immunosuppressive agents were excluded. TST was considered as dependent variable. Independent variables were gender, age, geographical origin, BCG scar, nutritional status, immune status and intestinal parasitism. One thousand seventy four children were included; 69.6 % were girls. There was a BCG scar in 79 % of children. Mantoux = 0 mm was found in 84.4 %, <10 mm in 4.1 %, and ≥10 mm in 11.4 % of children. Nutrition (McLaren's classification) was normal (≥90 %) in 26.7 % of the subjects, with mild malnutrition (80-89 %) in 36 %, moderate (70-79 %) in 23.2 % and severe (≤69 %) in 14.1 %. There was no difference in TST results among different nutritional status children. The nutritional status, measured by McLaren's classification, does not changes the results of TST. McLaren's classification only grades protein-caloric malnutrition, so in authors' experience this type of malnutrition does not interfere with TST results. Implementing other nutritional parameters could help to determine whether nutritional status should be taken into account when interpreting TST results.

  12. Comparing nasal secretion eosinophil count with skin sensitivity test in allergic rhinitis in Ibadan, Nigeria.

    PubMed

    Takwoingi, Yohanna; Akang, Effiong; Nwaorgu, George; Nwawolo, Clement

    2003-12-01

    The aim of this prospective study was to assess the usefulness of nasal smear eosinophilia compared with a skin sensitivity test for the diagnosis of allergic rhinitis and to determine the degree of correlation between the tests. Fifty patients with a clinical history suggestive of nasal allergy and 20 controls were studied. A range of allergens were used for the skin sensitivity test in both groups. Nasal smears were examined by light microscopy. A positive skin test reaction was demonstrated in 90% of the study population and 25% of the controls, whereas 76% of the patients and 15% of the controls demonstrated significant nasal smear eosinophilia. There was 66% correlation between the skin test and nasal eosinophilia, although this was not statistically significant (correlation coefficient -0.187 p = 0.193). This study does, however, demonstrate that both tests are sensitive for the diagnosis of allergic rhinitis, with sensitivities of 0.90 (95% CI 0.82-0.98) for the skin test and 0.76 (95% CI 0.64-0.88) for nasal eosinophilia. Both the skin-prick test and the nasal smear eosinophilia showed correlation with the clinical history, although the skin-prick test was more sensitive. No statistically significant correlation was demonstrable between the two tests.

  13. Insertion Testing of Polyethylene Glycol Microneedle Array into Cultured Human Skin with Biaxial Tension

    NASA Astrophysics Data System (ADS)

    Takano, Naoki; Tachikawa, Hiroto; Miyano, Takaya; Nishiyabu, Kazuaki

    Aiming at the practical use of polyethylene glycol (PEG) microneedles for transdermal drug delivery system (DDS), a testing apparatus for their insertion into cultured human skin has been developed. To simulate the variety of conditions of human skin, biaxial tension can be applied to the cultured human skin. An adopted testing scheme to apply and control the biaxial tension is similar to the deep-draw forming technique. An attention was also paid to the short-time setup of small, thin and wet cultured skin. One dimensional array with four needles was inserted and influence of tension was discussed. It was found that tension, deflection of skin during insertion and original curvature of skin are the important parameters for microneedles array design.

  14. Interferon gamma release assay compared with the tuberculin skin test for latent tuberculosis detection in pregnancy.

    PubMed

    Worjoloh, Ayaba; Kato-Maeda, Midori; Osmond, Dennis; Freyre, Rachel; Aziz, Natali; Cohan, Deborah

    2011-12-01

    To estimate agreement and correlation between the tuberculin skin test and an interferon gamma release assay for detecting latent tuberculosis (TB) infection in pregnant women. We conducted a cross-sectional study of pregnant women initiating prenatal care at a university-affiliated public hospital between January 5, 2009, and March 15, 2010. Eligible women received a questionnaire about TB history and risk factors as well as the tuberculin skin test and phlebotomy for the interferon gamma release assay. Agreement and correlation between tests were estimated, and different cutoffs for interferon gamma release assay positivity were used to assess effect on agreement. Furthermore, predictors of test positivity and test discordance were evaluated using multivariable analysis. Of the 220 enrolled women, 199 (90.5%) returned for tuberculin skin test evaluation. Over 70% were Hispanic and 65% were born in a country with high TB prevalence. Agreement between the tuberculin skin test and interferon gamma release assay was 77.39 (κ=0.26). This agreement was not significantly changed using different cutoffs for the assay. Birth bacille Calmette-Guérin vaccination was associated with tuberculin skin test positivity (odds ratio [OR] 4.33, 95% confidence interval [CI] 1.4-13.48, P=.01), but not interferon gamma release assay positivity. There were no statistically significant predictors of the tuberculin skin test and interferon gamma release assay result discordance; however, birth in a high-prevalence country was marginally associated with tuberculin skin test-positive and interferon gamma release assay-negative results (OR 2.94, 95% CI 0.86-9.97 P=.08). Comparing the tuberculin skin test and interferon gamma release assay results in pregnancy, concordance and agreement were poor. Given that much is still unknown about the performance of interferon gamma release assays in pregnancy, further research is necessary before the tuberculin skin test is abandoned for screening of

  15. Interferon Gamma Release Assay Compared With Tuberculin Skin Test for Latent Tuberculosis Detection in Pregnancy

    PubMed Central

    Worjoloh, Ayaba; –Maeda, Midori Kato; Osmond, Dennis; Freyre, Rachel; Aziz, Natali; Cohan, Deborah

    2011-01-01

    Objective To estimate agreement and correlation between the tuberculin skin test and an interferon gamma release assay for detecting latent tuberculosis (TB) infection in pregnant women. Methods We conducted a cross-sectional study of pregnant women initiating prenatal care at a university-affiliated public hospital between January 5, 2009 and March 15, 2010. Eligible women received a questionnaire about tuberculosis history and risk factors, as well as the tuberculin skin test and phlebotomy for the interferon gamma release assay. Agreement and correlation between tests were estimated, and different cut-offs for interferon gamma release assay positivity were used to assess effect on agreement. Furthermore, predictors of test positivity and test discordance were evaluated using multivariable analysis. Results Of the 220 enrolled women, 199 (90.5%) returned for tuberculin skin test evaluation. Over 70% were Hispanic and 65% were born in a country with high tuberculosis prevalence. Agreement between tuberculin skin test and interferon gamma release assay was 77.39 (k=0.26). This agreement was not significantly changed using different cut-offs for the assay. Birth bacille Calmette-Guérin vaccination was associated with tuberculin skin test positivity (OR 4.33, 95%CI 1.4–13.48, p=0.01), but not interferon gamma release assay positivity. There were no statistically significant predictors of tuberculin skin test and interferon gamma release assay result discordance, however birth in high prevalence country was marginally associated with tuberculin skin test positive and interferon gamma release assay negative results (OR 2.94, 95% CI 0.86–9.97, p=0.08). Conclusion Comparing tuberculin skin test and interferon gamma release assay results in pregnancy, concordance and agreement were poor. Given that much is still unknown about the performance of interferon gamma release assays in pregnancy, further research is necessary before tuberculin skin test is abandoned for

  16. Design and implementation of fast allergy skin test detector for traditional Chinese medicine injections

    PubMed Central

    Xiao, Ying; Zhao, Yubin; Xie, Yanming

    2017-01-01

    Traditional Chinese medicine (TCM) injections are prepared from active substances extracted from TCMs and other natural medicines to establish scientific and technological methods, based on TCM hypotheses and experiences. A device was designed to provide a fast allergy skin test detector for TCM injections that could be applied to drugs of a single component or complex components. A novel fast allergy skin test detector for TCM injections was developed combining direct-current main, drug solution permeation devices of various shape that were compatible with the skin test electrode, nano-sponge patch adsorption, and flexible liposome coverage technologies with high-amplitude pulse. The detector was characterized by simple structure, easy manipulation, low dose of drug required for the skin test, no irritation to human skin, and low-false positive rate. According to the pilot clinical use, it was able to meet the clinical demand and was promising for the prevention of allergy to TCM injections. PMID:28565781

  17. Skin test and RAST responses to wheat and common allergens and respiratory disease in bakers.

    PubMed

    Prichard, M G; Ryan, G; Walsh, B J; Musk, A W

    1985-03-01

    Interrelationships between skin and humoral tests for immediate hypersensitivity to wheat and indicators of respiratory disease were examined in 176 male bakers. Skin tests were assessed by measuring the diameter of the weal resulting from prick innoculation of allergen extract and circulating allergen-specific IgE by radioallergosorbent test (RAST). Fifteen per cent of subjects showed positive skin-prick test responses to wheat extracts. These subjects demonstrated an increased prevalence of respiratory symptoms and of measurable bronchial responsiveness to methacholine. Thirty per cent of subjects had positive skin test responses to common allergens but negative responses to whole wheat. Compared to subjects with no positive skin test responses they had an increased prevalence of bronchial responsiveness to methacholine but a similar prevalence of respiratory symptoms. There was a significant association between skin test responses to whole wheat and skin test responses to common allergens suggesting that bakers with pre-existing sensitivity to common allergens are at increased risk of developing wheat flour sensitization. There was no significant difference between skin-prick test and RAST responses to wheat, water-soluble wheat protein and common allergens. Both tests showed similar relationships with indices of respiratory disease. The associations between skin test and RAST responses to wheat extracts and indices of respiratory disease was stronger for the water-soluble wheat proteins than for other wheat grain extracts. These results suggest that immediate hypersensitivity to wheat flour is important in the development of non-specific bronchial hyperreactivity in bakers and that the water-soluble fractions of wheat flour are the most important allergenic components.(ABSTRACT TRUNCATED AT 250 WORDS)

  18. An analysis of skin prick test reactions in 656 asthmatic patients.

    PubMed Central

    Hendrick, D J; Davies, R J; D'Souza, M F; Pepys, J

    1975-01-01

    Of 656 asthmatic patients referred specifically for allergy assessments, 544 (84 percent) gave positive immediate skin prick tests to at least one of 22 common allergens used routinely. Comparison of these skin test positive patients with the 102 (16 percent) who were skin test negative showed a number of significant differences. The majority of the skin test positive patients (52 percent) were less than 10 years old at the time of onset of the asthma, whereas, of the skin test negative patients, 56 percent were aged over 30 years at the time of onset. Seventy per cent report rhinitis compared with 48 per cent of the skin test negative patients, and 29 per cent reported infantile eczema compared with 9 per cent. Symptoms attributed to house dust, pollens, and animals were noted two to three times more frequently by the skin test positive patients, while corticosteroid drugs had been used more commonly by the skin test negative patients (45 percent compared with 35 percent). No significant differences were observed with the other factors studied, namely, history of urticaria or angio-oedema, family history of "allergic" disease, and awareness of sensitivity to foods, aspirin or penicillin. Prick test reactions in the skin test positive patients were most commonly seen to house dust or the acarine mite, Dermatophagoides farinae (82 percent), followed by pollens (66 percent), animal danders (38 percent), foods (16 percent), Aspergillus fumigatus (16 percent), and other moulds (21 percent). There was a highly significant association of positive history with positive prick test for all allergens studied. Images PMID:1168378

  19. [The relationship between the skin allergy test and house dust mites].

    PubMed

    Atambay, Metin; Aycan, Ozlem M; Yoloğlu, Saim; Karaman, Ulkü; Daldal, Nilgün

    2006-01-01

    Since 1960 it has been known that house dust mites are related to allergy and that they cause pulmonary tract diseases. There are various house dust mites and among these Dermatophagoides pteronyssinus (Trouessart, 1897) and Dermatophagoides farinae (Hughes, 1961) are best known with regard to their medical importance and morphological characteristics. Skin tests are used to determine the role of mites in allergic diseases. The tests are performed by using D. pteronyssinus and D. farinae antigens. In order to study, the concordance between the skin test results and the presence of house dust mites, dust samples from the houses of 49 patients diagnosed with allergic diseases who underwent skin tests were taken to investigate the presence of mites in dust. House dust mites were determined in 23 (46.3%) of the houses. Mites were found in the houses of 15 (50.0%) of 30 patients with positive skin test results and 8 (42.0%) of 19 patients with negative skin test results. There was no significant difference between the skin test positivity and negativity in the presence of house dust mites (P>0,005). In conclusion, we thought that it was necessary to evaluate the presence of mites in the houses of people who have allergic symptoms even if they had negative skin test results.

  20. Feasibility, Benefits, and Limitations of a Penicillin Allergy Skin Testing Service.

    PubMed

    Narayanan, Prasanna P; Jeffres, Meghan N

    2017-06-01

    To critically examine the feasibility, benefits, and limitations of an inpatient penicillin skin testing service and how pharmacists can be utilized. A PubMed search was performed from July 2016 through September 2016 using the following search terms: penicillin skin testing, penicillin allergy, β-lactam allergy. Additional references were identified from a review of literature citations. All English-language studies assessing the use of penicillin skin testing as well as management and clinical outcomes of patients with a β-lactam allergy were evaluated. The prevalence of people self-identifying as penicillin allergic ranges from 10% to 20% in the United States. Being improperly labeled as penicillin allergic is associated with higher health care costs, worse clinical outcomes, and an increased prevalence of multidrug-resistant infections. Penicillin skin testing can be a tool used to clarify penicillin allergies and has been demonstrated to be a successful addition to antimicrobial stewardship programs in multiple health care settings. Prior to implementing a penicillin skin testing service, institutions will need to perform a feasibility analysis of who will supply labor and accept the financial burden as well as identify if the positive benefits of a penicillin skin testing service overcome the limitations of this diagnostic test. We conclude that institutions with high percentages of patients receiving non-β-lactams because of penicillin allergy labels would likely benefit the most from a penicillin skin testing service.

  1. Immediate hypersensitivity to iodinated contrast media: diagnostic accuracy of skin tests and intravenous provocation test with low dose.

    PubMed

    Sesé, L; Gaouar, H; Autegarden, J-E; Alari, A; Amsler, E; Vial-Dupuy, A; Pecquet, C; Francès, C; Soria, A

    2016-03-01

    The diagnosis of HSR to iodinated contrast media (ICM) is challenging based on clinical history and skin tests. This study evaluates the negative predictive value (NPV) of skin tests and intravenous provocation test (IPT) with low-dose ICM in patients with suspected immediate hypersensitivity reaction (HSR) to ICM. Thirty-seven patients with suspected immediate hypersensitivity reaction to ICM were included retrospectively. Skin tests and a single-blind placebo-controlled intravenous provocation test (IPT) with low-dose iodinated contrast media (ICM) were performed. Skin tests with ICM were positive in five cases (one skin prick test and five intradermal test). Thirty-six patients were challenged successfully by IPT, and only one patient had a positive challenge result, with a grade I reaction by the Ring and Messmer classification. Ten of 23 patients followed up by telephone were re-exposed to a negative tested ICM during radiologic examination; two experienced a grade I immediate reaction. For immediate hypersensitivity reaction to ICM, the NPV for skin tests and IPT with low dose was 80% (95% CI 44-97%). © 2016 John Wiley & Sons Ltd.

  2. Advanced Developement of Leishmania Tropical Skin Test Antigen

    DTIC Science & Technology

    2011-09-01

    addressed in FDA Letter Allermed Laboratories Inc 2017 2018 2019 2025 2027 2021 2022 2023 2024 2026 2028 2029 2030 no. G0082 Barnstead...Herpes zoster, impetigo, diabetic ulcers, cutaneous T cell lymphoma, bacterial infection of the skin, arterial ulcer in drepanocytosis, pemphigus

  3. [Variations of the skin permeability in premature newborn infants. Value of the skin vasoconstriction test with neosynephrine].

    PubMed

    Plantin, P; Jouan, N; Karangwa, A; Gavanou, J; Cauvin, J M; Schollhammer, M; Sizun, J; Guillois, B; Sassolas, B; Collet, M

    1992-01-01

    The skin of preterm infants is defective as a barrier and does not function like that of mature until about 2 weeks of age. Percutaneous drug absorption was studied by observing the blanching response to aqueous solutions of 10% Neosynephrin applied to a small area of skin on the internal surface of the thigh. The subjects, 10 preterm infants born at gestational ages 29 to 32 weeks (mean: 31 weeks 2 days), were tested when they were aged from day 0 to 7. The controls were 8 normal newborns aged 2 days. All preterm infants were tested a second time at the age 7 to 17 days (mean: 10 days). The blanching response was measured after 5 minutes, and graded on a scale of 0 to 4. The first test was positive grade 2 to 4 in all the preterm babies, while it was negative in the normal newborns. The second test was negative in 7 of the 10 preterm infants; in other 3, the grade was at least 50% lower. Infants nursed under radiant heaters were not different from the other infants. Skin permeability is increased in immature infants, but falls steadily until about the age of 10 days. The results of the Neosynephrin test could be useful in predicting the response to topically administered drug.

  4. Development of action levels for MED/MPD skin-testing units in ultraviolet phototherapy

    NASA Astrophysics Data System (ADS)

    O'Connor, Una M.; O'Hare, Neil J.

    2003-03-01

    Ultraviolet (UV) Phototherapy is commonly used for treatment of skin diseases such as psoriasis and eczema. Treatment is carried out using UV phototherapy units, exposing all or part of the body for a certain exposure time. Prior to exposure in treatment units, an unaffected area of skin may be tested using UV skin-testing units in order to determine a suitable treatment regime. The exposure time at which barely perceptible erythema has developed is known as the Minimal Erythemal Dose (MED) for UVB therapy and Minimal Phototoxic Dose (MPD) for UVA therapy. This is used to determine the starting dose in the treatment regime. The presence of 'hotspots' and 'coldspots' in UV skin-testing units can result in inaccurate determination of MED/MPD. This could give rise to severe burns during treatment, or in a sub-optimal dose regime being used. Quality assurance protocols for UV phototherapy equipment have recently been developed and these protocols have highlighted the need for action levels for skin-testing units. An action level is a reference value, which is used to determine whether the difference in irradiance output level across a UV unit is acceptable. Current methodologies for skin-testing in Ireland have been characterised and errors introduced during testing have been estimated. Action levels have been developed based on analysis of errors and requirements of skin-testing.

  5. Skin and radioallergosorbent tests in patients with sensitivity to bee and wasp venom.

    PubMed

    Harries, M G; Kemeny, D M; Youlten, L J; Mills, M M; Lessof, M H

    1984-09-01

    Intradermal (ID) and prick tests with bee or wasp venom (Pharmalgen) have been performed on 102 subjects with a history of adverse reactions to stings and forty-six control subjects giving no such history. Venom was diluted 100, 10 and 1 microgram/ml for prick testing and 10(-2), 10(-2), 10(-3) and 10(-4) micrograms/ml for ID injections. In forty-six control subjects all were tested with the highest concentration of prick testing solution (100 micrograms/ml), eight (17%) had positive reactions, a similar reaction rate to that reported in control subjects using 10(-1) micrograms/ml ID. In our 102 test subjects skin tests were therefore regarded as positive only if the reaction was elicited by 10 micrograms/ml or less by prick test of 10(-2) micrograms/ml or less ID. In general the results with skin prick tests and ID tests were comparable when the prick solution was 1000 times the concentration of that used for ID testing. ID tests were positive in thirteen with negative skin prick, seven of whom had detectable antibodies when tested by RAST. Conversely four with a positive skin prick test (two of whom were RAST positive) were considered negative on ID testing. As judged either by RAST or skin tests it appeared that sensitivity diminished with the time interval from the last sting (P less than 0.001).

  6. Reconstructed human epidermis for skin absorption testing: results of the German prevalidation study.

    PubMed

    Schäfer-Korting, Monika; Bock, Udo; Gamer, Armin; Haberland, Annekathrin; Haltner-Ukomadu, Eleonore; Kaca, Monika; Kamp, Hennicke; Kietzmann, Manfred; Korting, Hans Christian; Krächter, Hans-Udo; Lehr, Claus-Michael; Liebsch, Manfred; Mehling, Annette; Netzlaff, Frank; Niedorf, Frank; Rübbelke, Maria K; Schäfer, Ulrich; Schmidt, Elisabeth; Schreiber, Sylvia; Schröder, Klaus-Rudolf; Spielmann, Horst; Vuia, Alexander

    2006-06-01

    Exposure to chemicals absorbed by the skin can threaten human health. In order to standardise the predictive testing of percutaneous absorption for regulatory purposes, the OECD adopted guideline 428, which describes methods for assessing absorption by using human and animal skin. In this study, a protocol based on the OECD principles was developed and prevalidated by using reconstructed human epidermis (RHE). The permeation of the OECD standard compounds, caffeine and testosterone, through commercially available RHE models was compared to that of human epidermis and animal skin. In comparison to human epidermis, the permeation of the chemicals was overestimated when using RHE. The following ranking of the permeation coefficients for testosterone was obtained: SkinEthic > EpiDerm, EPISKIN > human epidermis, bovine udder skin, pig skin. The ranking for caffeine was: SkinEthic, EPISKIN > bovine udder skin, EpiDerm, pig skin, human epidermis. The inter-laboratory and intra-laboratory reproducibility was good. Long and variable lag times, which are a matter of concern when using human and pig skin, did not occur with RHE. Due to the successful transfer of the protocol, it is now in the validation process.

  7. Factors influencing and modifying the decision to pursue genetic testing for skin cancer risk.

    PubMed

    Fogel, Alexander L; Jaju, Prajakta D; Li, Shufeng; Halpern-Felsher, Bonnie; Tang, Jean Y; Sarin, Kavita Y

    2017-05-01

    Across cancers, the decision to pursue genetic testing is influenced more by subjective than objective factors. However, skin cancer, which is more prevalent, visual, and multifactorial than many other malignancies, may offer different motivations for pursuing such testing. The primary objective was to determine factors influencing the decision to receive genetic testing for skin cancer risk. A secondary objective was to assess the impact of priming with health questions on the decision to receive testing. We distributed anonymous online surveys through ResearchMatch.org to assess participant health, demographics, motivations, and interest in pursuing genetic testing for skin cancer risk. Two surveys with identical questions but different question ordering were used to assess the secondary objective. We received 3783 responses (64% response rate), and 85.8% desired testing. Subjective factors, including curiosity, perceptions of skin cancer, and anxiety, were the most statistically significant determinants of the decision to pursue testing (P < .001), followed by history of sun exposure (odds ratio 1.85, P < .01) and history of skin cancer (odds ratio 0.5, P = .01). Age and family history of skin cancer did not influence this decision. Participants increasingly chose testing if first queried about health behaviors (P < .0001). The decision to pursue hypothetical testing may differ from in-clinic decision-making. Self-selected, online participants may differ from the general population. Surveys may be subject to response bias. The decision to pursue genetic testing for skin cancer is primarily determined by subjective factors, such as anxiety and curiosity. Health factors, including skin cancer history, also influenced decision-making. Priming with consideration of objective health factors can increase the desire to pursue testing. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  8. 75 FR 47592 - Final Test Guideline; Product Performance of Skin-applied Insect Repellents of Insect and Other...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-06

    ... Health Organization (WHO) has also published guidelines for testing efficacy of skin-applied mosquito... mosquito repellents applied to human skin. EPA's harmonized test guidelines coincide with the WHO...

  9. The use of reconstructed human epidermis for skin absorption testing: Results of the validation study.

    PubMed

    Schäfer-Korting, Monika; Bock, Udo; Diembeck, Walter; Düsing, Hans-Jürgen; Gamer, Armin; Haltner-Ukomadu, Eleonore; Hoffmann, Christine; Kaca, Monika; Kamp, Hennicke; Kersen, Silke; Kietzmann, Manfred; Korting, Hans Christian; Krächter, Hans-Udo; Lehr, Claus-Michael; Liebsch, Manfred; Mehling, Annette; Müller-Goymann, Christel; Netzlaff, Frank; Niedorf, Frank; Rübbelke, Maria K; Schäfer, Ulrich; Schmidt, Elisabeth; Schreiber, Sylvia; Spielmann, Horst; Vuia, Alexander; Weimer, Michaela

    2008-05-01

    A formal validation study was performed, in order to investigate whether the commercially-available reconstructed human epidermis (RHE) models, EPISKIN, EpiDerm and SkinEthic, are suitable for in vitro skin absorption testing. The skin types currently recommended in the OECD Test Guideline 428, namely, ex vivo human epidermis and pig skin, were used as references. Based on the promising outcome of the prevalidation study, the panel of test substances was enlarged to nine substances, covering a wider spectrum of physicochemical properties. The substances were tested under both infinite-dose and finite-dose conditions, in ten laboratories, under strictly controlled conditions. The data were subjected to independent statistical analyses. Intra-laboratory and inter-laboratory variability contributed almost equally to the total variability, which was in the same range as that in preceding studies. In general, permeation of the RHE models exceeded that of human epidermis and pig skin (the SkinEthic RHE was found to be the most permeable), yet the ranking of substance permeation through the three tested RHE models and the pig skin reflected the permeation through human epidermis. In addition, both infinite-dose and finite-dose experiments are feasible with RHE models. The RHE models did not show the expected significantly better reproducibility, as compared to excised skin, despite a tendency toward lower variability of the data. Importantly, however, the permeation data showed a sufficient correlation between all the preparations examined. Thus, the RHE models, EPISKIN, EpiDerm and SkinEthic, are appropriate alternatives to human and pig skin, for the in vitro assessment of the permeation and penetration of substances when applied as aqueous solutions.

  10. Is the skin sensitivity test required for administering equine rabies immunoglobulin?

    PubMed

    Sudarshan, M K; Ashwath Narayana, D H; Ravish, H S

    2011-01-01

    Rabies immunoglobulins are life-saving in patients with severe exposure to rabies. Despite the high degree of purification of equine rabies immunoglobulin (ERIG), the product inserts still recommend a skin sensitivity test before administration of this heterologous serum. A recent WHO recommendation states that there are no scientific grounds for performing a skin test before administering ERIG because testing does not predict reactions and it should be given irrespective of the result of the test. In this conflicting situation, we assessed the use of the skin sensitivity test in predicting adverse events to ERIG. The data analysed were from the Antirabies Clinic of the Kempegowda Institute of Medical Sciences Hospital, Bengaluru, India. The period of study was 26 months (June 2008-July 2010). The skin sensitivity test was validated by evaluating its sensitivity, specificity, predictability, falsepositive and false-negative results. A total of 51 (2.6%) adverse events were reported in 31 (1.5%) subjects. Most of these were mild to moderate in nature and subsided without medication. There was no serious adverse event. The sensitivity and specificity of the skin sensitivity test to predict an adverse event was 41.9% and 73.9%, respectively. Our experience with the skin sensitivity test suggests that it may not be required before administering ERIGs, as recommended by WHO. Copyright 2011, NMJI.

  11. The Return of Delayed-Type Hypersensitivity Skin Testing for Coccidioidomycosis.

    PubMed

    Wack, Elizabeth E; Ampel, Neil M; Sunenshine, Rebecca H; Galgiani, John N

    2015-09-01

    A skin test that detects dermal hypersensitivity in persons with past infection with Coccidioides species is again available for clinical use. Nearly all of the clinical studies with similar materials were published prior to the 1990s, and as a result, many practicing physicians will be unfamiliar with how skin testing for coccidioidomycosis might be useful in patient management or as a research tool. We review clinical and epidemiological studies with past skin test antigens, the composition of past and current skin test preparations with particular attention to differences in the preservatives, and how the current preparation could be used today. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  12. Tuberculin skin test conversion among health sciences students: A retrospective cohort study

    PubMed Central

    Pérez-Lu, José E.; Cárcamo, Cesar P.; García, Patricia J.; Bussalleu, Alejandro; Bernabé-Ortiz, Antonio

    2014-01-01

    SUMMARY Previous studies have reported that health sciences students are at greater risk for tuberculosis infection, especially in developing countries. The objective of this study was to estimate the prevalence, incidence, and factors associated with latent tuberculosis infection among Health Sciences students in Peru. Students enrolled at private university (in Lima – Peru) are tested annually for tuberculosis infection by tuberculin skin test. Data on tuberculin skin test results between 2002 and 2009 was used in this retrospective cohort study, a total of 4842 students were included. Tuberculin skin test conversion was defined as the change of tuberculin skin test from negative (<10 mm) to positive (≥10 mm) after 48 –72 h of inoculation. Baseline tuberculin skin test positivity was 1.0% (95%CI: 0.6%–1.3%), whereas tuberculin skin test conversion incidence was 12.4 per 100 person-years (95%CI: 11.8–13.0). This study showed that students from clinical careers in close contact with patients had an increased risk of tuberculosis infection in the internship, especially Medicine, Dentistry, Medical Technology and Nursing. Administrative, environmental and personal protection measures should be implemented and evaluated periodically in order to reduce the risk of exposure. PMID:23116653

  13. Tuberculosis screening and compliance with return for skin test reading among active drug users.

    PubMed Central

    Malotte, C K; Rhodes, F; Mais, K E

    1998-01-01

    OBJECTIVES: This study assessed the independent and combined effects of different levels of monetary incentives and a theory-based educational intervention on return for tuberculosis (TB) skin test reading in a sample of active injection drug and crack cocaine users. Prevalence of TB infection in this sample was also determined. METHODS: Active or recent drug users (n = 1004), recruited via street outreach techniques, were skin tested for TB. They were randomly assigned to 1 of 2 levels of monetary incentive ($5 and $10) provided at return for skin test reading, alone or in combination with a brief motivational education session. RESULTS: More than 90% of those who received $10 returned for skin test reading, in comparison with 85% of those who received $5 and 33% of those who received no monetary incentive. The education session had no impact on return for skin test reading. The prevalence of a positive tuberculin test was 18.3%. CONCLUSIONS: Monetary incentives dramatically increase the return rate for TB skin test reading among drug users who are at high risk of TB infection. PMID:9585747

  14. Skin test screening for tuberculosis among healthcare students: a retrospective cohort study.

    PubMed

    Orsi, G B; Antoniozzi, T; Ortis, M; Pippia, V; Sernia, S

    2013-01-01

    Aim of the study was to document the baseline prevalence of healthcare students positive to tuberculosis skin tests screening. Between 2008-2010, students admitted to healthcare courses (medicine, nursing, physiotherapy...) at Sapienza university in Rome were requested to carry out personal tuberculosis skin test screening in their local district or town healthcare centers according to the italian guidelines. At the time interferongamma release assays (IGRA) testing was not adopted for large screening. Demographic characteristics, tuberculosis screening results, healthcare course, tuberculosis vaccination status were recorded. A cohort of 2,500 university healthcare students were screened by several Italian Hygiene Offices using tuberculin skin test and Tine test. Overall 131 (5.2%) healthcare students resulted positive to some tuberculosis skin test screening. Tuberculin skin test was carried out on 2,029 students (81.2%) and conversion was observed in 107 (5.3%), whereas Tine test was carried out on 498 students (19.9%) and positive result was observed in 24 (4.8%). The Tine test use and non optimal (<72h) recording of the forearm induration in tuberculin skin tests was related mostly to some healthcare centers in Lazio and Campania regions. Previous BCG vaccination was reported by 27 healthcare students (1.1%), and only two of them showed tuberculin skin test conversion, whereas the large majority 105 (98.1%) of Mantoux positives had not been vaccinated. In univariate analysis positive tuberculin skin test was associated to growing students age (29.2 ± 10.3 vs. 23.1 ± 6.0; p<0.01). Positive tuberculin skin test was recorded in 25 (20.3%) foreign and 82 (4.3%) italian students showing a higher risk for International students (RR 4.72; 95%CI 3.14 - 7.11; p<0.01). There was no significant correlation between the different Italian regions, the various healthcare courses or gender. The study evaluated the baseline positive skin test rate for tuberculosis among

  15. CAT SCRATCH DISEASE: RESULTS OF COMPLEMENT-FIXATION AND SKIN TESTS

    DTIC Science & Technology

    Serologic and skin-testing data on a group of patients having cat scratch disease are presented to demonstrate a possible relationship to the psitt...indicate that the incidence of positive serologic reactions with the psitt-LGV group antigen is consistently higher in patients with cat scratch disease...patients, 2 of 5 did not respond with positive skin reactions when tested with cat scratch antigen, and at least 2 of the remaining 3 responded in a manner difficult to interpret.

  16. Skin test reactivity to female sex hormones in women with primary unexplained recurrent pregnancy loss.

    PubMed

    Ellaithy, Mohamed I; Fathi, Hesham M; Farres, Mohamed N; Taha, Marwa S

    2013-09-01

    The objective was to examine the hypothesis that primary unexplained recurrent pregnancy loss might be associated with an inappropriate immunologically mediated response to progesterone and/or estrogen. This prospective study included 47 women with two or more documented consecutive early pregnancy losses of unknown etiology, and no previous history of deliveries. Intradermal skin testing was performed in the luteal phase of the cycle (days 16-20) using estradiol benzoate, progesterone, and a placebo of refined sesame oil. Immediate (20 min) and late (24h and 1 week) skin test readings for all cases were compared with those of 12 parous women of comparable age with no history of spontaneous miscarriages, premenstrual disorders, pregnancy, or sex hormone-related allergic or autoimmune diseases. Main outcome measure was skin test reactivity to estradiol and/or progesterone. Immediate skin test reactivity to both hormones was observed among half of the cases at 20 min. A papule after 24h, which persisted for up to 1 week, was observed among 32 (68.1%) and 34 (72.3%) cases at the sites of estrogen and progesterone injection, respectively. 55.3% of cases had combined skin test reactivity to both estradiol and progesterone at 1 week. All women in the control group showed absence of skin test reactivity for both estradiol and progesterone at 20 min, 24h, and 1 week. None of the subjects in either group showed skin test reactivity to placebo. There is an association between primary unexplained recurrent pregnancy loss and skin test reactivity to female sex hormones.

  17. ESAT-6/CFP10 skin test predicts disease in M. tuberculosis-infected guinea pigs.

    PubMed

    Weldingh, Karin; Andersen, Peter

    2008-04-23

    Targeted preventive chemotherapy of individuals with progressive subclinical (incipient) disease before it becomes contagious would break the chain of tuberculosis transmission in high endemic regions. We have studied the ability of a skin test response to ESAT-6 and CFP10 (E6/C10) to predict later development of tuberculosis disease in the guinea pig model. Guinea pigs, either vaccinated with BCG or unvaccinated, were infected with a low dose of Mycobacterium tuberculosis by the aerosol route and the development of delayed type hypersensitivity responses to E6/C10 and to purified protein derivative (PPD) were followed until the onset of clinical disease. We demonstrated a negative correlation between the size of the skin test response and the time to the onset of clinical disease; a large E6/C10 skin test response correlated to a shorter survival time post skin testing, while a small E6/C10 skin test reaction correlated with a longer survival time (r = -0.6 and P<0.0001). No correlation was found using PPD. Our data suggest that it may be possible to develop a prognostic skin test based on E6/C10 that will allow the identification of individuals with incipient disease, who have the highest risk of developing active tuberculosis in the near future.

  18. [Practice patterns in Mexican allergologists about skin tests with allergens during 2005-2006].

    PubMed

    Larenas Linnemann, Désirée; Fogelbach, Guillermo Arturo Guidos; Cruz, Alfredo Arias

    2008-01-01

    Immunotherapy has been practiced since over a hundred years. The exact composition of the immunotherapy concentrate, with which the patient is treated, depends partly on the results of the skin prick tests applied to the allergic patient. As such, the effectiveness of the immunotherapy depends heavily on the quality of the skin prick test. The detailed recommendations for the realization of the skin prick tests have evolved and changed over the years, leading to multiple variations in its application in Mexico. We tried to get a picture of the daily practice patterns of the members of CMICA and CoMPedIA concerning the application of skin prick tests. Aquestionnaire was sent in various occasions to all members of the Colegio Mexicano de Inmunologia Clinica y Alergia (CMICA) and of the Colegio Mexicano de Pediatras, Especialistas en Inmunologia y Alergia (CoMPedIA). The results are presented descriptively and by calculation of the frequency/percentages of intervals of replies, in the case of numerical responses. A response rate of 61 (17%) was obtained of the College members, showing consistency in some replies but a wide variation in others, for example in the time certain medication has to be suspended before the execution of the skin prick test. Comparing the replies obtained with recent recommendations in international publications, some discrepancy can be detected. In some aspects of the survey there is coincidence of the skin test practices among the participants; however, in other items there is an important variation.

  19. Evaluation of antibiotic allergy: the role of skin tests and drug challenges.

    PubMed

    Solensky, Roland; Khan, David A

    2014-09-01

    Antibiotic allergies are frequently reported in both adult and pediatric populations. While a detailed drug history is essential in the evaluation of antibiotic allergy, the history is typically insufficient to determine the presence of a drug allergy. The most readily available diagnostic testing for evaluating antibiotic allergies are drug skin testing and drug challenges. This review will focus on updates in the evaluation of antibiotic allergy utilizing immediate skin tests, delayed intradermal testing, drug patch tests, and drug challenges for both adults and children with histories of antibiotic allergies.

  20. Multi-chamber microfluidic platform for high-precision skin permeation testing.

    PubMed

    Alberti, M; Dancik, Y; Sriram, G; Wu, B; Teo, Y L; Feng, Z; Bigliardi-Qi, M; Wu, R G; Wang, Z P; Bigliardi, P L

    2017-05-02

    The established in vitro tool used for testing the absorption and penetration of chemicals through skin in pharmacology, toxicology and cosmetic science is the static Franz diffusion cell. While widespread, Franz cells are relatively costly, low-throughput and results may suffer from poor reproducibility. Microfluidics has the potential to overcome these drawbacks. In this paper, we present a novel microfluidic skin permeation platform and validate it rigorously against the Franz cell by comparing the transport of 3 model chemicals of varying lipophilicity: caffeine, salicylic acid and testosterone. Permeation experiments through silicone membranes show that the chip yields higher sensitivity in permeant cumulative amounts and comparable or lower coefficients of variation. Using a skin organotypic culture, we show that the chip decreases the effect of unstirred water layers that can occur in static Franz cells. The validation reported herein sets the stage for efficient skin permeation and toxicity screening and further development of microfluidic skin-on-chip devices.

  1. Contribution to the Determination of In Vivo Mechanical Characteristics of Human Skin by Indentation Test

    PubMed Central

    Zahouani, Hassan

    2013-01-01

    This paper proposes a triphasic model of intact skin in vivo based on a general phenomenological thermohydromechanical and physicochemical (THMPC) approach of heterogeneous media. The skin is seen here as a deforming stratified medium composed of four layers and made out of different fluid-saturated materials which contain also an ionic component. All the layers are treated as linear, isotropic materials described by their own behaviour law. The numerical simulations of in vivo indentation test performed on human skin are given. The numerical results correlate reasonably well with the typical observations of indented human skin. The discussion shows the versatility of this approach to obtain a better understanding on the mechanical behaviour of human skin layers separately. PMID:24324525

  2. Penicillin skin testing is a safe and effective tool for evaluating penicillin allergy in the pediatric population.

    PubMed

    Fox, Stephanie J; Park, Miguel A

    2014-01-01

    Penicillin skin testing has been validated in the evaluation of adult patients with penicillin allergy. However, the commercially available benzylpenicilloyl polylysine (Pre-Pen) is not indicated in the pediatric population. Moreover, the safety and validity of penicillin skin testing in the pediatric population has not been well studied. We describe the safety and validity of penicillin skin testing in the evaluation of children with a history of penicillin allergy. Children (<18 years) with a history of penicillin allergy were evaluated with penicillin skin tests and were reviewed for basic demographics, penicillin skin test results, adverse drug reaction to penicillin after penicillin skin test, and adverse reaction to penicillin skin test. By using the χ(2) test, we compared the differences in the proportion of children and adults with a positive penicillin skin test. P value (<.05) was considered statistically significant. The institutional review board approved the study, and all the subjects signed written informed consents. A total of 778 children underwent penicillin skin testing; 703 of 778 patients had a negative penicillin skin test (90.4%), 66 had a positive test (8.5%), and 9 had an equivocal test (1.1%). Children were more likely to have a positive penicillin skin test (P < .0001) compared with adults (64 of 1759 [3.6%]); 369 of 703 patients with negative penicillin skin test (52%) were challenged with penicillin, and 14 of 369 patients (3.8%) had an adverse drug reaction. No adverse reactions to penicillin skin testing were observed. Penicillin skin testing was safe and effective in the evaluation of children with a history of penicillin allergy. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  3. Skin age testing criteria: characterization of human skin structures by 500 MHz MRI multiple contrast and image processing.

    PubMed

    Sharma, Rakesh

    2010-07-21

    Ex vivo magnetic resonance microimaging (MRM) image characteristics are reported in human skin samples in different age groups. Human excised skin samples were imaged using a custom coil placed inside a 500 MHz NMR imager for high-resolution microimaging. Skin MRI images were processed for characterization of different skin structures. Contiguous cross-sectional T1-weighted 3D spin echo MRI, T2-weighted 3D spin echo MRI and proton density images were compared with skin histopathology and NMR peaks. In all skin specimens, epidermis and dermis thickening and hair follicle size were measured using MRM. Optimized parameters TE and TR and multicontrast enhancement generated better MRI visibility of different skin components. Within high MR signal regions near to the custom coil, MRI images with short echo time were comparable with digitized histological sections for skin structures of the epidermis, dermis and hair follicles in 6 (67%) of the nine specimens. Skin % tissue composition, measurement of the epidermis, dermis, sebaceous gland and hair follicle size, and skin NMR peaks were signatures of skin type. The image processing determined the dimensionality of skin tissue components and skin typing. The ex vivo MRI images and histopathology of the skin may be used to measure the skin structure and skin NMR peaks with image processing may be a tool for determining skin typing and skin composition.

  4. Skin age testing criteria: characterization of human skin structures by 500 MHz MRI multiple contrast and image processing

    NASA Astrophysics Data System (ADS)

    Sharma, Rakesh

    2010-07-01

    Ex vivo magnetic resonance microimaging (MRM) image characteristics are reported in human skin samples in different age groups. Human excised skin samples were imaged using a custom coil placed inside a 500 MHz NMR imager for high-resolution microimaging. Skin MRI images were processed for characterization of different skin structures. Contiguous cross-sectional T1-weighted 3D spin echo MRI, T2-weighted 3D spin echo MRI and proton density images were compared with skin histopathology and NMR peaks. In all skin specimens, epidermis and dermis thickening and hair follicle size were measured using MRM. Optimized parameters TE and TR and multicontrast enhancement generated better MRI visibility of different skin components. Within high MR signal regions near to the custom coil, MRI images with short echo time were comparable with digitized histological sections for skin structures of the epidermis, dermis and hair follicles in 6 (67%) of the nine specimens. Skin % tissue composition, measurement of the epidermis, dermis, sebaceous gland and hair follicle size, and skin NMR peaks were signatures of skin type. The image processing determined the dimensionality of skin tissue components and skin typing. The ex vivo MRI images and histopathology of the skin may be used to measure the skin structure and skin NMR peaks with image processing may be a tool for determining skin typing and skin composition.

  5. Skin test protocol for the prevention of hypersensitivity reactions to oxaliplatin.

    PubMed

    Pagani, Mauro; Bonadonna, Patrizia

    2014-01-01

    Several hypersensitivity reactions (HSRs) to oxaliplatin have been reported. Presently, there is no reliable way to predict the development of this adverse reaction. The aim of the present study was to evaluate the reliability of skin tests in the detection of patients at risk of developing HSRs to oxaliplatin. Patients under treatment with oxaliplatin underwent the prick test at a concentration of 1 mg/ml and, if negative, intradermal injection at a concentration of 0.1 mg/ml, one hour before each course of oxaliplatin, starting from the second administration. A group of 101 patients were submitted to skin tests: two were positive, whereas five developed HSR despite negative tests (false-negative rate: 5.05%). These patients underwent desensitization, which permitted to conclude the planned schedule in five cases. A negative skin test to oxaliplatin has a good reliability in predicting HSRs. We suggest performing tests only in patients that have received at least five courses of oxaliplatin.

  6. Suitability of skin integrity tests for dermal absorption studies in vitro.

    PubMed

    Guth, Katharina; Schäfer-Korting, Monika; Fabian, Eric; Landsiedel, Robert; van Ravenzwaay, Ben

    2015-02-01

    Skin absorption testing in vitro is a regulatory accepted alternative method (OECD Guideline 428). Different tests can be applied to evaluate the integrity of the skin samples. Here, we compared the pre- or post-run integrity tests (transepidermal electrical resistance, TEER; transepidermal water loss, TEWL; absorption of the reference compounds water, TWF, or methylene blue, BLUE) and additionally focused on co-absorption of a (3)H-labeled internal reference standard (ISTD) as integrity parameter. The results were correlated to absorption profiles of various test compounds. Limit values of 2kΩ, 10 gm(-2)h(-1) and 4.5∗10(-3)cmh(-1) for the standard methods TEER, TEWL and TWF, respectively, allowed distinguishing between impaired and intact human skin samples in general. Single skin samples did, however, not, poorly and even inversely correlate with the test-compound absorption. In contrast, results with ISTD (e.g. (3)H-testosterone) were highly correlated to the absorption of (14)C-labeled test compounds. Importantly, ISTD did not influence analytics or absorption of test compounds. Therefore, ISTD, especially when adjusted to the physico-chemical properties of test compounds, is a promising concept to assess the integrity of skin samples during the whole course of absorption experiments. However, a historical control dataset is yet necessary for a potential routine application.

  7. Systematic evaluation of non-animal test methods for skin sensitisation safety assessment.

    PubMed

    Reisinger, Kerstin; Hoffmann, Sebastian; Alépée, Nathalie; Ashikaga, Takao; Barroso, Joao; Elcombe, Cliff; Gellatly, Nicola; Galbiati, Valentina; Gibbs, Susan; Groux, Hervé; Hibatallah, Jalila; Keller, Donald; Kern, Petra; Klaric, Martina; Kolle, Susanne; Kuehnl, Jochen; Lambrechts, Nathalie; Lindstedt, Malin; Millet, Marion; Martinozzi-Teissier, Silvia; Natsch, Andreas; Petersohn, Dirk; Pike, Ian; Sakaguchi, Hitoshi; Schepky, Andreas; Tailhardat, Magalie; Templier, Marie; van Vliet, Erwin; Maxwell, Gavin

    2015-02-01

    The need for non-animal data to assess skin sensitisation properties of substances, especially cosmetics ingredients, has spawned the development of many in vitro methods. As it is widely believed that no single method can provide a solution, the Cosmetics Europe Skin Tolerance Task Force has defined a three-phase framework for the development of a non-animal testing strategy for skin sensitization potency prediction. The results of the first phase – systematic evaluation of 16 test methods – are presented here. This evaluation involved generation of data on a common set of ten substances in all methods and systematic collation of information including the level of standardisation, existing test data,potential for throughput, transferability and accessibility in cooperation with the test method developers.A workshop was held with the test method developers to review the outcome of this evaluation and to discuss the results. The evaluation informed the prioritisation of test methods for the next phase of the non-animal testing strategy development framework. Ultimately, the testing strategy – combined with bioavailability and skin metabolism data and exposure consideration – is envisaged to allow establishment of a data integration approach for skin sensitisation safety assessment of cosmetic ingredients.

  8. Integrating non-animal test information into an adaptive testing strategy - skin sensitization proof of concept case.

    PubMed

    Jaworska, Joanna; Harol, Artsiom; Kern, Petra S; Gerberick, G Frank

    2011-01-01

    There is an urgent need to develop data integration and testing strategy frameworks allowing interpretation of results from animal alternative test batteries. To this end, we developed a Bayesian Network Integrated Testing Strategy (BN ITS) with the goal to estimate skin sensitization hazard as a test case of previously developed concepts (Jaworska et al., 2010). The BN ITS combines in silico, in chemico, and in vitro data related to skin penetration, peptide reactivity, and dendritic cell activation, and guides testing strategy by Value of Information (VoI). The approach offers novel insights into testing strategies: there is no one best testing strategy, but the optimal sequence of tests depends on information at hand, and is chemical-specific. Thus, a single generic set of tests as a replacement strategy is unlikely to be most effective. BN ITS offers the possibility of evaluating the impact of generating additional data on the target information uncertainty reduction before testing is commenced.

  9. Skin tests with soluble tumor membrane antigens in patients with transitional cell cancers.

    PubMed

    Hollinshead, A C

    1978-12-01

    Patients with transitional cell cancers and control patients with other forms of cancer were tested with cell membranes and soluble membrane antigens with the use of delayed hypersensitivity skin tests. These ongoing and parallel studies in which LMI tests are used have not been completed.

  10. Construction of Tests in the Cognitive and Psychomotor Domains for Skin and Scuba Diving.

    ERIC Educational Resources Information Center

    McCarthy, Jean

    The fundamental purposes of this study were to develop mastery tests in the cognitive and psychomotor domains for skin and scuba diving and to establish validity and reliability for the tests. A table of specifications was developed for each domain, and a pilot study refined the initial test batteries into their final form. In the main study,…

  11. Construction of Tests in the Cognitive and Psychomotor Domains for Skin and Scuba Diving.

    ERIC Educational Resources Information Center

    McCarthy, Jean

    The fundamental purposes of this study were to develop mastery tests in the cognitive and psychomotor domains for skin and scuba diving and to establish validity and reliability for the tests. A table of specifications was developed for each domain, and a pilot study refined the initial test batteries into their final form. In the main study,…

  12. [Hypersensitivity to platinum salts and taxanes: The value of skin tests and tolerance induction procedures].

    PubMed

    Brault, F; Waton, J; Poreaux, C; Schmutz, J-L; Barbaud, A

    2017-07-28

    The rate of hypersensitivity reactions to platinum salts (PS) and taxanes (TX) is on the increase. The aim of our study was to show the value of skin testing and efficacy of rapid drug desensitization. This was a retrospective study conducted between January 2007 and February 2016 in patients consulting for immediate or delayed hypersensitivity to PS and TX. Skin prick tests (pT) and intradermal reaction tests (IDR) were performed according to the ENDA/EAACI recommendations. We used a 12-step desensitization protocol for rapid drug desensitization. Among the 99 patients included (30 men, 69 women, age 60.4) PS were suspected in 86 cases and taxanes in 13 cases. Skin tests were positive in 25 patients (7 pT, 18 IDR), 23 for platinum salts and 2 for taxanes. Rapid drug desensitization was proposed in 50 patients and performed in 33 (30 PS and 3 TX), proved effective in 29 patients, with protocol adaptation being necessary in 7 cases, and was ineffective in 4 patients. The skin tests for the latter 4 patients were positive. Seventy-five percent of patients with positive skin tests to oxaliplatin presented hypersensitivity reactions during desensitization, i.e. twice as many as patients having negative skin tests. Two percent of patient for PS and 7% for TX had cross reactivity. This French study confirms the efficacy of the 12-step protocol that allows patients to receive chemotherapy after hypersensitivity reaction. Skin test permits the detection of cross-reactions but their practice must be considered based on the patient's history. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  13. Skin tests in patients with hypersensitivity reaction to iodinated contrast media: a meta-analysis.

    PubMed

    Yoon, S H; Lee, S-Y; Kang, H-R; Kim, J-Y; Hahn, S; Park, C M; Chang, Y-S; Goo, J M; Cho, S-H

    2015-06-01

    Patients with a previous history of hypersensitivity reaction (HSR) to iodinated contrast media (ICM) are at high risk of the development of HSR to ICM. Many studies have tried to evaluate the diagnostic potential of skin tests in this population but have not yet reached a common conclusion. We investigated the role of skin tests in patients with HSR to ICM in terms of positive rate, cross-reactivity rate, and tolerability to skin test-negative ICM according to the type of HSR. We performed literature searches of the MEDLINE and EMBASE databases and included studies where skin tests were performed in patients with HSR to ICM, with extractable outcomes. Outcomes were pooled using a random-effects model. Twenty-one studies were included. Pooled per-patient positive rates of skin tests were 17% (95% CI, 10-26%) in patients with immediate HSR, and up to 52% (95% CI, 31-72%) when confined to severe immediate HSR. Among patients with nonimmediate HSR, the positive rate was 26% (95% CI, 15-41%). The pooled per-patient cross-reactivity rate was higher in nonimmediate HSR (68%; 95% CI, 48-83%) than that in immediate HSR (39%; 95% CI, 29-50%). Median per-test cross-reactivity rates between pairs of ICM were 7% (IQR, 6-9%) in immediate HSR and 38% (IQR, 22-51%) in nonimmediate HSR. Pooled per-patient recurrence rates of HSR to skin test-negative ICM were 7% (95% CI, 4-14%) in immediate HSR and 35% (95% CI, 19-55%) in nonimmediate HSR. Skin tests may be helpful in diagnosing and managing patients with HSR to ICM, especially in patients with severe immediate HSR. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. [Optimization of emollient formulation for treating atopic dermatitis by skin physiological index testing].

    PubMed

    Huang, Song-Gen; Yang, Xi-Xiao; Mo, Li-Qian; Zhou, Xian-Yi

    2017-07-20

    To optimize the formulation of an emollient for treatment of atopic dermatitis prepared using ceramide, sodium hyaluronate, paeonol, and camellia-seed oil. The emollients with different ratios of the 4 components were designed according to the L9(34)orthogonal table with 4 factors and 3 levels. The efficacy of the prepared emollients was tested in 4-6 week-old BALB/c mouse models of atopic dermatitis to determine the optimal formulation of the emollient by evaluating skin water content, transepidermal water loss (TEWL), pharmacodynamics and skin irritation. Range analysis of the orthogonal table and analysis of variance showed that ceramide and camellia seed oil contents had the greatest impact on the skin water content and TEWL, respectively, and the optimal composition of the emollient contained the 4 components at the ratios of D1E1F1G1. Pharmacodynamic experiments showed that at high, medium and low doses, the emollient with the optimal formulation significantly improved the skin water content, pH and TEWL in the mice (P<0.05) with similar effects in the positive control group (P>0.05) and a skin irritation test score of 0. The emollient we prepared can significantly improve skin water content, pH and TEWL in the mouse model of atopic dermatitis without skin irritations.

  15. Use of recombinant purified protein derivative (PPD) antigens as specific skin test for tuberculosis.

    PubMed

    Stavri, Henriette; Bucurenci, Nadia; Ulea, Irina; Costache, Adriana; Popa, Loredana; Popa, Mircea Ioan

    2012-11-01

    Purified protein derivative (PPD) is currently the only available skin test reagent used worldwide for the diagnosis of tuberculosis (TB). The aim of this study was to develop a Mycobacterium tuberculosis specific skin test reagent, without false positive results due to Bacillus Calmette-Guerin (BCG) vaccination using recombinant antigens. Proteins in PPD IC-65 were analyzed by tandem mass spectrometry and compared to proteins in M. tuberculosis culture filtrate; 54 proteins were found in common. Top candidates MPT64, ESAT 6, and CFP 10 were overexpressed in Escherichia coli expression strains and purified as recombinant proteins. To formulate optimal immunodiagnostic PPD cocktails, the antigens were evaluated by skin testing guinea pigs sensitized with M. tuberculosis H37Rv and BCG. For single antigens and a cocktail mixture of these antigens, best results were obtained using 3 μg/0.1 ml, equivalent to 105 TU (tuberculin units). Each animal was simultaneously tested with PPD IC-65, 2 TU/0.1 ml, as reference. Reactivity of the multi-antigen cocktail was greater than that of any single antigen. The skin test results were between 34.3 and 76.6 per cent the level of reactivity compared to that of the reference when single antigens were tested and 124 per cent the level of reactivity compared to the reference for the multi-antigen cocktail. Our results showed that this specific cocktail could represent a potential candidate for a new skin diagnostic test for TB.

  16. Further evaluation of the skin micronucleus test: results obtained using 10 polycyclic aromatic hydrocarbons.

    PubMed

    Nishikawa, Takashi; Nakamura, Tsuneaki; Fukushima, Akira; Takagi, Yutaka

    2005-12-07

    The standard in vivo micronucleus (MN) test detects clastogenicity in hematopoietic cells and is not suitable for detecting chemicals that target the skin. Previously, we have developed an in vivo rodent skin MN test that is simple to perform and can be applied to several laboratory animals, including the hairless mouse-a species whose use simplifies the procedure of skin testing. In this paper, we report new data that confirms the predictive ability of the test. Following the application of 10 polycyclic aromatic hydrocarbons (7,12-dimethylbenz[a]anthracene; 3-methylcholanthrene; benzo[a]pyrene; dibenz[a,h]anthracene; benz[a]anthracene; dibenz[a,c]anthracene; chrysene; benzo[e]pyrene; pyrene; anthracene) with various degrees of genotoxicity to the dorsal skin of hairless mice, we found that these compounds caused MN production that in general correlated with their reported carcinogenicity. We believe that this test will be useful in detecting skin clastogens that test negative when analyzed using the standard micronucleus test.

  17. Skin-prick tests for hypersensitivity to alpha-amylase preparations.

    PubMed

    Moneo, I; Alday, E; Sanchez-Agudo, L; Curiel, G; Lucena, R; Calatrava, J M

    1995-06-01

    Twenty-five asthmatic subjects with suspected alpha-amylase hypersensitivity were studied by skin-prick tests, a capture ELISA, immunoblotting and bronchial provocation tests. At the same time, different amylases were analysed by SDS-PAGE and immunoblotting using a polyclonal rabbit antiserum. Eight patients showed a positive bronchial response to amylase. Seven of them had positive skin-prick tests, with this method being the most sensitive approach for diagnosis. However, in four cases, skin tests were also positive although the patients had a negative provocation test, thus demonstrating that skin tests are not specific. ELISA and blotting showed similar results in terms of sensitivity and specificity. The enzymes used by the workers included several antigens besides alpha-amylase. The rabbit antiserum to alpha-amylase detected a protein in a wheat flour extract. In one case, the IgE antibodies were specific only for a contaminant of lower molecular weight than amylase. These facts suggest that proteins from the culture medium could be responsible for some cases of amylase hypersensitivity, making the diagnosis difficult. The presence of amylase in another enzymatic extract, a protease produced by Aspergillus oryzae, was proved by means of skin tests and immunoblotting, thus demonstrating the allergenic properties of this enzymatic preparation.

  18. Development of a standardized testing procedure for assessing the irritation potential of occupational skin cleansers.

    PubMed

    Elsner, Peter; Seyfarth, Florian; Antonov, Dimitar; John, Swen Malte; Diepgen, Thomas; Schliemann, Sibylle

    2014-03-01

    Frequent skin cleaning fulfils the definition of occupational 'wet work'. Standardized methods are required to assess the irritation potential of workplace cleansers. To develop a standardized procedure for testing the irritation potential of occupational skin cleansers. In this single-blind, single-centre trial in 25 healthy volunteers, the irritation potential of five generic reference cleansers was tested by three-times-daily washing with an automated skin cleaning device for 4 days, and quantification of cumulative skin barrier damage was performed by visual scoring, chromametry, transepidermal water loss TEWL, and corneometry. For two cleansers, reproducibility of the irritancy assessment was assessed. Furthermore, the irritation induced by four commercial workplace skin cleansers was studied. Whereas no significant changes were observed for any of the tested cleansers by either visual scoring or chromametry, significant increases in TEWL and significant decreases in stratum corneum hydration were found for all cleansers. Cleansers differed significantly in their irritation potential. On retesting of two cleansers, the first results were confirmed. Among the four commercial cleansers, one that was claimed to be mild was found to be disproportionally irritant. The presented model for testing cleansing preparations allows a highly controlled, practically relevant and reproducible irritancy assessment of occupational skin cleansers. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. The effects of cyclic tensile and stress-relaxation tests on porcine skin.

    PubMed

    Remache, D; Caliez, M; Gratton, M; Dos Santos, S

    2017-09-11

    When a living tissue is subjected to cyclic stretching, the stress-strain curves show a shift down with the increase in the number of cycles until stabilization. This phenomenon is referred to in the literature as a preconditioning and is performed to obtain repeatable and predictable measurements. Preconditioning has been routinely performed in skin tissue tests; however, its effects on the mechanical properties of the material such as viscoelastic response, tangent modulus, sensitivity to strain rate, the stress relaxation rate, etc….remain unclear. In addition, various physical interpretations of this phenomenon have been proposed and there is no general agreement on its origin at the microscopic or mesoscopic scales. The purpose of this study was to investigate the effect of the cyclical stretching and the stress-relaxation tests on the mechanical properties of the porcine skin. Cyclic uniaxial tensile tests at large and constant strain were performed on different skin samples. The change in the reaction force, and skin's tangent modulus as a function of the number of cycles, as well as the strain rate effect on the mechanical behavior of skin samples after cycling were investigated. Stress-relaxation tests were also performed on skin samples. The change in the reaction force as a function of relaxation time and the strain rate effect on the mechanical behavior of skin samples after the stress-relaxation were investigated. The mechanical behavior of a skin sample under stress-relaxation test was modeled using a combination of hyperelasticity and viscoelasticity. Overall, the results showed that the mechanical behavior of the skin was strongly influenced by cycling and stress relaxation tests. Indeed, it was observed that the skin's resistance decreased by about half for two hours of cycling; the tangent modulus degraded by nearly 30% and skin samples became insensitive to the strain rates and accumulated progressively an inelastic deformation over time during

  20. Surfactant-induced dermatitis: comparison of corneosurfametry with predictive testing on human and reconstructed skin.

    PubMed

    Piérard, G E; Goffin, V; Hermanns-Lê, T; Arrese, J E; Piérard-Franchimont, C

    1995-09-01

    Surfactants elicit alterations in the stratum corneum. Predictive tests that avoid animal experimentation are needed. This study compares three methods of rating and predicting shampoo-induced irritation. Corneosurfametry entails collection of stratum corneum followed by brief contact with diluted surfactants and measurement of variations in staining of samples. Corneosurfametry appears to correlate well with in vivo testing in volunteers with sensitive skin. However, corneosurfametry presents less interindividual variability than in vivo testing and allows better discrimination among mild products. Morphologic information about surfactant-induced loosening of corneocytes may be increased by testing surfactants on human skin equivalent. Results are similar to those provided by specimens used for corneosurfametry. The corneosurfametric prediction of surfactant irritancy correlates with in vivo testing and with in vitro evaluation on human skin equivalent.

  1. [Assessment of hypersensitivity to honey-bee venom in beekeepers by skin tests].

    PubMed

    Becerril-Ángeles, Martín; Núñez-Velázquez, Marco; Marín-Martínez, Javier

    2013-01-01

    Beekeepers are exposed to frequent honey-bee stings, and have the risk to develop hypersensitivity to bee venom, but long-term exposure can induce immune tolerance in them. Up to 30% of beekeepers show positive skin tests with honey-bee venom. The prevalence of systemic reactions to bee stings in beekeepers is from 14% to 42%. To know the prevalence of hypersensitivity to honeybee venom in Mexican beekeepers and non-beekeepers by the use of skin tests. A group of 139 beekeepers and a group of 60 non-beekeeper volunteers had a history and physical related to age, sex, family and personal atopic history and time of exposure to bee stings. Both groups received intradermal skin tests with honey-bee venom, 0.1 mcg/mL and 1 mcg/mL, and histamine sulphate 0.1 mg/mL and Evans solution as controls. The skin tests results of both groups were compared by chi-squared test. Of the group of beekeepers, 116 were men (83%) and 23 women, average age was 39.3 years, had atopic family history 28% and personal atopy 13%, average time of exposure to bee stings was 10.9 years, skin tests with honey-bee venom were positive in 16.5% and 11% at 1 mcg/mL and 0.1 mcg/mL, respectively. In the non-beekeepers group venom skin tests were positive in 13.3% and 6.7% at 1 mcg/mL and 0.1 mcg/mL. We did not find significant differences between the two venom concentrations tested in both groups, neither in the number of positive skin tests between the two groups. We found hypersensivity to honey-bee venom slightly higher in the beekeepers than in the group apparently not exposed. Both honey-bee venom concentrations used did not show difference in the results of the skin tests. The similarity of skin tests positivity between both groups could be explained by immune tolerance due to continued exposure of beekeepers.

  2. The use of ex vivo human skin tissue for genotoxicity testing

    SciTech Connect

    Reus, Astrid A.; Usta, Mustafa; Krul, Cyrille A.M.

    2012-06-01

    As a result of the chemical legislation concerning the registration, evaluation, authorization and restriction of chemicals (REACH), and the Seventh Amendment to the Cosmetics Directive, which prohibits animal testing in Europe for cosmetics, alternative methods for safety evaluation of chemicals are urgently needed. Current in vitro genotoxicity assays are not sufficiently predictive for the in vivo situation, resulting in an unacceptably high number of misleading positives. For many chemicals and ingredients of personal care products the skin is the first site of contact, but there are no in vitro genotoxicity assays available in the skin for additional evaluation of positive or equivocal responses observed in regulatory in vitro genotoxicity assays. In the present study ex vivo human skin tissue obtained from surgery was used for genotoxicity evaluation of chemicals by using the comet assay. Fresh ex vivo human skin tissue was cultured in an air–liquid interface and topically exposed to 20 chemicals, including true positive, misleading positive and true negative genotoxins. Based on the results obtained in the present study, the sensitivity, specificity and accuracy of the ex vivo skin comet assay to predict in vivo genotoxicity were 89%, 90% and 89%, respectively. Donor and experimental variability were mainly reflected in the magnitude of the response and not the difference between the presence and absence of a genotoxic response. The present study indicates that human skin obtained from surgery is a promising and robust model for safety evaluation of chemicals that are in direct contact with the skin. -- Highlights: ► We use human skin obtained from surgery for genotoxicity evaluation of chemicals. ► We use the comet assay as parameter for genotoxicity in ex vivo human skin. ► Sensitivity, specificity and accuracy to predict in vivo genotoxins are determined. ► Sensitivity, specificity and accuracy are 89%, 90% and 90%, respectively. ► The method

  3. Development, validation and testing of a skin sampling method for assessment of metal exposure.

    PubMed

    Erfani, Behnaz; Midander, Klara; Lidén, Carola; Julander, Anneli

    2017-07-01

    Nickel, cobalt and chromium are frequent skin sensitizers. Skin exposure results in eczema in sensitized individuals, the risk being related to the skin dose. To develop a self-sampling method for quantification of skin exposure to metals, to validate the method, and to assess its feasibility. Defined metal doses (0.01-5 µg) were applied to the fingers of 5 participants. Skin areas (2 cm(2) ) were sampled with 1% HNO3 , either as 0.1 ml on a swab, or as 0.5 ml on a wipe. Furthermore, 17 participants performed self-sampling by swab after 2 h of leisure activity. Samples were extracted in 1% HNO3 and analysed by inductively coupled plasma mass spectrometry. The sampling efficiency by swab was 46%, as compared with 93% for acid wipe sampling, for all tested doses. Most metal from the skin dose was detected in the first swab (33-43%). Despite lower sampling efficiency by swab, skin doses of metals following 2 h of leisure activity without hand washing were quantified in all participants, and ranged from 0.0016 to 0.15 µg/cm(2) , from 0.00014 to -0.0020 µg/cm(2) and from 0.00048 to -0.027 µg/cm(2) for nickel, cobalt, and chromium, respectively. The results indicate a future potential of skin sampling by swab to detect and monitor metals on skin by self-sampling. This will contribute to better knowledge of metal skin exposure among dermatitis patients, workers, and the general population. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. The potential utility of iodinated contrast media (ICM) skin testing in patients with ICM hypersensitivity.

    PubMed

    Ahn, Young-Hwan; Koh, Young-Il; Kim, Joo-Hee; Ban, Ga-Young; Lee, Yeon-Kyung; Hong, Ga-Na; Jin, U-Ram; Choi, Byung-Joo; Shin, Yoo-Seob; Park, Hae-Sim; Ye, Young-Min

    2015-03-01

    Both immediate and delayed hypersensitivity reactions to iodinated contrast media (ICM) are relatively common. However, there are few data to determine the clinical utility of immunologic evaluation of ICM. To evaluate the utility of ICM skin testing in patients with ICM hypersensitivity, 23 patients (17 immediate and 6 delayed reactions) were enrolled from 3 university hospitals in Korea. With 6 commonly used ICM including iopromide, iohexol, ioversol, iomeprol, iopamidol and iodixanol, skin prick (SPT), intradermal (IDT) and patch tests were performed. Of 10 patients with anaphylaxis, 3 (30.0%) and 6 (60.0%) were positive respectively on SPTs and IDTs with the culprit ICM. Three of 6 patients with urticaria showed positive IDTs. In total, 11 (64.7%) had positive on either SPT or IDT. Three of 6 patients with delayed rashes had positive response to patch test and/or delayed IDT. Among 5 patients (3 anaphylaxis, 1 urticaria and 1 delayed rash) taken subsequent radiological examinations, 3 patients administered safe alternatives according to the results of skin testing had no adverse reaction. However, anaphylaxis developed in the other 2 patients administered the culprit ICM again. With 64.7% (11/17) and 50% (3/6) of the sensitivities of corresponding allergic skin tests with culprit ICM for immediate and delayed hypersensitivity reactions, the present study suggests that skin tests is useful for the diagnosis of ICM hypersensitivity and for selecting safe ICM and preventing a recurrence of anaphylaxis caused by the same ICM.

  5. The study of human skin irritation of a novel herbal skin care product and ingredients by human single closed patch testing.

    PubMed

    Wattanakrai, Penpun; Suwanachote, Suthida; Kulkollakarn, Sutinee; Rajatanavin, Natta

    2007-06-01

    The Government Pharmaceutical Organization of Thailand (GPO) has developed many products using liposome nanotechnology and Thai herbal extracts. Evaluate the irritation potential of GPO products on human skin using the single application closed patch test under occlusion. The authors also studied the moisturizing efficacy of a commercial curmin extract cream (GPO curmin cream). Thirty-six female volunteers were tested with 12 test materials developed by GPO including liposome, curmin extract: tetrahydrocurcuminoids (THC), and commercial curmin cream. Two and a half percent sodium dodecyl sulfate (SDS) was used as positive control. Standard Finn chambers on Scanpor tape with webril cotton were used as occlusive patch test devices. Cutaneous irritation responses were graded after patch removal and the incidence of irritation compared to the positive control was used for evaluation. Corneometer was used to measure skin hydration before and after application of curmin cream. All volunteers completed the present study. The skin irritation effects from the test materials were significantly lower (p-value < 0.001, McNemar statistic test) than the positive control. Measurement of skin hydration after twice daily application of GPO curmin cream was significantly higher (p-value < 0.001, paired t-test) than the control skin. The test materials and finished products developed by the GPO are not likely to induce skin irritation under normal conditions of use. Furthermore, twice-daily application of the commercial GPO curmin cream can significantly increase skin hydration.

  6. Optical coherence tomography applied to tests of skin care products in humans--a case study.

    PubMed

    Vasquez-Pinto, L M C; Maldonado, E P; Raele, M P; Amaral, M M; de Freitas, A Z

    2015-02-01

    When evaluating skin care products for human skin, quantitative test methods need to be simple, precise and reliable. Optical coherence tomography (OCT), provides high-resolution sectional images of translucent materials to a depth of a few millimeters, a technique usually applied to medical measurements in ophthalmology and dermatology. This study aimed to demonstrate the application of OCT as the main technique for monitoring changes in skin topography during tests of a wrinkle-reduction product in humans. We used a commercial OCT apparatus to perform clinical examinations of skin roughness in treated and non-treated sites in the periorbital region of thirty human voluntaries who were using an anti-aging product commercially available: Natura Chronos® Flavonóides de Passiflora 45+ FPS15, from Natura Cosméticos, Brazil. Measurements were performed days 0, 7, 14 and 28 of treatment. Equipment and software allowed real-time recording of skin roughness parameters and wrinkle depths. The OCT measurements have allowed the monitoring of changes in skin roughness, which have shown reduction in treated sites around 10%. The obtained depth distributions also indicate reduction in the occurrence of wrinkles deeper than 170 μm. The verified results are consistent with those typically obtained after successful treatment with modern anti-aging products. By using the OCT technique, it was possible to quantify changes in skin roughness and in the distribution of depths of skin wrinkles, with adequate sensitivity. OCT imaging allows the direct visualization of the skin topography with resolution of micrometers, a reliable and interactive tool for clinical use. Therefore, for the first time, we demonstrated the use of OCT technique to verify the efficacy of cosmetic products in real time. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Ibrutinib, a BTK inhibitor used for treatment of lymphoproliferative disorders, eliminates both aeroallergen skin test and basophil activation test reactivity.

    PubMed

    Regan, Jennifer A; Cao, Yun; Dispenza, Melanie C; Ma, Shuo; Gordon, Leo I; Petrich, Adam M; Bochner, Bruce S

    2017-04-04

    Ibrutinib, a Bruton's tyrosine kinase (BTK) inhibitor, was shown to eliminate skin test reactivity in vivo and IgE-dependent basophil activation testing ex vivo. Blockade of the BTK pathway may represent a novel therapeutic strategy for the effective reduction of allergic reactivity.

  8. Sensitivity and specificity of skin tests in the diagnosis of clarithromycin allergy.

    PubMed

    Mori, Francesca; Barni, Simona; Pucci, Neri; Rossi, Elisabetta; Azzari, Chiara; de Martino, Maurizio; Novembre, Elio

    2010-05-01

    Clarithromycin is one of the most frequently prescribed oral macrolidic antibiotics in the pediatric population. Suspected adverse reactions to clarithromycin have been frequently described by parents of children examined in pediatric allergy units, but there is a lack of reliable methods available in detecting the presence of specific IgE antibodies. To investigate the prevalence of a clarithromycin allergy in children seen in a pediatric allergy unit using standardized skin tests and oral provocation tests (OPTs). Sixty-four children were referred with a history of a clarithromycin-associated adverse drug reaction. All these children underwent skin tests and OPTs. The nonirritating intradermal skin test concentration for clarithromycin was determined in a control group of 18 children who had tolerated clarithromycin in the previous month. The threshold nonirritating intradermal concentration was established at the 10:2 dilution (0.5 mg/mL). Nine of the 64 children had an immediately positive intradermal response to the 10:2 dilution and only 1 child to the 10:3 dilution (0.05 mg/mL). None had positive skin prick test results or delayed skin responses to intradermal tests. Four of 64 children (6%) with previously described adverse reactions due to clarithromycin intake had a positive OPT reaction. When we correlated the intradermal skin test results to the OPT results, intradermal test sensitivity and specificity were 75% and 90%, respectively. Intradermal tests seem to be useful in allergologic workup in children with suspected clarithromycin hypersensitivity and may help reduce the need for OPTs.

  9. Controlling tuberculosis in a llama (Lama glama) herd using clinical signs, tuberculin skin testing and serology.

    PubMed

    Twomey, D F; Collins, R; Cranwell, M P; Crawshaw, T R; Higgins, R J; Dean, G S; Vordermeier, H M; Hollingdale, A; de la Rua-Domenech, R

    2012-05-01

    An outbreak of tuberculosis (TB), caused by Mycobacterium bovis, was investigated in a small herd of llamas (Lama glama). Based on three ante-mortem diagnostic methods (clinical signs, tuberculin skin test reactions, and 'Rapid Test' serology), 12 llamas were selected for examination post-mortem. Grossly visible lesions suspicious of TB were observed in eight animals, four of which had exhibited clinical signs, one was a skin test 'reactor', and three had been seropositive. M. bovis was isolated from seven of these eight animals. Clinical signs combined with serology were found to be useful in identifying infected animals, but tuberculin skin testing had limited negative predictive value as four llamas that were subsequently confirmed as infected were not detected using this assay. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

  10. [Anaphylactic reaction caused by the performance of skin tests: report of a case].

    PubMed

    Eleuterio González, J; Leal de Hernández, L; González Spencer, D

    1997-01-01

    A case of anaphylaxis following skin tests for airborne allergens in a 25-year-old female patient diagnosed with bronchial asthma and allergic rhinitis, is presented. The purpose of this paper is to alert against severe systemic reactions related to skin tests. The reaction occurred 15 minutes after administration of various airborne allergens (pollens, air molds, and house dust), and the symptoms were: hypogastric pain, transvaginal bleeding, generalized urticaria, and bronchospasm. Immediate treatment consisted of antihistamines, bronchodilatators and steroids; the symptoms subsided in 12 hours. We conclude that skin testing can give rise to severe systemic reactions which should be identified and treated immediately by trained physicians and ancillary personnel, and that these tests should be avoided when pregnancy is suspected.

  11. Early skin testing is effective for diagnosis of hypersensitivity reactions occurring during anesthesia.

    PubMed

    Lafuente, A; Javaloyes, G; Berroa, F; Goikoetxea, M J; Moncada, R; Núñez-Córdoba, J M; Cabrera-Freitag, P; D'Amelio, C; Sanz, M L; Gastaminza, G

    2013-06-01

    Allergic skin tests have to be performed 4-6 weeks after an allergic anesthetic reaction. Patients with allergic reactions during anesthesia were prospectively included (n = 44). Skin tests were performed in two stages: (i) Stage 1 (S1), 0-4 days after the reaction; and (ii) Stage 2 (S2), 4-8 weeks after. Five (11.5%) surgical procedures were suspended due to the reaction. Positive skin tests were obtained in 25/44 patients (57%). Allergic diagnosis was carried out at S1 in 15/25 (60%) and at S2 in 10/25 (40%). Three patients resulted positive only in S1. Overall agreement among S1 and S2 skin tests was 70.45%. The kappa statistic was 0.41 (P-value = 0.002). Odds ratio of obtaining a false negative in S1 (compared with S2) was 3.33. Early allergological study is useful, could minimize false negatives, but should be considered as a complement to late skin tests. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Use of genotoxicity information in the development of integrated testing strategies (ITS) for skin sensitization.

    PubMed

    Mekenyan, Ovanes; Patlewicz, Grace; Dimitrova, Gergana; Kuseva, Chanita; Todorov, Milen; Stoeva, Stoyanka; Kotov, Stefan; Donner, E Maria

    2010-10-18

    Skin sensitization is an end point of concern for various legislation in the EU, including the seventh Amendment to the Cosmetics Directive and Registration Evaluation, Authorisation and Restriction of Chemicals (REACH). Since animal testing is a last resort for REACH or banned (from 2013 onward) for the Cosmetics Directive, the use of intelligent/integrated testing strategies (ITS) as an efficient means of gathering necessary information from alternative sources (e.g., in vitro, (Q)SARs, etc.) is gaining widespread interest. Previous studies have explored correlations between mutagenicity data and skin sensitization data as a means of exploiting information from surrogate end points. The work here compares the underlying chemical mechanisms for mutagenicity and skin sensitization in an effort to evaluate the role mutagenicity information can play as a predictor of skin sensitization potential. The Tissue Metabolism Simulator (TIMES) hybrid expert system was used to compare chemical mechanisms of both end points since it houses a comprehensive set of established structure-activity relationships for both skin sensitization and mutagenicity. The evaluation demonstrated that there is a great deal of overlap between skin sensitization and mutagenicity structural alerts and their underlying chemical mechanisms. The similarities and differences in chemical mechanisms are discussed in light of available experimental data. A number of new alerts for mutagenicity were also postulated for inclusion into TIMES. The results presented show that mutagenicity information can provide useful insights on skin sensitization potential as part of an ITS and should be considered prior to any in vivo skin sensitization testing being initiated.

  13. QSAR models of human data can enrich or replace LLNA testing for human skin sensitization.

    PubMed

    Alves, Vinicius M; Capuzzi, Stephen J; Muratov, Eugene; Braga, Rodolpho C; Thornton, Thomas; Fourches, Denis; Strickland, Judy; Kleinstreuer, Nicole; Andrade, Carolina H; Tropsha, Alexander

    2016-12-21

    Skin sensitization is a major environmental and occupational health hazard. Although many chemicals have been evaluated in humans, there have been no efforts to model these data to date. We have compiled, curated, analyzed, and compared the available human and LLNA data. Using these data, we have developed reliable computational models and applied them for virtual screening of chemical libraries to identify putative skin sensitizers. The overall concordance between murine LLNA and human skin sensitization responses for a set of 135 unique chemicals was low (R = 28-43%), although several chemical classes had high concordance. We have succeeded to develop predictive QSAR models of all available human data with the external correct classification rate of 71%. A consensus model integrating concordant QSAR predictions and LLNA results afforded a higher CCR of 82% but at the expense of the reduced external dataset coverage (52%). We used the developed QSAR models for virtual screening of CosIng database and identified 1061 putative skin sensitizers; for seventeen of these compounds, we found published evidence of their skin sensitization effects. Models reported herein provide more accurate alternative to LLNA testing for human skin sensitization assessment across diverse chemical data. In addition, they can also be used to guide the structural optimization of toxic compounds to reduce their skin sensitization potential.

  14. Utility testing of an apple skin color MdMYB1 marker in two progenies

    USDA-ARS?s Scientific Manuscript database

    A reported allele-specific dCAP PCR marker associated with apple fruit red skin color was tested in 18 elite breeding parents and two apple cross populations. Among all tested cultivars except one, a consistent relationship was observed between red fruit color and the presence of allele. In both pop...

  15. Comparison of quantiferon test with tuberculin skin test for the detection of tuberculosis infection in children.

    PubMed

    Onur, Hatice; Hatipoğlu, Sami; Arıca, Vefik; Hatipoğlu, Nevin; Arica, Seçil Gunher

    2012-08-01

    The efficacy of Quantiferon-TB gold test (QFT-GIT) remains to be documented in pediatric population. Tuberculin skin test (TST) is a conventional test available for the diagnosis of latent tuberculosis infection (LTBI). We aimed to investigate the concordance between QFT-GIT and TST in children with and without tuberculosis infection. Ninety-seven patients, aged 3 months-14 years, admitted to pediatric outpatient clinics of Dr. Sadi Konuk Training Hospital Bakırköy, Turkey between March 2008 and April 2009 were recruited. Demographic features, TST results, history of exposure to active tuberculosis (TB), chest X-ray findings, clinical history, presence of Bacillus Calmette Guerin (BCG) vaccination scar were recorded. Patients were categorized into four groups namely, active TB, LTBI, no TB and healthy. It was found that BCG scar positivity did not influence QFT-GIT results. There was a statistically significant agreement between QFT-GIT and TST results (κ = 0.486; p < 0.01). In patients ≥ 5 years of age, TST positivity and QFT positivity had a significant relationship (p < 0.01). In all patient groups, sensitivity and specificity was 65.85 % and 82.14 %, respectively. In active TB group, TST and QFT-GIT results demonstrated significant agreement ratio of 40.8 % (κ = 0.364; p < 0.01). Sensitivity and specificity was 100 % and 30 %, respectively. Utilization of QFT-GIT in the diagnosis of LTBI reduces false-positive results and prevents unnecessary treatment with INH and its adverse effects.

  16. The Phenion full-thickness skin model for percutaneous absorption testing.

    PubMed

    Ackermann, K; Borgia, S Lombardi; Korting, H C; Mewes, K R; Schäfer-Korting, M

    2010-01-01

    In recent years many efforts have been made to replace dermal toxicity testing of chemicals in the animal by in vitro assays. As a member of a German research consortium, we have previously contributed to the validation of an in vitro test protocol for percutaneous absorption studies on the basis of reconstructed human epidermis and both human and pig skin ex vivo. Aiming to assess the barrier properties of a newly developed reconstructed skin model, this protocol has now been transferred to the Phenion Full-Thickness Skin Model (FT model). The permeation of testosterone and caffeine was quantified in parallel to that of pig skin using Franz-type diffusion cells. In addition, the permeation of benzoic acid and nicotine was studied. As expected, the FT model is more permeable than pig skin, yet its barrier properties are well in accordance with those of reconstructed human epidermis when compared to previous data. In fact, the FT model most efficiently retards testosterone as the compound of highest lipophilicity, which can be explained by an additional uptake by a reservoir formed by the dermis equivalent. Thus, the structure closely parallels human skin. In consequence, the Phenion FT model appears to be suitable for percutaneous absorption studies in hazard analysis and should be subjected to a catch-up validation study.

  17. A computer program based on parallel line assay for analysis of skin tests.

    PubMed

    Martín, S; Cuesta, P; Rico, P; Cortés, C

    1997-01-01

    A computer program for the analysis of differences or changes in skin sensitivity has been developed. It is based on parallel line assay, and its main features are its ability to conduct a validation process which ensures that the data from skin tests conform to the conditions imposed by the analysis which is carried out (regression, parallelism, etc.), the estimation of the difference or change in skin sensitivity, and the determination of the 95% and 99% confidence intervals of this estimation. This program is capable of managing data from independent groups, as well as paired data, and it may be applied to the comparison of allergen extracts, with the aim of determining their biologic activity, as well as to the analysis of changes in skin sensitivity appearing as a consequence of treatment such as immunotherapy.

  18. Penicillin hypersensitivity: value of clinical history and skin testing in daily practice.

    PubMed

    Kalogeromitros, Dimitrios; Rigopoulos, Dimitrios; Gregoriou, Stamatios; Papaioannou, Dimitrios; Mousatou, Vassiliki; Katsarou-Katsari, Alexandra

    2004-01-01

    Penicillin often is excluded as a treatment option based on patients' self-reported history of an adverse reaction to penicillin. The objective of this prospective study was to determine the likelihood of true penicillin allergy in patients with vague and convincing histories of penicillin allergy and to evaluate the diagnostic value added by appropriate skin testing. Six hundred thirty-eight patients with prior beta-lactam intake had a current indication for penicillin therapy and were referred for testing with the major (benzylpenicilloyl polylysine) and minor (minor determinant mixture) penicillin determinants from the inpatient and outpatient service of Athens University Dermatological hospital from January 2000 to December 2002. The prevalence of positive skin tests in the total group and in those patients with vague and convincing histories of penicillin allergy was determined. Positive skin tests were observed in 19/638 (3%) of the total group, 5 out of 542 (0.9%) patients without any history of penicillin allergy, 14 out of 96 (14.6%) patients with vague history (confidence interval [CI] 95% = 5.95-59.92), and 13 out of 18 (72.2%) patients with a convincing history of type I hypersensitivity reaction (chi2 = 286.3: odds ratio = 281.3: CI 95% = 62.19-1440.8). Patients with a vague history of penicillin allergy are 18 times more likely to have a positive penicillin skin test, and a convincing reaction history increases the likelihood by 281-fold compared with patients without a history of penicillin allergy. However, the fact that 5 of 18 (27.8%) patients with a convincing history were negative when skin tested points out that skin testing is helpful if the need for penicillin administration is compelling.

  19. Skin prick test results to artesunate in children sensitized to Artemisia vulgaris L.

    PubMed

    Mori, F; Pantano, S; Rossi, M E; Montagnani, C; Chiappini, E; Novembre, E; Galli, L; de Martino, M

    2015-09-01

    Artemisia vulgaris L and Artemisia annua L (Chinese: qinghao) are similar plants of the Asterbaceae family. Artesunate, a semi-synthetic derivate of artemisin which is the active principle extract of the plant qinghao, has antimalarial properties. Some cases of severe allergic reactions to artesunate have been described. The purpose of this study was to evaluate the association between positive skin tests to Artemisia vulgaris L allergen and a preparation of injectable artesunate. A total of 531 children were skin prick tested with inhalants (including Artemisia vulgaris L), foods, and artesunate. Among the 59 patients positive to Artemisia vulgaris L only one child was also positive to artesunate. No child was positive to artesunate in those negative to Artemisia vulgaris L. We conclude that Artemisia vulgaris L sensitization is not associated with sensitization to artesunate; consequently, skin test to artesunate should not be carried out before using the drug considering the rare allergic reactions. © The Author(s) 2015.

  20. Optimisation of the EpiDerm test protocol for the upcoming ECVAM validation study on in vitro skin irritation tests.

    PubMed

    Kandárová, Helena; Liebsch, Manfred; Genschow, Elke; Gerner, Ingrid; Traue, Dieter; Slawik, Birgitta; Spielmann, Horst

    2004-01-01

    An ECVAM-funded prevalidation study (PV) was conducted during 1999 and 2000 to identify in vitro tests capable of reliably distinguishing between skin irritants (I) and non-irritants (NI) according to European Union risk phrases ("R38" or no classification). The tests evaluated were EpiDerm, EPISKIN, PREDISKIN, the non-perfused pig ear method, and the mouse skin integrity function test (SIFT). Whereas reproducibility of the two human skin model tests and SIFT was acceptable, none of the methods was deemed ready to enter a formal validation study due to their low predictivity. The ECVAM Skin Irritation Task Force therefore suggested improvements of protocols and prediction models for these tests. Furthermore, it was agreed that experience gained with the two human-skin models be shared, and a common protocol should be developed for EpiDerm and EPISKIN (Zuang et al., 2002). When we applied an improved EPISKIN protocol (Portes et al., 2002) to the EpiDerm model, an acceptable specificity (80%) was achieved, whereas the sensitivity (60%) was far too low. In 2003, the EPISKIN protocol was further refined by extension of the post-incubation period following chemical exposure. In the current study, we evaluated this EPISKIN refinement by applying it to EpiDerm. In addition, we developed technical improvements for the application of the test chemicals and rinsing procedure, which reduced the variability of results and increased the percentage of correct predictions. A set of twenty non-coded reference substances from the ECVAM prevalidation study phase III (Fentem et al., 2001) was tested with the final protocol in three independent runs. Both high sensitivity (80%) and high specificity (78%) were achieved, and the statistical probability of correct classifications was high, so that the test is now regarded ready for formal validation.

  1. Mouse allergen-specific immunoglobulin G4 and risk of mouse skin test sensitivity.

    PubMed

    Matsui, E C; Diette, G B; Krop, E J M; Aalberse, R C; Smith, A L; Eggleston, P A

    2006-08-01

    High serum levels of cat-specific IgG and IgG4 are associated with protection against allergic sensitization to cat, but whether this association applies to other animal allergens remains unclear. To determine if high levels of mouse-specific IgG and IgG4 are associated with a decreased risk of mouse skin test sensitivity. Two hundred and sixty workers of a mouse facility underwent skin prick testing and completed a questionnaire. Serum levels of mouse-specific IgG and IgG4 were quantified by solid-phase antigen binding assays. Room air samples were collected and airborne Mus m 1 was quantified by ELISA. Forty-nine participants had a positive skin prick test to mouse. Mouse-specific IgG was detected in 219 (84%) participants and IgG4 was detected in 72 (28%) participants. A detectable mouse-specific IgG4 level was associated with an increased risk of mouse skin test sensitivity (odds ratios (OR) 6.4, 95% confidence intervals (CI) 3.3-12.4). Mouse-specific IgG and IgG4 were both positively correlated with mouse allergen exposure (r(s)=0.31, P=0.0001, and r(s)=0.27, P=0.0006, respectively). The odds of skin test sensitivity peaked at moderate levels of IgG4, but decreased at the highest levels of mouse-specific IgG4. In contrast, the odds of skin test sensitivity increased monotonically with IgG levels. A detectable level of mouse-specific IgG4 is associated with an increased risk of skin test sensitivity to mouse. However, the highest IgG4 levels appear to be associated with an attenuated risk of mouse skin test sensitivity, suggesting that induction of high levels of IgG4 through natural exposure may protect against the development of allergic sensitization.

  2. A study of skin sensitivity to various allergens by skin prick test in patients of nasobronchial allergy

    PubMed Central

    Prasad, R.; Verma, S. K.; Dua, R.; Kant, S.; Kushwaha, R.A.S; Agarwal, S. P.

    2009-01-01

    Objective: To study skin sensitivity to various allergens in patients of nasobronchial allergy. Materials and Methods: 2880 skin prick tests with 60 allergens were performed in 48 patients of nasobronchial allergy. Results: Most common offending allergens were insects (21.2%), followed by dusts (12.0%), pollens (7.8%), animal dander (3.1%), and fungi (1.3%). The common insect antigen were locust female (33.3%) followed by locust male (25%), grasshopper (20.8%), cricket (16.7%), cockroach female (16.7%) and cockroach male (14.6%). Common dust allergens were house dust, wheat dust, cotton mill and paper dust. Among pollens, Amaranthus spinosus, Argemone mexicana, Adhatoda vasica, Ailanthus and Cannabis were found to be common allergens. In animal danders common offending allergens were cow dander and dog dander. Among fungi Aspergillus fumigatus, Aspergillus flavus, Alternaria teneis and Fusarium sodani were common allergens. Patients of bronchial asthma had associated allergic rhinitis in 80% cases. Conclusion: Common allergens in patients of nasobronchial allergy were identified. The data may prove useful in of allergen avoidance and immunotherapy in these patients. PMID:20442839

  3. Tannins from Potentilla officinalis display antiinflammatory effects in the UV erythema test and on atopic skin.

    PubMed

    Hoffmann, Julia; Wölfle, Ute; Schempp, Christoph M; Casetti, Federica

    2016-09-01

    Rich in tannins, the rhizome of Potentilla officinalis (PO) has traditionally been used in the topical treatment of inflammatory disorders of the skin and mucous membranes. The objective of the present study was to examine the antiinflammatory effects of PO in the UV erythema test as well as in patients with atopic skin. Using the UV erythema test, the antiinflammatory effects of a PO extract (2 %) - compared to 1 % hydrocortisone acetate - were assessed in a randomized, prospective, placebo-controlled double-blind study of 40 healthy volunteers. In the context of a prospective non-controlled trial, the efficacy and tolerability of 2 % PO cream (applied to defined test areas twice daily for two weeks) was evaluated in twelve adults and twelve children with atopic skin using a partial SCORAD. In addition, the effects on the degree of erythema in the test areas was measured photometrically. In the UV erythema test, PO cream significantly reduced the erythema index compared to the vehicle. The antiinflammatory effects of PO cream were comparable to those of 1 % hydrocortisone acetate cream. The clinical study with atopic patients revealed a significant reduction in the partial SCORAD as well as erythema in the test areas. No adverse events were recorded. PO cream displays antiinflammatory effects in vivo. It is effective in and well tolerated by patients with atopic skin. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  4. A new model for preclinical testing of dermal substitutes for human skin reconstruction.

    PubMed

    Hartmann-Fritsch, Fabienne; Biedermann, Thomas; Braziulis, Erik; Meuli, Martin; Reichmann, Ernst

    2013-05-01

    Currently, acellular dermal substitutes used for skin reconstruction are usually covered with split-thickness skin grafts. The goal of this study was to develop an animal model in which such dermal substitutes can be tested under standardized conditions using a bioengineered dermo-epidermal skin graft for coverage. Bioengineered grafts consisting of collagen type I hydrogels with incorporated human fibroblasts and human keratinocytes seeded on these gels were produced. Two different dermal substitutes, namely Matriderm(®), and an acellular collagen type I hydrogel, were applied onto full-thickness skin wounds created on the back of immuno-incompetent rats. As control, no dermal substitute was used. As coverage for the dermal substitutes either the bioengineered grafts were used, or, as controls, human split-thickness skin or neonatal rat epidermis were used. Grafts were excised 21 days post-transplantation. Histology and immunofluorescence was performed to investigate survival, epidermis formation, and vascularization of the grafts. The bioengineered grafts survived on all tested dermal substitutes. Epidermis formation and vascularization were comparable to the controls. We could successfully use human bioengineered grafts to test different dermal substitutes. This novel model can be used to investigate newly designed dermal substitutes in detail and in a standardized way.

  5. Porcine ear skin as a biological substrate for in vitro testing of sunscreen performance.

    PubMed

    Sohn, Myriam; Korn, Verena; Imanidis, Georgios

    2015-01-01

    The purpose of the study was to examine the use of skin from porcine ears as a biological substrate for in vitro testing of sunscreens in order to overcome the shortcomings of the presently used polymethylmethacrylate (PMMA) plates that generally fail to yield a satisfactory correlation between sun protection factors (SPF) in vitro and in vivo. Trypsin-separated stratum corneum and heat-separated epidermis provided UV-transparent substrates that were laid on quartz or on PMMA plates. These were used to determine surface roughness by chromatic confocal imaging and to measure SPF in vitro of 2 sunscreens by diffuse transmission spectroscopy. The recovered skin layers showed a lower roughness than full-thickness skin but yielded SPF in vitro values that more accurately reflected the SPF determined in vivo by a validated procedure than PMMA plates, although the latter had in part roughness values identical to those of intact skin. Combination of skin tissue with a high roughness PMMA plate also provided accurate SPF in vitro. Besides roughness, the improved affinity of the sunscreen to the skin substrate compared to PMMA plates may explain the better in vitro prediction of SPF achieved with the use of a biological substrate. © 2014 S. Karger AG, Basel.

  6. Role of the skin patch test in diagnosing food allergy in children with atopic dermatitis.

    PubMed

    Rokaite, Rūta; Labanauskas, Liutauras; Vaideliene, Laimute

    2004-01-01

    The aim of the study was to determine peculiarities of food allergy in children with atopic dermatitis and to evaluate the significance of skin patch test in determining the main food allergens. One hundred and eight children (57 boys and 51 girls) with atopic dermatitis were examined. Atopic dermatitis was diagnosed by standard diagnostic criteria, severity of the progress of the disease was determined using SCORAD index and the amount of total IgE in blood, skin prick and patch tests with the main food allergens were performed. The age of the patients varied from 6 months to 16 years, however, almost half (41%) of them were toddlers (1-3 years old). Mild form of atopic dermatitis was dominating (52%). Analysis of the total IgE amount in blood showed different degree of sensitivity of the children tested. Normal amount of the total IgE in blood was found in 73.1% of children with atopic dermatitis, and the increased total IgE amount was found only in 26.9% of children. Positive skin prick test with the standard and the most common food allergens was found only in 4.63% of children with atopic dermatitis, while the positive skin patch test with 25 food allergens was found in 68.5% of children. Depending on the type of the allergic reaction, immediate type reaction dominated only in 10.3% of children with atopic dermatitis, while the delayed type allergic reactions were characteristic to food allergies in 48.3% of children with atopic dermatitis. Food allergy was not found in one fifth of children with atopic dermatitis. Skin patch test is an informative and reliable diagnostic test in evaluating the delayed type allergic reactions. In about half of the tested persons with atopic dermatitis, food allergy appeared in delayed type allergic reactions. Therefore it is very important to do the skin patch test for toddlers and pre-school age children. The most common allergens found with the help of skin patch test are soy, milk, peanuts, carrot, egg whites, wheat, and

  7. A tiered approach to the use of alternatives to animal testing for the safety assessment of cosmetics: skin irritation.

    PubMed

    Macfarlane, Martin; Jones, Penny; Goebel, Carsten; Dufour, Eric; Rowland, Joanna; Araki, Daisuke; Costabel-Farkas, Margit; Hewitt, Nicola J; Hibatallah, Jalila; Kirst, Annette; McNamee, Pauline; Schellauf, Florian; Scheel, Julia

    2009-07-01

    Evaluation of the skin irritancy and corrosivity potential of an ingredient is a necessity in the safety assessment of cosmetic ingredients. To date, there are two formally validated alternatives to the rabbit Draize test for skin corrosivity in place, namely the rat skin transcutaneous electrical resistance (TER) assay and the Human Skin Model Test using EpiSkin, EpiDerm and SkinEthic reconstructed human epidermal equivalents. For skin irritation, EpiSkin, EpiDerm and SkinEthic are validated as stand-alone test replacements for the rabbit Draize test. Data from these tests are rarely considered in isolation and are evaluated in combination with other factors to establish the overall irritating or corrosive potential of an ingredient. In light of the deadlines established in the Cosmetics Directive for cessation of animal testing for cosmetic ingredients, a COLIPA scientific meeting was held in Brussels on 30th January, 2008 to review the use of alternative approaches and to set up a decision tree approach for their integration into tiered testing strategies for hazard and safety assessment of cosmetic ingredients and their use in products. In conclusion, the safety assessments for skin irritation/corrosion of new chemicals for use in cosmetics can be confidently accomplished using exclusively alternative methods.

  8. Correlation of quantitative tests of nerve and target organ dysfunction with skin immunohistology in leprosy.

    PubMed

    Facer, P; Mathur, R; Pandya, S S; Ladiwala, U; Singhal, B S; Anand, P

    1998-12-01

    Loss of nociception and hypohidrosis in skin are hallmarks of leprosy, attributed to early invasion by Mycobacterium leprae of Schwann cells related to unmyelinated nerve fibres. We have studied skin lesions and contralateral clinically unaffected skin in 28 patients across the leprosy spectrum with a range of selective quantitative sensory and autonomic tests, prior to biopsy of both sites. Unaffected sites showed normal skin innervation, when antibodies to the pan-neuronal marker PGP (protein gene product) 9.5 were used, with the exception of intraepidermal fibres which were not detected in the majority of cases. Elevation of thermal thresholds and reduced sensory axon-reflex flare responses in affected skin correlated with decreased nerve fibres in the subepidermis, e.g. axon-reflex flux units (means+/-SEM) for no detectable innervation; decreased innervation; and clinically unaffected skin, were 23+/-3.1; 41.2+/-7.3; and 84.5+/-4.0, respectively. Reduced nicotine-induced axon-reflex sweating was correlated with decreased innervation of sweat glands. Where methacholine-induced direct activation of sweat glands was affected, there was inflammatory infiltrate and loss of sweat gland structure. This study demonstrates a correlation between selective nerve dysfunction on clinical tests and morphological changes in skin, irrespective of the type of leprosy, and is the first to show that loss of sweating in leprosy may result either from decreased innervation and/or involvement of the sweat glands. The findings have implications for the selection and monitoring of patients with leprosy in clinical trials which aim to restore cutaneous function.

  9. Use of recombinant purified protein derivative (PPD) antigens as specific skin test for tuberculosis

    PubMed Central

    Stavri, Henriette; Bucurenci, Nadia; Ulea, Irina; Costache, Adriana; Popa, Loredana; Popa, Mircea Ioan

    2012-01-01

    Background & objectives: Purified protein derivative (PPD) is currently the only available skin test reagent used worldwide for the diagnosis of tuberculosis (TB). The aim of this study was to develop a Mycobacterium tuberculosis specific skin test reagent, without false positive results due to Bacillus Calmette-Guerin (BCG) vaccination using recombinant antigens. Methods: Proteins in PPD IC-65 were analyzed by tandem mass spectrometry and compared to proteins in M. tuberculosis culture filtrate; 54 proteins were found in common. Top candidates MPT64, ESAT 6, and CFP 10 were overexpressed in Escherichia coli expression strains and purified as recombinant proteins. To formulate optimal immunodiagnostic PPD cocktails, the antigens were evaluated by skin testing guinea pigs sensitized with M. tuberculosis H37Rv and BCG. Results: For single antigens and a cocktail mixture of these antigens, best results were obtained using 3 μg/0.1 ml, equivalent to 105 TU (tuberculin units). Each animal was simultaneously tested with PPD IC-65, 2 TU/0.1 ml, as reference. Reactivity of the multi-antigen cocktail was greater than that of any single antigen. The skin test results were between 34.3 and 76.6 per cent the level of reactivity compared to that of the reference when single antigens were tested and 124 per cent the level of reactivity compared to the reference for the multi-antigen cocktail. Interpretation & conclusions: Our results showed that this specific cocktail could represent a potential candidate for a new skin diagnostic test for TB. PMID:23287127

  10. Testing of viable human skin cell dilution cultures as an approach to validating microsampling.

    PubMed

    Ainger, Stephen A; Yong, X L Hilary; Soyer, H Peter; Sturm, Richard A

    2017-05-01

    Skin biopsies are a valuable technique in the diagnosis of cutaneous inflammatory and neoplastic conditions. We were interested to test the minimal size or equivalent volume by dilution of proteolytically disassociated skin tissue required to allow the isolation and propagation of cutaneous cells, for freezing, storage and biochemical analysis. It was possible to propagate with 100% efficiency fibroblast and melanocytic cells from a 0.1 to 0.5 mm(3) equivalent neonatal foreskin sample using a combination of DispaseII and CollagenaseIV. The smallest tissue dilution that allowed melanocytic cell culture was 0.01 mm(3), which equated to approximately 16 cells based on the average skin density of melanocytes. However, passaging of cells to create frozen stocks was achieved routinely only from 1 mm(3) skin, equating to 1560 cells. Tissue-specific antigen expression of these cultures was tested by western blot of total protein extracts. There was no pigmentation antigen expression in fibroblast cultures; however, smooth muscle actin protein expression was high in fibroblast but absent from melanocytic cell strains. Melanocytic cells expressed pigmentation antigens and E-cadherin, but these were not detected in fibroblasts. Moreover, maturation of these melanocytic cells resulted in a decrease of Dopachrome Tautomerase antigen expression and induction of Tyrosinase protein consistent with the differentiation potential seen in cell cultures derived routinely from large sections of skin tissue.

  11. Anaphylaxis to Spirulina confirmed by skin prick test with ingredients of Spirulina tablets.

    PubMed

    Le, Thuy-My; Knulst, André C; Röckmann, Heike

    2014-12-01

    Spirulina (Arthrospira platensis), blue-green microalgae, has high content in proteins, γ-linoleic acid and vitamins and therefore gained popularity as food supplement. According to the Food and Agriculture Organization of the United Nations Spirulina is also an interesting alternative and sustainable protein source with the growing world population. We present a case of a 17-year-old male, who developed anaphylaxis the first time he ingested a Spirulina tablet. Skin prick test with diluted Spirulina tablet was positive. Further skin prick testing with separated ingredients (Spirulina platensis algae, silicon dioxide, inulin and magnesium stearate) was only positive for Spirulina platensis algae and negative in controls, confirming the allergy was caused by Spirulina and not by one of the additives. This case report shows that diagnosis of Spirulina allergy can safely be made by skin prick test with dilutions of the A. platensis or even more simple by skin prick test with the diluted tablet. Since Spirulina has gained popularity as food and nutritional supplement, it is important to realize the potential risk of this dietary supplement. Before Spirulina is produced and consumed on a wider scale, allergenicity risk assessment should be performed, including investigation of potential crossreactivity with well-known inhalant allergens and foods.

  12. Analysis of skin patch test results and metalloproteinase-2 levels in a patient with contact dermatitis.

    PubMed

    Wojciechowska, Milena; Czajkowski, Rafał; Kowaliszyn, Bogna; Żbikowska-Gotz, Magdalena; Bartuzi, Zbigniew

    2015-06-01

    The complex course of skin reactions that contact eczema involves is due in part to abnormalities of the extracellular matrix function. Proteins that degrade extracellular matrix components include metalloproteinases (MMP), which are divided into subcategories depending on the chemical structure and substrate specificity. To analyse patch test results in contact dermatitis patients and to assess MMP-2 levels during skin lesion exacerbation and remission. Fifty patients suffering from contact eczema were qualified to the study and 20 healthy volunteers as a control group. The study group patients had epidermal skin tests performed with the "European Standard" set. To assess the MMP-2 level in serum, venous blood was drawn, twice from study group patients - during contact dermatitis exacerbation and remission periods - and once from control group patients. Assessment of MMP-2 in serum was done with ELISA immunoassay. To verify the proposed hypotheses, parametric and nonparametric significance tests were used. Hands were the most frequent location of contact dermatitis. Nickel (II) sulphate was the most frequent sensitizing substance. Mean MMP-2 levels were statistically higher in the study group both in contact dermatitis exacerbation and remission periods than in the control group. There was no statistically significant difference between MMP-2 levels and skin patch test results. Nickel is one of the most allergenic contact allergens in patients with contact dermatitis. Metalloproteinase-2 is a good marker of contact dermatitis in various stages of the disease.

  13. Analysis of skin patch test results and metalloproteinase-2 levels in a patient with contact dermatitis

    PubMed Central

    Czajkowski, Rafał; Kowaliszyn, Bogna; Żbikowska-Gotz, Magdalena; Bartuzi, Zbigniew

    2015-01-01

    Introduction The complex course of skin reactions that contact eczema involves is due in part to abnormalities of the extracellular matrix function. Proteins that degrade extracellular matrix components include metalloproteinases (MMP), which are divided into subcategories depending on the chemical structure and substrate specificity. Aim To analyse patch test results in contact dermatitis patients and to assess MMP-2 levels during skin lesion exacerbation and remission. Material and methods Fifty patients suffering from contact eczema were qualified to the study and 20 healthy volunteers as a control group. The study group patients had epidermal skin tests performed with the “European Standard” set. To assess the MMP-2 level in serum, venous blood was drawn, twice from study group patients – during contact dermatitis exacerbation and remission periods – and once from control group patients. Assessment of MMP-2 in serum was done with ELISA immunoassay. To verify the proposed hypotheses, parametric and nonparametric significance tests were used. Results Hands were the most frequent location of contact dermatitis. Nickel (II) sulphate was the most frequent sensitizing substance. Mean MMP-2 levels were statistically higher in the study group both in contact dermatitis exacerbation and remission periods than in the control group. There was no statistically significant difference between MMP-2 levels and skin patch test results. Conclusions Nickel is one of the most allergenic contact allergens in patients with contact dermatitis. Metalloproteinase-2 is a good marker of contact dermatitis in various stages of the disease. PMID:26161054

  14. Outpatient penicillin use after negative skin testing and drug challenge in a pediatric population.

    PubMed

    Picard, Matthieu; Paradis, Louis; Nguyen, Mélanie; Bégin, Philippe; Paradis, Jean; Des Roches, Anne

    2012-01-01

    The practice of elective penicillin skin testing could be compromised by the fact that patients, their parents, or their physicians remain reluctant to reuse penicillin-class antibiotics (PCAs) despite a negative evaluation by an allergist. This study addresses reuse of PCAs in a pediatric population after negative penicillin skin testing and drug challenge and factors associated with its reluctance. All children evaluated for a history of penicillin allergy at the CHU Sainte-Justine Allergy Clinic between January 1998 and June 2000 with negative skin testing and drug challenge were included in the study. A telephone survey was conducted between May and October 2002 to assess the perception of the initial reaction by the parents, subsequent use of antibiotics, and antibiotic-related adverse reactions. Among the 200 children selected, parents of 170 (85%) children completed the survey. Since the allergist evaluation, 130 (76%) children had received antibiotics. PCA was used in 59 (45%) children. Parents of 24 (18%) children refused PCAs because they still feared an adverse reaction. They were more likely to have been very frightened by their child's allergic reaction than other parents whose children had used PCAs (p = 0.008). Although elective penicillin skin testing is useful and safe in the pediatric population, a significant proportion of parents still refuse PCAs even though they are needed. Identification of parents that were very frightened by their children's allergic reactions and additional reassurance could improve this situation.

  15. Biaxial tensile tests identify epidermis and hypodermis as the main structural elements of sweet cherry skin

    PubMed Central

    Brüggenwirth, Martin; Fricke, Heiko; Knoche, Moritz

    2014-01-01

    The skin of developing soft and fleshy fruit is subjected to considerable growth stress, and failure of the skin is associated with impaired barrier properties in water transport and pathogen defence. The objectives were to establish a standardized, biaxial tensile test of the skin of soft and fleshy fruit and to use it to characterize and quantify mechanical properties of the sweet cherry (Prunus avium) fruit skin as a model. A segment of the exocarp (ES) comprising cuticle, epidermis, hypodermis and adhering flesh was mounted in the elastometer such that the in vivo strain was maintained. The ES was pressurized from the inner surface and the pressure and extent of associated bulging were recorded. Pressure : strain responses were almost linear up to the point of fracture, indicating that the modulus of elasticity was nearly constant. Abrading the cuticle decreased the fracture strain but had no effect on the fracture pressure. When pressure was held constant, bulging of the ES continued to increase. Strain relaxation upon releasing the pressure was complete and depended on time. Strains in longitudinal and latitudinal directions on the bulging ES did not differ significantly. Exocarp segments that released their in vivo strain before the test had higher fracture strains and lower moduli of elasticity. The results demonstrate that the cherry skin is isotropic in the tangential plane and exhibits elastic and viscoelastic behaviour. The epidermis and hypodermis, but not the cuticle, represent the structural ‘backbone’ in a cherry skin. This test is useful in quantifying the mechanical properties of soft and fleshy fruit of a range of species under standardized conditions. PMID:24876301

  16. Hypersensitivity reactions to penicillins: studies in a group of patients with negative benzylpenicillin G skin test.

    PubMed

    Qiao, H-L; Li, Z; Yang, J; Tian, X; Gao, N; Jia, L-J

    2009-06-01

    Although skin tests are usually employed to evaluate current penicillin allergy status, a negative result does not exclude hypersensitivity. There is a need for accurate in vitro tests to exclude hypersensitivity. A radioallergosorbent test (RAST) is a potentially good supplementary approach, but there is little information on the suitability of this method to diagnose penicillin hypersensitivity in subjects with a negative skin test to benzylpenicillin. A total of 133 patients with a negative skin test to benzylpenicillin G (PG) and all of whom developed allergic reactions to PG were studied. RAST was used to detect eight kinds of specific IgE antibodies to penicillins in serum, which included four kinds of major and minor antigenic determinants to four penicillin drugs. The combination sites for the specific IgE antibodies were studied by RAST inhibition test. The rate of positive reactions for the specific IgE antibodies was 59.40% (79/133). Of the eight kinds of antigenic determinants, the positive rates for specific IgE against the major and minor determinants were 39.10% (52) and 42.86% (57) respectively. Of the four drugs, positive cases only to PG were 10 (7.5%), were significantly fewer than the cross-reacting positive cases (36) to PG (P < 0.01). In the RAST inhibition studies all drugs exhibited good inhibitory potencies, and in some instances the side-chain of the penicillins could induce specific responses with a variable degree of cross-reactivity among the different penicillins. Radioallergosorbent test is a good complementary test in persons who are skin-test negative with PG, and the sensitivity of RAST increases with increasing specificity of IgE antibodies to be detected. 6-APA and the groups, making part of the different side-chains on penicillins, all contributed to the cross-reactivity.

  17. Antibiotic allergies in children and adults: from clinical symptoms to skin testing diagnosis.

    PubMed

    Romano, Antonino; Caubet, Jean-Christoph

    2014-01-01

    Hypersensitivity reactions to β-lactam and non-β-lactam antibiotics are commonly reported. They can be classified as immediate or nonimmediate according to the time interval between the last drug administration and their onset. Immediate reactions occur within 1 hour after the last drug administration and are manifested clinically by urticaria and/or angioedema, rhinitis, bronchospasm, and anaphylactic shock; they may be mediated by specific IgE-antibodies. Nonimmediate reactions occur more than 1 hour after the last drug administration. The most common manifestations are maculopapular exanthems; specific T lymphocytes may be involved in this type of manifestation. The diagnostic evaluation of hypersensitivity reactions to antibiotics is usually complex. The patient's history is fundamental; the allergic examination is based mainly on in vivo tests selected on the basis of the clinical features and the type of reaction, immediate or nonimmediate. Immediate reactions can be assessed by immediate-reading skin tests and, in selected cases, drug provocation tests. Nonimmediate reactions can be assessed by delayed-reading skin tests, patch tests, and drug provocation tests. However, skin tests have been well validated mainly for β-lactams but less for other classes of antibiotics.

  18. Sensitivity of the skin prick test and specificity of the serum-specific IgE test for airway responsiveness to house dust mites in asthma.

    PubMed

    Choi, Inseon S; Koh, Youngil I; Koh, Jeom-seok; Lee, Min-Gu

    2005-04-01

    The concept that asthma diagnosis based on allergen-specific IgE levels in serum is more accurate than diagnosis based on skin test reactivity is controversial. To determine the atopy parameter that correlates most closely with airway reactivity to house dust mites in asthma. Forty-three asthma cases were examined retrospectively for data on Dermatophagoides farinae-specific bronchoprovocation, serum-specific IgE, and skin prick tests. The maximal decreases in FEV1 following bronchoprovocation were correlated significantly with both the IgE levels and skin test scores. The accuracies of the tests were highest at a cutoff value of class 4 or higher for the IgE and of 3+ or higher for the skin test. At the cutoff values, the accuracies of both tests were similar (70% vs. 70%). The sensitivity of the skin test (81%) was higher than that of the IgE test (67%), whereas the specificity of the IgE test (71%) was higher than that of the skin test (52%). The sensitivity of the skin test was 91% at 2+ or higher, and the specificity of the IgE test was 95% at class 6 or higher. These results suggest that both the specific IgE level and the skin test reactivity are useful parameters in the prediction of positive airway responses to house dust mites in asthma. However, the skin test is more sensitive, whereas the IgE test is more specific. Therefore, these tests can be used in a complementary fashion (i.e., the skin test for screening and the specific IgE test for confirmation of the relevant allergen).

  19. [Skin test: guide of post-marketed re-evaluation of clinical safety in traditional Chinese medicine injection].

    PubMed

    Wei, Xu; Xie, Yanming; Wang, Yongyan

    2011-10-01

    Anaphylaxis is the most common adverse reaction caused by traditional Chinese medicine (TCM) injection, the most serious of which is type I, so post-marketed safety re-evaluation is necessary. Skin test can be used to screen type I allergy reaction, which is of great significance for TCM injection safe use. Skin test is not only able to find the population sensitization situation of TCM injection, but also is a way of understanding the mechanism of allergy reaction. TCM injection varieties that often occur type I anaphylaxis are applicable to skin test, and study population include healthy volunteers and patients whose disease is listed in the drug specification, intracutaneous test and prick test are the alternative method. The concentration of skin-test solution may influence the positive rate of skin test, penicillin skin-test solution preparation method can be used as the reference in TCM injection. Different doses of TCM injection skin-test solution,glucose injection and normal saline, histamine hydrochloride are comprised in comparison. Given the characteristics of type I allergy reaction,we should be pay close attention to skin test reaction in half an hour, and observation index need be designed based on post-marketed re-evaluation of clinical safety.

  20. T cell-mediated reactions to iodinated contrast media: evaluation by skin and lymphocyte activation tests.

    PubMed

    Kanny, Gisèle; Pichler, Werner; Morisset, Martine; Franck, Patricia; Marie, Béatrice; Kohler, Chantal; Renaudin, Jean-Marie; Beaudouin, Etienne; Laudy, Jean Sainte; Moneret-Vautrin, D Anne

    2005-01-01

    In addition to immediate reactions, late adverse reactions to iodinated contrast media (ICM) were reported in 2% to 5% of patients exposed to ICM and, as a consequence, have recently gained more attention. A few well-documented case reports postulate a hypersensitivity mechanism. The aim of this study is to demonstrate a T cell-mediated mechanism to the ICM by using in vitro and ex vivo tests. We analyzed 12 patients with 13 adverse ICM reactions, 9 of whom were women. Clinical history suggested an immune reaction to ICM. Skin tests (skin prick, intradermal, and patch tests) were performed with various ICM and read after 15 minutes and 24 and 48 hours. Skin biopsy specimens of positive test sites of 11 patients were evaluated by means of immunohistology. T-cell reactivity to ICM in vitro was analyzed with lymphocyte activation tests. Seven patients showed generalized maculopapular eruptions, one of them with fever; 4 had a so-called drug hypersensitivity syndrome with exanthema, eosinophilia, and fever; 1 had maculopapular eruptions and fever; 1 had late-onset urticaria with loss of consciousness; and 1 had facial edema and respiratory distress. An immune reaction to ICM was inferred from positive skin prick test (2 patients), positive patch test (10 patients), and positive intradermal test (9 patients) at 24 and 48 hours. Skin biopsy specimens revealed a T-cell infiltrate in the dermis with predominantly CD4 + T cells in 8 patients, CD8 + T cells in 1 patient, and equal numbers in 1 patient. Cross-sensitivities to several ICM were observed (9/12). Other drug allergies were noted in 6 of the 12 patients. Delayed reactions to ICM are most likely caused by immune reactions to these drugs and can elicit different clinical features. The involvement of T cells is suggested by positive skin test, as well as positive proliferative responses, to the drugs in vitro . A high degree of cross-reactivity with other than the eliciting ICM was observed. Moreover, 50% of these

  1. The adverse outcome pathway for skin sensitisation: Moving closer to replacing animal testing.

    PubMed

    Schultz, Terry W; Dimitrova, Gergana; Dimitrov, Sabcho; Mekenyan, Ovanes G

    2016-10-01

    This article outlines the work of the Organisation for Economic Co-operation and Development (OECD) that led to being jointly awarded the 2015 Lush Black Box Prize. The award-winning work centred on the development of 'The Adverse Outcome Pathway for Skin Sensitisation Initiated by Covalent Binding to Proteins'. This Adverse Outcome Pathway (AOP) has provided the mechanistic basis for the integration of skin sensitisation-related information. Recent developments in integrated approaches to testing and assessment, based on the AOP, are summarised. The impact of the AOP on regulatory policy and on the Three Rs are discussed. An overview of the next generation of the skin sensitisation AOP module in the OECD QSAR Toolbox, based on more-recent work at the Laboratory of Mathematical Chemistry, is also presented. 2016 FRAME.

  2. [Skin tests for diagnostics of allergic immediate-type reactions. Guideline of the German Society for Allergology and Clinical Immunology].

    PubMed

    Ruëff, F; Bergmann, K-C; Brockow, K; Fuchs, T; Grübl, A; Jung, K; Klimek, L; Müsken, H; Pfaar, O; Przybilla, B; Sitter, H; Wehrmann, W

    2011-08-01

    Skin tests in patients with IgE-mediated immediate type allergy are performed with the intention to establish a contact between allergens and skin mast cells. The latter carry specific IgE antibodies on their surface. If mast cells get activated, mediators (mainly histamine) are released which induce a visible skin reaction (wheal and erythema).[nl]Skin tests are indicated, if an immediate type allergic disease is suspected. Systemic anaphylactic reactions at skin testing are very rare. However, it is necessary to take them into account and to provide emergency treatment. Relative contraindications comprise skin diseases in the test area, poor general condition and insufficiently treated severe asthma. If tests are used, which have a higher risk for a systemic anaphylactic reaction, pregnancy or beta-blocker therapy, are further contraindications.[nl]Skin test application does not depend on patient age. However, in pre-school age tests are reluctantly performed. It is essential to consider the half-life of drugs which may interfere with the test result, and which have to be discontinued early enough before testing. After anaphylactic reactions there may be a refractory period. Therefore, tests should not be done within the first week after such reactions. Skin prick tests are the procedures of first choice, intradermal tests are more sensitive than prick tests. Skin tests are performed at the flexor side of the forearm. As intradermal tests are more inconvenient, testing can be also done at a less susceptible site of the body (upper back).[nl]It is recommended to use standardized test extracts. However, if standardised extracts are not available or do not yield suitable test results, one may switch to other preparations. If the patient shows a positive reaction to a non-standardized substance, control tests should be performed in healthy subjects in order to exclude an unspecific reaction.[nl]The reaction is read after 15 to 20 min. Skin tests are regarded positive

  3. Permeability test for transdermal and local therapeutic patches using Skin PAMPA method.

    PubMed

    Vizserálek, Gábor; Berkó, Szilvia; Tóth, Gergő; Balogh, Réka; Budai-Szűcs, Mária; Csányi, Erzsébet; Sinkó, Bálint; Takács-Novák, Krisztina

    2015-08-30

    Using the skin as absorption site presents unique advantages that have facilitated the progression of transdermal drug delivery in the past decades. Efforts in drug research have been devoted to find a quick and reproducible model for predicting the skin permeation of molecules. The Parallel Artificial Membrane Permeability Assay (PAMPA) has been extended for prediction of transdermal permeation by developing a model with completely artificial membrane, which can mimic the permeation through the stratum corneum. The present study aims to extend the Skin PAMPA method for testing transdermal and local therapeutic patches. The original method was modified and seven commercially available transdermal and local therapeutic patches with four different active pharmaceutical ingredients (nicotine, fentanyl, rivastigmine and ketoprofen) were studied. Data were compared to the declared delivery rates that are indicated by the manufacturers. Ex vivo permeation study was also performed in order to compare the permeated amount of the released drugs obtained by the two methods. The flux across the artificial membrane as well as the human skin (ex vivo) has been calculated and compared to the in vivo flux deduced from the labelled delivery rate and the active area of the patches. The results suggest that Skin PAMPA system can serve as a useful tool for evaluation and classification of the transdermal patches. Copyright © 2015 Elsevier B.V. All rights reserved.

  4. An inverse correlation of VZV skin-test reaction, but not antibody, with severity of herpes zoster skin symptoms and zoster-associated pain.

    PubMed

    Asada, Hideo; Nagayama, Kousuke; Okazaki, Aiko; Mori, Yasuko; Okuno, Yoshinobu; Takao, Yukiko; Miyazaki, Yoshiyuki; Onishi, Fumitake; Okeda, Masayuki; Yano, Shuichiro; Kumihashi, Hideaki; Gomi, Yasuyuki; Maeda, Kazuhiro; Ishikawa, Toyokazu; Iso, Hiroyasu; Yamanishi, Koichi

    2013-03-01

    Cell-mediated immunity (CMI) has been considered to be related to the development of herpes zoster (HZ). However, there have been no large-scale prospective studies on the relationship between VZV-specific CMI and severity of HZ. We carried out a large-scale prospective cohort study to clarify the relationship between immunological factors for varicella-zoster virus (VZV) and the clinical severity of HZ. We carried out a cohort study on VZV immunity in a population living on an island cluster, Shozu County in Japan, and examined the people who developed HZ during a median follow-up period of 2 years, with a focus on the relationship between cell-mediated and humoral immunity and the severity of skin lesions and zoster-associated pain. A total of 12,522 people over the age of 50 were enrolled in this study, and 258 registrants were diagnosed as HZ. CMI was measured by VZV skin test, and humoral immunity was assessed with serological tests (neutralization test, immunoadherence hemagglutination test, and gpELISA test) for VZV-specific antibodies. CMI to VZV assessed by VZV skin test showed a significant inverse relationship to the severity of HZ skin lesions, and also to the severity of acute and subacute pain. Furthermore, weak response to the VZV skin test was associated with a high risk of post-herpetic neuralgia. In contrast, VZV-specific antibody titer was not associated with the severity of skin lesions and zoster-associated pain. VZV-specific CMI, but not humoral immunity, may play a key role in controlling the severity of HZ skin lesions and zoster-associated pain. Copyright © 2012 Japanese Society for Investigative Dermatology. Published by Elsevier Ireland Ltd. All rights reserved.

  5. Performance and Pain Tolerability of Current Diagnostic Allergy Skin Prick Test Devices.

    PubMed

    Tversky, Jody R; Chelladurai, Yohalakshmi; McGready, John; Hamilton, Robert G

    2015-01-01

    Allergen skin prick testing remains an essential tool for diagnosing atopic disease and guiding treatment. Sensitivity needs to be defined for newly introduced devices. Our aim was to compare the performance of 10 current allergy skin prick test devices. Single- and multiheaded skin test devices (n = 10) were applied by a single operator in a prospective randomized manner. Histamine (1 and 6 mg/mL) and control diluent were introduced at 6 randomized locations onto the upper and lower arms of healthy subjects. Wheal and flare reactions were measured independently by 2 masked technicians. Twenty-four subjects provided consent, and 768 skin tests were placed. Mean wheal diameter among devices differed from 3.0 mm (ComforTen; Hollister-Stier, Spokane, Wash) to 6.8 mm (UniTest PC; Lincoln Diagnostics, Decatur, Ill) using 1 mg/mL histamine (P < .001) and 4.8 mm (GREER Pick; Greer, Lenoir, NC) to 8.4 mm (Duotip-Test II; Lincoln Diagnostics, Decatur, Ill; and Sharp-Test; Panatrex, Placentia, Calif) using 6 mg/mL histamine (P < .001). The false-negative rates ranged from 0% to 45% with 1 mg/mL histamine. The analytical specificity was 100% for all devices tested. All devices were well tolerated, with average pain score of less than 4 on a 10-point visual analog scale. Pain scores were higher among women, but this did not reach statistical significance. The Multi-Test PC and the UniTest PC had the lowest pain scores compared with the other devices. All 10 skin prick test devices displayed good analytical sensitivity and specificity; however, 3 mm cannot arbitrarily be used as a positive threshold. The use of histamine at 1 mg/mL is unacceptable for certain devices but may be preferable for the most sensitive devices. On average, there was no pain score difference between multiheaded and single-head devices. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  6. CON4EI: SkinEthic™ Human Corneal Epithelium Eye Irritation Test (SkinEthic™ HCE EIT) for hazard identification and labelling of eye irritating chemicals.

    PubMed

    Van Rompay, A R; Alépée, N; Nardelli, L; Hollanders, K; Leblanc, V; Drzewiecka, A; Gruszka, K; Guest, R; Kandarova, H; Willoughby, J A; Verstraelen, S; Adriaens, E

    2017-06-15

    Assessment of ocular irritancy is an international regulatory requirement and a necessary step in the safety evaluation of industrial and consumer products. Although a number of in vitro ocular irritation assays exist, none are capable of fully categorizing chemicals as a stand-alone assay. Therefore, the CEFIC-LRI-AIMT6-VITO CON4EI (CONsortium for in vitro Eye Irritation testing strategy) project was developed with the goal of assessing the reliability of eight in vitro/alternative test methods as well as establishing an optimal tiered-testing strategy. One of the in vitro assays selected was the validated SkinEthic™ Human Corneal Epithelium Eye Irritation Test method (SkinEthic™ HCE EIT). The SkinEthic™ HCE EIT has already demonstrated its capacity to correctly identify chemicals (both substances and mixtures) not requiring classification and labelling for eye irritation or serious eye damage (No Category). The goal of this study was to evaluate the performance of the SkinEthic™ HCE EIT test method in terms of the important in vivo drivers of classification. For the performance with respect to the drivers all in vivo Cat 1 and No Cat chemicals were 100% correctly identified. For Cat 2 chemicals the liquids and the solids had a sensitivity of 100% and 85.7%, respectively. For the SkinEthic™ HCE EIT test method, 100% concordance in predictions (No Cat versus No prediction can be made) between the two participating laboratories was obtained. The accuracy of the SkinEthic™ HCE EIT was 97.5% with 100% sensitivity and 96.9% specificity. The SkinEthic™ HCE EIT confirms its excellent results of the validation studies. Copyright © 2017. Published by Elsevier Ltd.

  7. American cutaneous leishmaniasis: use of a skin test as a predictor of relapse after treatment.

    PubMed Central

    Passos, V. M.; Barreto, S. M.; Romanha, A. J.; Krettli, A. U.; Volpini, A. C.; Lima e Costa, M. F.

    2000-01-01

    While relapses following clinical cure of American cutaneous leishmaniasis are frequent, no test has been described until now to predict such relapses. A cohort of 318 American cutaneous leishmaniasis patients was followed up for two years after treatment with meglumine antimoniate, during which time 32 relapses occurred, 30 in the first year and two in the second (accumulated risk: 10.5%). No association was found between these relapses and the parasite-specific antibody response before and after treatment, or between the relapses and stratification by sociodemographic and clinical characteristics. However when Leishmania was used as antigen, patients with a negative skin test at the time of diagnosis presented a 3.4-fold higher risk (hazard risk = 3.4; 95% confidence interval, 1.7-7.0) of American cutaneous leishmaniasis relapse, compared with patients with a positive response. This result shows that the skin test can be a predictor of American cutaneous leishmaniasis relapse after treatment. PMID:10994280

  8. Natural rubber latex hypersensitivity with skin prick test in operating room personnel.

    PubMed

    Nabavizadeh, Seyed Hessamedin; Anushiravani, Amir; Amin, Reza

    2009-12-01

    Hypersensitivity reactions to natural rubber latex have increased recently, especially among people with high exposure to latex allergens. Hypersensitivity reactions to latex are related to many conditions like occupational asthma. Our study was performed to determine the prevalence of hypersensitivity to natural rubber latex and potential food cross reactions in operation room personnel in Shiraz hospitals. In this cross-sectional, descriptive study, 580 operation room personnel filled out our questionnaire which included data about their personal history, symptoms of latex hypersensitivity, and other related allergies such as food hypersensitivity. An informed consent was obtained and skin prick tests were performed for natural rubber latex and potential food cross reactions (kiwi, banana, and potato). The obtained data were analyzed by SPSS and Chi-square test. 104 (17.9%) of the operating room personnel showed positive latex skin tests. We revealed a significant correlation between those with positive skin tests to latex with atopia, urthicaria, and food hypersensitivity. The prevalence did not vary by sex, age, education, surgical and non-surgical gloves users, or history of contact dermatitis. Latex hypersensitivity is common among operation room personnel. Evaluation of symptoms and prediction of future diseases necessitate screening tests in individuals at risk.

  9. Comparative Evaluation of a Silicone Membrane as an Alternative to Skin for Testing Mosquito Repellents.

    PubMed

    Agramonte, Natasha M; Gezan, Salvador A; Bernier, Ulrich R

    2017-05-01

    Repellents prevent mosquito bites and help reduce mosquito-borne disease, a global public health issue. Laboratory-based repellent bioassays predict the ability of compounds to deter mosquito feeding, but the variety of repellent bioassays and statistical analysis methods makes it difficult to compare results across methodologies. The most realistic data are collected when repellents are applied on the skin; however, this method exposes volunteers to chemicals and mosquito bites. Silicone membranes were investigated as an alternative to human skin in assays of repellent efficacy. Results from module system bioassays conducted in vitro with a silicone membrane were compared with in vivo bioassays conducted with N,N-diethyl-3-methylbenzamide (referred to as DEET), 1-piperidinecarboxylic acid 2-(2-hydroxyethyl)-1-methylpropylester (referred to as Picaridin), ethyl 3-[acetyl(butyl)amino]propanoate (referred to as IR3535), and para-menthane-3,8-diol (referred to as PMD) applied directly on the skin of the leg. No significant difference in mosquito feeding was found when comparing skin and volunteer-worn membrane controls using blood; however, feeding was significantly lower in unworn membrane controls using either 10% sucrose or blood, indicating that worn membranes are a possible surrogate for untreated human skin. Pooled data from six volunteers were used to generate dose-response curves of blood-feeding activity. Results from skin-applied repellents were modeled to determine if membranes could provide a predictive correlate for skin. Goodness-of-fit comparisons indicated that the nonlinear dose-response curves for the skin and membrane differed significantly for DEET and Picaridin, but did not differ significantly for IR3535 and PMD. With knowledge of the dose-response relationships and further modifications to this system, the membrane-based tests could be used for standardized repellent testing with infected vectors. Published by Oxford University Press on behalf

  10. Testing and Analysis of Composite Skin/Stringer Debonding Under Multi-Axial Loading

    NASA Technical Reports Server (NTRS)

    Krueger, Ronald; Cvitkovich, Michael K.; O'Brien, T. Kevin; Minguet, Pierre J.

    2000-01-01

    A consistent step-wise approach is presented to investigate the damage mechanism in composite bonded skin/stringer constructions under uniaxial and biaxial (in-plane/out-of-plane) loading conditions. The approach uses experiments to detect the failure mechanism, computational stress analysis to determine the location of first matrix cracking and computational fracture mechanics to investigate the potential for delamination growth. In a first step, tests were performed on specimens, which consisted of a tapered composite flange, representing a stringer or frame, bonded onto a composite skin. Tests were performed under monotonic loading conditions in tension, three-point bending, and combined tension/bending to evaluate the debonding mechanisms between the skin and the bonded stringer. For combined tension/bending testing, a unique servohydraulic load frame was used that was capable of applying both in-plane tension and out-of-plane bending loads simultaneously. Specimen edges were examined on the microscope to document the damage occurrence and to identify typical damage patterns. For all three load cases, observed failure initiated in the flange, near the flange tip, causing the flange to almost fully debond from skin. In a second step, a two dimensional plane-strain finite element model was developed to analyze the different test cases using a geometrically nonlinear solution. For all three loading conditions, computed principal stresses exceeded the transverse strength of the material in those areas of the flange where the matrix cracks had developed during the tests. In a third step, delaminations of various lengths were simulated in two locations where delaminations were observed during the tests. The analyses showed that at the loads corresponding to matrix ply crack initiation computed strain energy release rates exceeded the values obtained from a mixed mode failure criterion in one location, Hence. Unstable delamination propagation is likely to occur as

  11. Testing and Analysis of Composite Skin/Stringer Debonding under Multi-Axial Loading

    NASA Technical Reports Server (NTRS)

    Krueger, Ronald; Cvitkovich, Michael; OBrien, Kevin; Minguet, Pierre J.

    2000-01-01

    A consistent step-wise approach is presented to investigate the damage mechanism in composite bonded skin/stringer constructions under uniaxial and biaxial (in-plane/out-of-plane) loading conditions. The approach uses experiments to detect the failure mechanism, computational stress analysis to determine the location of first matrix cracking and computational fracture mechanics to investigate the potential for delamination growth. In a first step, tests were performed on specimens, which consisted of a tapered composite flange, representing a stringer or frame, bonded onto a composite skin. Tests were performed under monotonic loading conditions in tension, three-point bending, and combined tension/bending to evaluate the debonding mechanisms between the skin and the bonded stringer. For combined tension/bending testing, a unique servohydraulic load frame was used that was capable of applying both in-plane tension and out-of-plane bending loads simultaneously. Specimen edges were examined on the microscope to document the damage occurrence and to identify typical damage patterns. For all three load cases, observed failure initiated in the flange, near the flange tip, causing the flange to almost fully debond from the skin. In a second step, a two-dimensional plane-strain finite element model was developed to analyze the different test cases using a geometrically nonlinear solution. For all three loading conditions, computed principal stresses exceeded the transverse strength of the material in those areas of the flange where the matrix cracks had developed during the tests. In a third step, delaminations of various lengths were simulated in two locations where delaminations were observed during the tests. The analyses showed that at the loads corresponding to matrix ply crack initiation computed strain energy release rates exceeded the values obtained from a mixed mode failure criterion in one location. Hence, unstable delamination propagation is likely to occur as

  12. Testing and Analysis of Composite Skin/Stringer Debonding under Multi-Axial Loading

    NASA Technical Reports Server (NTRS)

    Krueger, Ronald; Cvitkovich, Michael; OBrien, Kevin; Minguet, Pierre J.

    2000-01-01

    A consistent step-wise approach is presented to investigate the damage mechanism in composite bonded skin/stringer constructions under uniaxial and biaxial (in-plane/out-of-plane) loading conditions. The approach uses experiments to detect the failure mechanism, computational stress analysis to determine the location of first matrix cracking and computational fracture mechanics to investigate the potential for delamination growth. In a first step, tests were performed on specimens, which consisted of a tapered composite flange, representing a stringer or frame, bonded onto a composite skin. Tests were performed under monotonic loading conditions in tension, three-point bending, and combined tension/bending to evaluate the debonding mechanisms between the skin and the bonded stringer. For combined tension/bending testing, a unique servohydraulic load frame was used that was capable of applying both in-plane tension and out-of-plane bending loads simultaneously. Specimen edges were examined on the microscope to document the damage occurrence and to identify typical damage patterns. For all three load cases, observed failure initiated in the flange, near the flange tip, causing the flange to almost fully debond from the skin. In a second step, a two-dimensional plane-strain finite element model was developed to analyze the different test cases using a geometrically nonlinear solution. For all three loading conditions, computed principal stresses exceeded the transverse strength of the material in those areas of the flange where the matrix cracks had developed during the tests. In a third step, delaminations of various lengths were simulated in two locations where delaminations were observed during the tests. The analyses showed that at the loads corresponding to matrix ply crack initiation computed strain energy release rates exceeded the values obtained from a mixed mode failure criterion in one location. Hence, unstable delamination propagation is likely to occur as

  13. VZV skin-test reaction, but not antibody, is an important predictive factor for postherpetic neuralgia.

    PubMed

    Imoto, Kyoko; Okazaki, Aiko; Onishi, Fumitake; Miyazaki, Yoshiyuki; Okeda, Masayuki; Yano, Shuichiro; Takao, Yukiko; Gomi, Yasuyuki; Ishikawa, Toyokazu; Okuno, Yoshinobu; Mori, Yasuko; Iso, Hiroyasu; Yamanishi, Koichi; Asada, Hideo

    2015-09-01

    The decline of cell-mediated immunity (CMI) is thought to be related to the risk of postherpetic neuralgia (PHN) as well as herpes zoster (HZ). However, the relationship between immunological condition and the incidence of PHN is still unclear. We conducted a large-scale prospective cohort study to clarify the relationship between immunological factors for varicella-zoster virus (VZV) and the incidence of PHN. We carried out a cohort study on VZV immunity in a population living on an island cluster, Shozu County in Japan, and examined the people who developed HZ during a follow-up period of 3 years, with a focus on the relationship between cell-mediated and humoral immunity and the incidence of PHN. A total of 12,522 people over the age of 50 were enrolled in this study, and 401 registrants were diagnosed with HZ, including 79 PHN cases. We evaluated anatomical location and severity of skin lesion, acute pain severity, presence or absence of abnormal sensations, CMI assessed by VZV skin test, and VZV-specific antibody titer measured by serological tests. The incidence of PHN was significantly associated with a weak response to the VZV skin test, as well as facial or lumbosacral localization of skin rash, severe skin lesion, severe acute pain, and presence of abnormal sensations, but not related to VZV-specific antibody titer. The incidence of PHN is significantly associated with the decline of VZV-specific CMI, but not related to VZV-specific humoral immunity. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  14. Assuring consumer safety without animal testing: a feasibility case study for skin sensitisation.

    PubMed

    Maxwell, Gavin; Aleksic, Maja; Aptula, Aynur; Carmichael, Paul; Fentem, Julia; Gilmour, Nicola; Mackay, Cameron; Pease, Camilla; Pendlington, Ruth; Reynolds, Fiona; Scott, Daniel; Warner, Guy; Westmoreland, Carl

    2008-11-01

    Allergic Contact Dermatitis (ACD; chemical-induced skin sensitisation) represents a key consumer safety endpoint for the cosmetics industry. At present, animal tests (predominantly the mouse Local Lymph Node Assay) are used to generate skin sensitisation hazard data for use in consumer safety risk assessments. An animal testing ban on chemicals to be used in cosmetics will come into effect in the European Union (EU) from March 2009. This animal testing ban is also linked to an EU marketing ban on products containing any ingredients that have been subsequently tested in animals, from March 2009 or March 2013, depending on the toxicological endpoint of concern. Consequently, the testing of cosmetic ingredients in animals for their potential to induce skin sensitisation will be subject to an EU marketing ban, from March 2013 onwards. Our conceptual framework and strategy to deliver a non-animal approach to consumer safety risk assessment can be summarised as an evaluation of new technologies (e.g. 'omics', informatics), leading to the development of new non-animal (in silico and in vitro) predictive models for the generation and interpretation of new forms of hazard characterisation data, followed by the development of new risk assessment approaches to integrate these new forms of data and information in the context of human exposure. Following the principles of the conceptual framework, we have been investigating existing and developing new technologies, models and approaches, in order to explore the feasibility of delivering consumer safety risk assessment decisions in the absence of new animal data. We present here our progress in implementing this conceptual framework, with the skin sensitisation endpoint used as a case study. 2008 FRAME.

  15. Skin Test for Paragonimiasis among Schoolchildren and Villagers in Namback District, Luangprabang Province, Lao PDR

    PubMed Central

    Song, Hyun-Ouk; Rim, Han-Jong; Youthanavanh, Vonghachack; Daluny, Bouakhasith; Sengdara, Vongsouvan; Virasack, Banouvong; Bounlay, Phommasak

    2008-01-01

    As a part of a broader effort to determine the status of Paragonimus species infection in Lao PDR, an epidemiological survey was conducted on villagers and schoolchildren in Namback District between 2003 and 2005. Among 308 villagers and 633 primary and secondary schoolchildren, 156 villagers and 92 children evidenced a positive reaction on a Paragonimus skin test. Only 4 schoolchildren out of 128 skin test-positive cases had Paragonimus sp. eggs in their sputum, all of which was collected on 1 day. Several types of crabs, which were identified as the second intermediate host of the Paragonimus species, were collected from markets and streams in a paragonimiasis endemic area for the inspection of metacercariae. Among the examined crabs, only "rock crabs" (Indochinamon ou) harbored Paragonimus sp. metacercariae, and it is speculated that the life cycle of Paragonimus sp. was maintained via rock crabs in Namback District, Lao PDR. PMID:18830059

  16. Active tuberculosis among Iraqi schoolchildren with positive skin tests and their household contacts.

    PubMed

    Al Kubaisy, W; Al Dulayme, A; Hashim, D S

    2003-07-01

    In a prospective cohort study in Iraq, schoolchildren with a positive tuberculin skin test during the nationwide survey in 2000 were followed up in 2002 to determine prevalence of latent tuberculosis (TB) infection and risk factors among household contacts. Of 205 children, 191 remained skin-test positive in 2002. Based on X-ray and clinical examination, 9 children (4.4%) were active TB cases. Among 834 household contacts, there were 144 new TB cases, giving a cumulative incidence of 17.3%. Risk factors for TB among household contacts were: age > or = 15 years; technical/professional job; smoking; low body mass index; diabetes mellitus; steroid therapy; and closeness of contact with the index cases. Based on past history of TB in index children and their contacts, 77.2% of new TB cases were attributable to household contacts.

  17. Comparison of tuberculin skin test and quantiferon-TB gold in tube test for diagnosis of latent tuberculosis infection in health care workers: A cross sectional study.

    PubMed

    Bozkanat, Erkan; Kaya, Hatice; Sezer, Ogun; Caliskan, Tayfun; Kilic, Erol; Ciftci, Faruk; Gumus, Seyfettin; Kartaloglu, Zafer

    2016-03-01

    To compare the diagnostic efficacy and agreement of the traditional tuberculin skin test with QuantiFERON-Tuberculosis Gold In-Tube test for latent tuberculosis infection in healthcare workers. The cross-sectional analytical study was conducted between March 1 and 31, 2008, at a specialist tuberculosis hospital in Istanbul, Turkey, and comprised healthcare workers who had been employed for at least one year at the hospital and volunteered to take part. Tuberculin skin test and QuantiFERON-Tuberculosis Gold In-Tube test were both performed simultaneously and their results were compared Using SPSS 12. Out of 34 subjects, 20(58.8%) had a positive tuberculin skin test, and 7(20.6%) had a positive QuantiFERON-Tuberculosis Gold In-Tube test. The two tests agreed in only 15(44.1%) cases and disagreed in 19(55.9%). In 16(47.1%) subjects, the QuantiFERON-Tuberculosis Gold In-Tube test was negative and tuberculin skin testwas positive, while in 3(8.8%) participants QuantiFERON-Tuberculosis Gold In-Tube test was positive and tuberculin skin test was negative. Kappa test revealed discordance between the two tests (k=-0.13; p=0.92). Latent tuberculosis infection prevalence was higher based on tuberculin skin test than QuantiFERON-Tuberculosis Gold In-Tube test. The results of the two tests were discordant.

  18. Mold and Alternaria skin test reactivity and asthma in children in Connecticut.

    PubMed

    Lyons, Todd W; Wakefield, Dorothy B; Cloutier, Michelle M

    2011-04-01

    Sensitivity to mold has been associated with asthma incidence, persistence, and severity. To examine the relationship between skin test reactivity (STR) to molds and specifically to Alternaria and asthma severity in a group of ethnically diverse children in Connecticut. Demographics and STR to 14 local allergens, including Alternaria, Penicillium, and mold mix, were obtained for 914 Puerto Rican, African American, and non-Hispanic white children. A total of 126 children (14%) had a positive skin test result to mold, and 58 (6%) demonstrated STR to Alternaria. Compared with non-Hispanic white children, there was no difference in the likelihood of being sensitized to Alternaria for Puerto Rican and African American children (odds ratio [OR], 0.7; 95% confidence interval [CI], 0.3-1.5; and OR, 0.9; 95% CI, 0.4-2.2; respectively). In an adjusted analysis, Alternaria STR was associated with severe, persistent asthma (OR, 3.4; 95% CI, 1.2-8.6) but did not predict increasing asthma severity. STR to cat (OR, 2.5; 95% CI, 1.3-4.9) and dog (OR, 2.9; 95% CI, 1.3-6.0) was also associated with severe persistent asthma. Alternaria STR was associated with severe persistent asthma independent of the total number of positive skin test results. Mold and Alternaria STR were uncommon among children in Connecticut. Alternaria STR was not associated with increasing asthma severity but was associated with severe, persistent asthma independent of the total number of positive skin test results. There was no association between ethnicity and Alternaria STR. Copyright © 2011 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  19. Skin testing and drug challenge outcomes in antibiotic-allergic patients with immediate-type hypersensitivity.

    PubMed

    Mawhirt, Stephanie L; Fonacier, Luz S; Calixte, Rose; Davis-Lorton, Mark; Aquino, Marcella R

    2017-01-01

    The evaluation of antibiotic immediate-type hypersensitivity is intricate because of nonstandardized skin testing and challenge method variability. To determine the safety outcomes and risk factors for antibiotic challenge reactions in patients reporting a history of antibiotic immediate-type hypersensitivity. A 5-year retrospective review of patients evaluated for immediate-type antibiotic allergy was conducted. Data analyzed included patient demographics, index reaction details, and outcomes of skin testing and challenges, classified as single-step or multistep. Antibiotic hypersensitivity history was identified in 211 patients: 78% to penicillins, 10% to fluoroquinolones, 7.6% to cephalosporins, and 3.8% to carbapenems. In total, 179 patients completed the challenges (median age 67 years, range 50-76 years, 56% women), and compared with nonchallenged patients, they reported nonanaphylactic (P < .001) and remote index (P = .003) reactions. Sixteen patients (8.9%) experienced challenge reactions (5 of 28 for single-step challenge, 11 of 151 for multistep challenge), and 11 of these patients had negative skin testing results before the challenge. Challenge-reactive patients were significantly younger (P = .007), more often women (P = .036), and had additional reported antibiotic allergies (P = .005). No correlation was detected between the reported index and observed challenge reaction severities (κ = -0.05, 95% confidence interval -0.34 to 0.24). Anaphylactic rates were similar during single-step and multistep challenges (3.6% vs 3.3%). In the present population, younger women with multiple reported antibiotic allergies were at greatest risk for challenge reactions. Negative skin testing results did not exclude reactions, and index severity was not predictive of challenge outcome. The multistep and full-dose methods demonstrated a comparable reaction risk for anaphylaxis. Copyright © 2016 American College of Allergy, Asthma & Immunology. Published by

  20. Risk stratification and skin testing to guide re-exposure in taxane-induced hypersensitivity reactions.

    PubMed

    Picard, Matthieu; Pur, Leyla; Caiado, Joana; Giavina-Bianchi, Pedro; Galvão, Violeta Regnier; Berlin, Suzanne T; Campos, Susana M; Matulonis, Ursula A; Castells, Mariana C

    2016-04-01

    The optimal approach to patients with hypersensitivity reactions (HSRs) to taxanes has not been established. We sought to assess the safety and efficacy of risk stratification based on the severity of the initial HSR and skin testing for guiding taxane reintroduction in patients with an HSR to these agents. Data on 164 patients treated for a taxane-related HSR from April 2011 to August 2014 at the Dana-Farber Cancer Institute and Brigham and Women's Hospital were collected retrospectively. Patients were re-exposed to taxanes either through desensitization, challenge, or regular infusion based on the severity of the initial HSR and skin test response. Depending on the initial risk stratification and tolerance to re-exposure, patients were then treated with shorter desensitization protocols, challenge, or both with the aim of resuming regular infusions, except in patients with a severe immediate initial HSR. Of 138 patients desensitized, 29 (21%) had an immediate and 20 (14%) had a delayed HSR with the procedure. Of 49 patients challenged, 2 (4%) had a mild immediate and 1 (2%) had a delayed HSR with the procedure. No patients had a severe immediate HSR with desensitization or challenge. Thirty-six (22%) patients eventually resumed regular infusions. These patients were more likely to have negative skin test responses and to have experienced a delayed or mild immediate initial HSR. Risk stratification based on the severity of the initial HSR and skin testing to guide taxane reintroduction is safe and allows a significant number of patients to resume regular infusions. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  1. Mold and Alternaria skin test reactivity and asthma in children in Connecticut

    PubMed Central

    Lyons, Todd W.; Wakefield, Dorothy B.; Cloutier, Michelle M.

    2013-01-01

    Background Sensitivity to mold has been associated with asthma incidence, persistence, and severity. Objective To examine the relationship between skin test reactivity (STR) to molds and specifically to Alternaria and asthma severity in a group of ethnically diverse children in Connecticut. Methods Demographics and STR to 14 local allergens, including Alternaria, Penicillium, and mold mix, were obtained for 914 Puerto Rican, African American, and non-Hispanic white children. Results A total of 126 children (14%) had a positive skin test result to mold, and 58 (6%) demonstrated STR to Alternaria. Compared with non-Hispanic white children, there was no difference in the likelihood of being sensitized to Alternaria for Puerto Rican and African American children (odds ratio [OR], 0.7; 95% confidence interval [CI], 0.3–1.5; and OR, 0.9; 95% CI, 0.4–2.2; respectively). In an adjusted analysis, Alternaria STR was associated with severe, persistent asthma (OR, 3.4; 95% CI, 1.2–8.6) but did not predict increasing asthma severity. STR to cat (OR, 2.5; 95% CI, 1.3–4.9) and dog (OR, 2.9; 95% CI, 1.3–6.0) was also associated with severe persistent asthma. Alternaria STR was associated with severe persistent asthma independent of the total number of positive skin test results. Conclusions Mold and Alternaria STR were uncommon among children in Connecticut. Alternaria STR was not associated with increasing asthma severity but was associated with severe, persistent asthma independent of the total number of positive skin test results. There was no association between ethnicity and Alternaria STR. PMID:21457878

  2. Tests of Flammability of Cotton Fabrics and Expected Skin Burns in Microgravity

    NASA Technical Reports Server (NTRS)

    Cavanagh, Jane M.; Torvi, David A.; Gabriel, Kamiel S.; Ruff, Gary A.

    2004-01-01

    During a shuttle launch and other portions of space flight, astronauts wear specialized flame resistant clothing. However during most of their missions on board the Space Shuttle or International Space Station, astronauts wear ordinary clothing, such as cotton shirts and pants. As the behaviour of flames is considerably different in microgravity than under earth's gravity, fabrics are expected to burn in a different fashion in microgravity than when tested on earth. There is interest in determining how this change in burning behaviour may affect times to second and third degree burn of human skin, and how the results of standard fabric flammability tests conducted under earth's gravity correlate with the expected fire behaviour of textiles in microgravity. A new experimental apparatus was developed to fit into the Spacecraft Fire Safety Facility (SFSF), which is used on NASA's KC-135 low gravity aircraft. The new apparatus was designed to be similar to the apparatus used in standard vertical flammability tests of fabrics. However, rather than using a laboratory burner, the apparatus uses a hot wire system to ignite 200 mm high by 80 mm wide fabric specimens. Fabric temperatures are measured using thermocouples and/or an infrared imaging system, while flame spread rates are measured using real time observations or video. Heat flux gauges are placed between 7 and 13 mm away from the fabric specimen, so that heat fluxes from the burning fabric to the skin can be estimated, along with predicted times required to produce skin burns. In November of 2003, this new apparatus was used on the KC-135 aircraft to test cotton and cotton/polyester blend fabric specimens in microgravity. These materials were also been tested using the same apparatus in 1-g, and using a standard vertical flammability test that utilizes a flame. In this presentation, the design of the test apparatus will be briefly described. Examples of results from the KC-135 tests will be provided, including

  3. Tests of Flammability of Cotton Fabrics and Expected Skin Burns in Microgravity

    NASA Technical Reports Server (NTRS)

    Cavanagh, Jane M.; Torvi, David A.; Gabriel, Kamiel S.; Ruff, Gary A.

    2004-01-01

    During a shuttle launch and other portions of space flight, astronauts wear specialized flame resistant clothing. However during most of their missions on board the Space Shuttle or International Space Station, astronauts wear ordinary clothing, such as cotton shirts and pants. As the behaviour of flames is considerably different in microgravity than under earth's gravity, fabrics are expected to burn in a different fashion in microgravity than when tested on earth. There is interest in determining how this change in burning behaviour may affect times to second and third degree burn of human skin, and how the results of standard fabric flammability tests conducted under earth's gravity correlate with the expected fire behaviour of textiles in microgravity. A new experimental apparatus was developed to fit into the Spacecraft Fire Safety Facility (SFSF), which is used on NASA's KC-135 low gravity aircraft. The new apparatus was designed to be similar to the apparatus used in standard vertical flammability tests of fabrics. However, rather than using a laboratory burner, the apparatus uses a hot wire system to ignite 200 mm high by 80 mm wide fabric specimens. Fabric temperatures are measured using thermocouples and/or an infrared imaging system, while flame spread rates are measured using real time observations or video. Heat flux gauges are placed between 7 and 13 mm away from the fabric specimen, so that heat fluxes from the burning fabric to the skin can be estimated, along with predicted times required to produce skin burns. In November of 2003, this new apparatus was used on the KC-135 aircraft to test cotton and cotton/polyester blend fabric specimens in microgravity. These materials were also been tested using the same apparatus in 1-g, and using a standard vertical flammability test that utilizes a flame. In this presentation, the design of the test apparatus will be briefly described. Examples of results from the KC-135 tests will be provided, including

  4. Sensitization to Food Additives in Patients with Allergy: A Study Based on Skin Test and Open Oral Challenge.

    PubMed

    Moghtaderi, Mozhgan; Hejrati, Zinatosadat; Dehghani, Zahra; Dehghani, Faranak; Kolahi, Niloofar

    2016-06-01

    There has been a great increase in the consumption of various food additives in recent years. The purpose of this study was to identify the incidence of sensitization to food additives by using skin prick test in patients with allergy and to determine the concordance rate between positive skin tests and oral challenge in hypersensitivity to additives. This cross-sectional study included 125 (female 71, male 54) patients aged 2-76 years with allergy and 100 healthy individuals. Skin tests were performed in both patient and control groups with 25 fresh food additives. Among patients with allergy, 22.4% showed positive skin test at least to one of the applied materials. Skin test was negative to all tested food additives in control group. Oral food challenge was done in 28 patients with positive skin test, in whom 9 patients showed reaction to culprit (Concordance rate=32.1%). The present study suggested that about one-third of allergic patients with positive reaction to food additives showed positive oral challenge; it may be considered the potential utility of skin test to identify the role of food additives in patients with allergy.

  5. Testing and Analysis of Composite Skin/Stringer Debonding Under Multi-Axial Loading

    NASA Technical Reports Server (NTRS)

    Krueger, Ronald; Cvitkovich, Michael K.; OBrien, T. Kevin; Minguet, Pierre J.

    1999-01-01

    Damage mechanisms in composite bonded skin/stringer constructions under uniaxial and biaxial (in-plane/out- of-plane) loading conditions were examined. Specimens consisted of a tapered composite flange bonded onto a composite skin. Tests were performed under monotonic loading conditions in tension, three-point bending, and combined tension/bending . For combined tension/bending testing, a unique servohydraulic load frame was used that was capable of applying both in-plane tension and out-of-plane bending loads simultaneously. Specimen edges were examined on the microscope to document the damage occurrence and to identify typical damage patterns. The observations showed that, for all three load cases, failure initiated in the flange, near the flange tip, causing the flange to almost fully debond from the skin. A two-dimensional plane-strain finite element model was developed to analyze the different test cases using a geometrically nonlinear solution. For all three loading conditions, principal stresses exceeded the transverse strength of the material in the flange area. Additionally, delaminations of various lengths were simulated in two locations where delaminations were observed. The analyses showed that unstable delamination propagation is likely to occur in one location at the loads corresponding to matrix ply crack initiation for all three load cases.

  6. Tests of Flammability of Cotton Fabrics and Expected Skin Burns in Microgravity

    NASA Technical Reports Server (NTRS)

    Cavanagh, Jane M.; Torvi, David A.; Gabriel, Kamiel S.; Ruff, Gary A.

    2004-01-01

    During a shuttle launch and other portions of space flight, astronauts wear specialized flame resistant clothing. However during most of their missions on board the Space Shuttle or International Space Station, astronauts wear ordinary clothing, such as cotton shirts and pants. As the behaviour of flames is considerably different in microgravity than under earth s gravity, fabrics are expected to burn in a different fashion in microgravity than when tested on earth. There is interest in determining how this change in burning behaviour may affect times to second and third degree burn of human skin, and how the results of standard fabric flammability tests conducted under earth s gravity correlate with the expected fire behaviour of textiles in microgravity. A new experimental apparatus was developed to fit into the Spacecraft Fire Safety Facility (SFSF), which is used on NASA s KC-135 low gravity aircraft. The new apparatus was designed to be similar to the apparatus used in standard vertical flammability tests of fabrics. However, rather than using a laboratory burner, the apparatus uses a hot wire system to ignite 200 mm high by 80 mm wide fabric specimens. Fabric temperatures are measured using thermocouples and/or an infrared imaging system, while flame spread rates are measured using real time observations or video. Heat flux gauges are placed between 7 and 13 mm away from the fabric specimen, so that heat fluxes from the burning fabric to the skin can be estimated, along with predicted times required to produce skin burns.

  7. The results of intradermal skin tests (IDST) in dogs with atopic dermatitis from the Lublin voivodeship.

    PubMed

    Taszkun, I

    2011-01-01

    The purpose of this study was to assess the positive immediate reactions received from intradermal skin tests (IDST) which confirmed the presence of IgE-dependent hypersensitivity in dogs with atopic dermatitis, which were patients of the Dermatology Consulting Section at the University of Life Sciences in Lublin between 2007 and 2009. Intradermal skin tests were performed on 142 dogs (72 females and 70 males) from the Lublin voivodeship of different breeds ranging in age from 1 to 6 years (average 2.8 years). The allergen set used in this study was the Artuvetrin Test (ARTU Biologicals Europe B.V, Holland). The owners of 84 dogs observed the presence of skin lesions all year round regardless of season, while 58 dog owners noted them only in spring and summer. Most immediate positive reactions were ascertained from mite allergens (70.61%), fewer from pollen allergens (19.55%), and the fewest from animal (4.15%) and mould allergens (1.66%). Immediate positive reactions for a flea allergen (4.03% of all positive reactions) were also ascertained. In 98.6% of dogs polysensitization was found.

  8. [Adverse reactions to skin tests and immunotherapy in the practice of Mexican allergologists].

    PubMed

    Larenas Linnemann, Désirée; Rodríguez Pérez, Noel; Becerril, Martín

    2008-01-01

    Immunotherapy is the only curative treatment recommended for allergic rhinoconjunctivitis and asthma, in which small amounts of allergen are administered sublingually or subcutaneously until the maximum tolerated dose has been reached. However, local or systemic adverse reactions (AR) -rarely even fatal- an occur. In Mexico there is no nationwide data on adverse reactions. To document the frequency of adverse reactions secondary to skin tests (ST) or immunotherapy (IT) in the allergist's office in Mexico, paying special attention to fatal and near fatal allergic reactions. We mailed a survey to all members of the Mexican Colleges of Allergy (CMICA) and Pediatric Allergy (CoMPedIA). A response rate of 59 (16%) for the adverse reactions part of the questionnaire was obtained from the College members. We found a near fatal reaction rate of 0.005 cases per year per allergy practice for skin testing and the same number -0.005 cases- for immunotherapy. This can be extrapolated to a total of 1.5 cases per year in the whole country of Mexico. No fatalities were reported. In Mexico the frequency of severe or near fatal adverse reactions to immunotherapy or skin tests is low and no fatal case has been reported till today.

  9. Skin Prick Test Reactivity in Patients with Chronic Eczematous External Otitis

    PubMed Central

    Kazikdas, K. Cagdas; Ozergin Coskun, Zerrin; Demirci, Munir

    2011-01-01

    Objectives To investigate the incidence of skin prick test (SPT) positivity in patients with eczematous external otitis. Methods Forty-six patients with eczematous external otitis and forty-four healthy volunteers were included in the study. All the patients were skin-tested by prick test. Reactions were assessed by the degree of redness and swelling and the size of the wheal produced. Results According to SPT positivity and total immunoglobulin E values, the difference between the study and the control groups was statistically significant (P<0.05). The most common skin reactions were against to mites and grasses in this study. Conclusion Eczematous external otitis is perhaps the most difficult to treat of all forms of external otitis because the provocative agents usually remain undiagnosed. Patients suffering from eczematous external otitis symptoms should be investigated for allergens and be informed for prevention of the causative agents. SPT might be performed in cases of prolonged or treatment-resistant external otitis. PMID:22232711

  10. Performance of QuantiFERON TB gold test compared with the tuberculin skin test for detecting latent tuberculosis infection in lung and heart transplant candidates.

    PubMed

    Mardani, Masoud; Farshidpour, Maham; Nekoonam, Mohsen; Varahram, Fatemeh; Najafizadeh, Katayoon; Mohammadi, Nazila; Sharifkashani, Babak; Gachkar, Latif; Farokhzad, Banafsheh; Droudinia, Atousa; Javanmard, Pedram; Tabarsi, Payam

    2014-04-01

    Evaluation for latent tuberculosis infection is advised before organ transplant. The interferon-gamma release assay has been shown to be more specific than the tuberculin skin test for screening for latent tuberculosis infection. We compared the tuberculin skin test and QuantiFERON-TB Gold In-Tube test for screening for latent tuberculosis infection and agreement between the tests in heart and lung transplant recipients before transplant. Fifty-five adult patients who had been evaluated for heart and lung transplant between September 2011 and September 2012 at Masih Daneshvari Hospital in Iran were prospectively enrolled. We performed the tuberculin skin test and QuantiFERON-TB Gold In-Tube test. Of the 55 patients, 3 (5%) had positive tuberculin skin test results, and 11 (20%) had positive QuantiFERON-TB Gold In-Tube test results. Agreement between the tuberculin skin test and QuantiFERON-TB Gold In-Tube test was fair (Kappa=0.061; 95% CI: - 0.185-0.307) (P = .56). The positivity for QuantiFERON-TB Gold In-Tube test was greater than the positivity for the tuberculin skin test, and QuantiFERON-TB Gold In-Tube test more accurately determined the risk for latent tuberculosis infection. However, a further longitudinal study is necessary to verify that the QFT-G test would predict developing tuberculosis after heart and lung transplant.

  11. Skin prick test response to enzyme enolase of the baker's yeast (Saccharomyces cerevisiae) in diagnosis of respiratory allergy.

    PubMed

    Nittner-Marszalska, M; Wójcicka-Kustrzeba, I; Bogacka, E; Patkowski, J; Dobek, R

    2001-01-01

    The aim of the study is to prove that Saccharomyces cerevisiae enolase, the major allergen of the baker's yeast, induces allergic immediate response in patients with inhalant allergy sensitized to Candida albicans extract. The study was performed in three groups of patients: I. 20 atopic patients with respiratory allergy sensitized to Candida albicans and inhalant allergens (mite, feather, pollens) II. 30 patients with respiratory allergy, positive skin tests to inhalant allergens but negative skin tests to Candida albicans and other fungi; III. 20 nonatopic, healthy individuals. Skin prick test of purified enolase from Saccharomyces cerevisiae (bakers yeast) at concentration 1 and 10 mg/ml was performed in all groups. The results were documented planimetrically. 95% of patients sensitized to Candida albicans extract showed positive skin reactions to Saccharomyces cerevisiae enolase, 10% of patients of group II and none of the patients of the control group had positive skin responses to enolase. The mean wheal size (mm2) in skin prick test to Candida albicans, Saccharomyces cerevisiae enolase at concentration 10 mg/ml was x = 15.17 +/- 11.08, 15.76 +/- 19.67 and at concentration 1 mg/ml 10.02 +/- 10.49, respectively. 1. Saccharomyces cerevisiae enolase induces an immediate allergic reaction in skin in subjects with respiratory allergy and positive skin prick test results to Candida albicans and other fungi. 2. Enolase can be an important allergenic component of the Candida albicans extract.

  12. Proficiency testing of skin prick testers as part of a quality assurance system.

    PubMed

    Malling, Hans-Jørgen; Allesen-Holm, Pernille; Karved, Lisbeth Sys; Poulsen, Lars K

    2016-01-01

    Skin prick test is an important diagnostic procedure in clinical allergy but documentation of the quality is often missing. We describe a proficiency system to evaluate staff members in relation to the international recommended reproducibility in terms of coefficient of variation (CV < 40 %) and the linearity (coefficient of regression >0.85) based on blinded octuplicate histamine testing using histamine 3, 10, 30 and 100 mg/ml. Fourteen trained allergy nurses participated in the proficiency testing. More than 95 % of the nurses, generated coefficient of variation less than 40 %, and for around 35 % of testers the CV were below 20 % based on wheal area. Regarding the linearity (coefficient of regression), only two nurses produced tests with a value below 0.85. On the contrary, 79 % of testers demonstrated a coefficient of regression >0.95. Depending on the gentleness of the prick procedure, the inter-nurse variability in wheal area varied more than twofold corresponding to a 10-doubling of histamine concentration. This would never have been detected without using a proficiency testing system. The described histamine testing provides an objective system for the evaluation of basic skin test quality assessment standards especially for documentation in scientific studies.

  13. Ranitidine-induced anaphylaxis: clinical features, cross-reactivity, and skin testing.

    PubMed

    Park, K H; Pai, J; Song, D-G; Sim, D W; Park, H J; Lee, J-H; Jeong, K Y; Pan, C-H; Shin, I; Park, J-W

    2016-04-01

    Histamine H2 receptor antagonists are commonly prescribed medications and are known to be well tolerated. However, 99 cases of ranitidine-induced anaphylaxis occurred in Korea from 2007 to 2014. The purpose of this study was to determine the incidence, clinical features, and diagnostic methods for ranitidine-induced anaphylaxis. Ranitidine-related pharmacovigilance data from 2007 to 2014 were reviewed. Adverse drug reactions with causal relationships were selected, and clinical manifestations, outcomes, and drug-related information were assessed. For further investigation, 8 years of pharmacovigilance data were collected at a single centre. Twenty-three patients participated in in vivo and in vitro studies. Skin tests, oral provocation tests, and laboratory tests were performed, including tests using other kinds of histamine H2 receptor antagonists. Over 7 years, 584 patients suffered adverse reactions to ranitidine. The most common manifestation was cutaneous symptoms. Among them, 99 patients (17.0%) experienced anaphylaxis. In a single-centre study, skin prick tests were positive in 91.7% of ranitidine-induced anaphylaxis patients (11/12); the optimal concentration was 20 mg/mL. Detection of ranitidine-specific immunoglobulin E failed. Cimetidine and proton pump inhibitors showed no cross-reactivity with ranitidine based on the skin prick test, oral provocation test, or clinical determination. Surprisingly, 82.6% of patients reintroduced ranitidine and re-experienced the same adverse reactions because ranitidine was not considered the culprit drug. Although ranitidine is known as a safe drug, it can also cause diverse adverse reactions, including anaphylaxis. This study demonstrates the need to pay attention to adverse reactions to ranitidine and consider ranitidine as a cause of anaphylaxis. © 2016 John Wiley & Sons Ltd.

  14. Sensitization to fungi: epidemiology, comparative skin tests, and IgE reactivity of fungal extracts.

    PubMed

    Mari, A; Schneider, P; Wally, V; Breitenbach, M; Simon-Nobbe, B

    2003-10-01

    Several fungal species are known to cause severe respiratory and cutaneous allergic diseases. Extracts from several allergenic fungi are used for in vivo and in vitro tests, as standard preparations are still not available. The aims are to define the pattern of in vivo and in vitro IgE reactivity to fungal species in an allergic population with respiratory symptoms; to determine the influence of different extract preparations on diagnostic results; and to evaluate whether there exists a relationship between the diagnostic pattern of reactivity and the pattern of specific IgE reactivity in immunoblots. Skin prick tests were applied to a cohort of 4962 respiratory subjects, aged 3-80 years. Fungal extracts from Alternaria, Aspergillus, Candida, Cladosporium, Penicillium, Saccharomyces, and Trichophyton were used, along with extracts from pollens, mites, and animal dander. Demographical and diagnostic data were recorded. IgE detection was carried out with the same allergenic extracts plus Malassezia. Comparative skin tests and IgE detection were carried out using extracts from three commercial suppliers. IgE immunoblots were carried out with the same panel of commercial fungal extracts and were compared with in-house extracts. Data analysis was carried out by grouping the population on the basis of their reactivity to a single, to two or to more than two, mould species. Nineteen percent of the allergic population reacted to at least one fungal extract by means of the skin test. Alternaria and Candida accounted for the largest number of positive tests, and along with Trichophyton they were the main sensitizers in the subset of patients with an isolated sensitization. The prevalence of skin test reactivity increased for these three fungi in the subsets with two associated reactivities and, furthermore, in the subset showing reactivity to more than two mould species. In the latter group, a steady increase of the skin test reactivity was recorded for all the other fungal

  15. Relation between dorsal and palmar hand skin temperatures during a cold stress test.

    PubMed

    Leijon-Sundqvist, K; Tegner, Y; Olsson, F; Karp, K; Lehto, N

    2017-05-01

    Hand skin temperature measurements have previously been performed on either dorsal or palmar sides and it is possible to find arguments for the advantage of both locations. Therefore, the aim of this study was to use dynamic infrared (IR) imaging to examine the relationship between dorsal and palmar hand skin temperature. The palmar and dorsal hand skin temperature before and after a cold stress test was measured with IR thermography in 112 healthy participants. Calculation of surface average temperature was made from nine regions of interest on each hand's dorsal and palmar side. Temperature values were recorded at baseline, directly after immersion of hands in vinyl gloves for one minute in water at 20 ±0.5 °C (gloves removed), and after eight minutes rewarming. Results showed that: a) the skin temperatures on the dorsal and palmar sides of the hand are strongly correlated; b) the correlation is stronger on the fingers than on the carpometacarpal (CMC) area; c) the palmar side of the CMC area is warmer than the dorsal side, but this is reversed in the fingers so that the nail bed is warmer than the finger pad; and d) the temperature difference ∆T between the dorsal and palmar sides of the fingers is independent of the skin temperature, though ∆T on the CMC area of the hand is temperature dependent. Such differences can be important in detailed investigations of thermal phenomena in the hand. In conclusion, results showed a strong correlation between the dorsal and palmar temperatures. If both sides cannot be measured, the purpose of the investigation should determine which side of the hand should be measured. Copyright © 2017. Published by Elsevier Ltd.

  16. Herbal preparation extract for skin after radiotherapy treatment. Part One--Preclinical tests.

    PubMed

    Skalska-Kamińska, Agnieszka; Woźniak, Anna; Paduch, Roman; Kocjan, Ryszard; Rejdak, Robert

    2014-01-01

    Naran R is a herbal composition made of Plantago lanceolate folium, Malvae arboreae flos, Calendulae flos, Chamomillae inflorescentia, Lamii albi flos to prepare compresses or to wash skin with inflammations. The extract of this preparation is mixed to be applied as an ointment on patients' skin after radiotherapy. Experiments performed in vitro are part of pre-clinical tests with Naran R ointment. This study examined the impact of the plant composition for ethanol-water extract on human skin fibroblasts (HSF) culture. Samples of extract, prepared from patented amounts of herbs, were in the range of 25-225 μg/mL. Six methods were applied: standard spectrophotometric 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, neutral red (NR) uptake assay, DPPH free radical scavenging test, labeling of cytoskeleton F-actin, staining of argyrophilic nucleolar organizer regions (AgNORs) and trypan blue coloration. The extract concentration 75 μg/mL was established as safe for application on human skin. In labeling of F-actin with rhodamine-phalloidin dye at this concentration the cytoskeleton was stable. The extract did not influence the membrane stability and had positive influence on the proliferation activity. It was confirmed in AgNOR test during incubation with extract, which led to formation of larger amount of smaller nucleolins. In DPPH scavenging activity test, the extract revealed over 8% higher free-radical scavenging activity in comparison to control. After trypan blue staining, the extract in concentration 125 μg/mL significantly lowered the cell viability. When the cytotoxic and anti-proliferative activity of the extracts were analyzed, MTT and Neutral Red (NR) methods were used. The cells' viability was maintained on a constant level (80-110%) after 24, 48 and 72 h of incubation. During all time of NR test (72 h) and even when 225 μg/mL of extract was applied, the viability of cells was in range 80-110% of control. Positive influence

  17. Patients with breakthrough reactions to iodinated contrast media have low incidence of positive skin tests.

    PubMed

    Berti, A; Della-Torre, E; Yacoub, Mr; Tombetti, E; Canti, V; Sabbadini, M G; Colombo, G

    2016-07-01

    The term "breakthrough reactions" designates repeated hypersensitivity reactions to iodinated contrast media (ICM) despite premedication with glucocorticoids and antihistamines. We aimed to retrospectively evaluate the rate of positive skin test (STs) in our cohort of patients with previous breakthrough reactions to different ICMs. A series of 35 patients, who experienced at least one breakthrough reaction to ICM and who underwent STs within 6 months from the reaction were studied, and results were compared to a control group of patients with a first hypersensitivity reaction occurred without premedication. Skin prick tests (SPT), intradermal tests (IDT) and patch tests (PT) at different dilutions, with a set of three to four ICM were performed. Of the 35 patients with prior breakthrough reactions, 57% had an immediate reaction (IR) and 43% had a non-immediate reaction (NIR). Patients who experienced the first hypersensitivity IR or NIR, later had one or more breakthrough IR or NIR, respectively. Overall, 29% (10/35) of patients with prior breakthrough reactions resulted positive to STs compared to 57% (16/28) of the control group (p < 0.05). No significant difference in allergy history, age, sex, other clinical / demographic features nor chronic use of ACE-inhibitor, beta-blockers or NSAIDs was observed. This preliminary finding suggests that patients with prior breakthrough reactions have significantly lower immunologically proven ICM reactions (positive STs) if compared to non-breakthrough patients. According to that, a considerable number of breakthrough reactions seems to be non-allergic hypersensitivity reactions or reactions which could be mostly prevented by a proper, well-timed skin testing. Larger prospective studies are needed to confirm these results, with a more careful analysis of patients' risk factors, a laboratory assessment that includes an in vitro allergy diagnostics, and hopefully a drug provocation test for selected cases.

  18. Stability and potency of raw and boiled shrimp extracts for skin prick test.

    PubMed

    Pariyaprasert, Wipada; Piboonpocanun, Surapon; Jirapongsananuruk, Orathai; Visitsunthorn, Nualanong

    2015-06-01

    The difference of stability between raw and boiled shrimp extracts used in prick tests has never been investigated despite its potential consequences in tests development. The aim of this study was to compare the raw and boiled shrimp extracts of two species; Macrobrachium rosenbergii (freshwater shrimp) and Penaeus monodon (seawater shrimp) held at 4 ?C for different periods of time for their stability and potency in vivo by using the skin prick test (SPT) method. Raw and boiled M. rosenbergii and P. monodon extracts were prepared and stored at 4 ?C for 1, 7, 14 and 30 days. Thirty patients were pricked with raw and boiled shrimp extracts at all storage times, as well as prick to prick skin test (PTP) to fresh raw and boiled shrimps of both species. The mean wheal diameter (MWD) resulting from prick tests for all shrimp extracts was measured and compared. The shrimp extracts of all storage times yielded positive skin test results in the range of 90% - 100%. Raw P. monodon extracts induced larger wheals than boiled extracts at all storage times. There was no significant difference of MWD between raw and boiled M. rosenbergii extracts on day 1, 7, and 14. Significant correlations between MWD of PTP to fresh shrimps and SPT to all shrimp extracts were observed. All shrimp extracts were sterile at all storage times. Raw and boiled M. rosenbergii and P. monodon extracts were stable and sterile at 4 ?C for at most 30 days. SPT with these extracts induced more than 10 mm in shrimp allergy patients and the results were comparable with PTP to fresh shrimps.

  19. Sorption-desorption test for functional assessment of skin treated with a lipid system that mimics epidermal lamellar bodies.

    PubMed

    Moner, Verónica; Fernández, Estibalitz; Del Pozo, Alfonso; Rodríguez, Gelen; Cócera, Mercedes; de la Maza, Alfonso; López, Olga

    2017-07-01

    Many skin diseases are associated with either increases or decreases in lamellar body secretion, or dysfunctional lamellar bodies. Consequently, diseased skin is characterized by reduced barrier function and altered lipid composition and organization. Human skin is commonly evaluated in vivo with non-invasive biophysical techniques. The dynamic functions of the skin are evaluated with repeat measurements such as the sorption-desorption test (SDT). The aim of this study was to evaluate in vivo skin hydration-dehydration kinetics after treatment with a lipid system that mimics the morphology, structure and composition of lamellar bodies in both healthy and irritated human skin. A patch with an aqueous solution of 2% sodium lauryl sulfate (SLS) was used to irritate the skin of the volunteers. The SDT was performed with the CM 820 corneometer. After treatment with this system, both healthy and SLS-irritated skin increased their ability to retain water and to release water slowly during the desorption phase. Treatment with this system seems to reinforce the barrier function in both healthy and SLS-irritated human skin. Therefore, the present study provides evidence that this system could be of interest for developing future treatments for protecting and repairing the skin. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Thermography for skin temperature evaluation during dynamic exercise: a case study on an incremental maximal test in elite male cyclists.

    PubMed

    Ludwig, Nicola; Trecroci, Athos; Gargano, Marco; Formenti, Damiano; Bosio, Andrea; Rampinini, Ermanno; Alberti, Giampietro

    2016-12-01

    The use of thermal imaging in monitoring the dynamic of skin temperature during prolonged physical exercise is central to assess athletes' ability to dissipate heat from the skin surface to the environment. In this study, seven elite cyclists completed an incremental maximal cycling test to evaluate their skin temperature response under controlled-environment conditions. Thermal images have been analyzed using a method based on maxima detection (Tmax). Data confirmed a reduction in skin temperature due to vasoconstriction during the exercise, followed by a temperature increment after exhaustion. A characteristic hot-spotted thermal pattern was found over the skin surface in all subjects. This research confirmed also the notable ability by highly trained cyclists to modify skin temperature during an incremental muscular effort. This study gives additional contributions for understanding the capability of the Tmax method applied to the thermoregulatory physiological processes.

  1. Experimental testing and constitutive modeling of the mechanical properties of the swine skin tissue.

    PubMed

    Łagan, Sylwia D; Liber-Kneć, Aneta

    2017-01-01

    The aim of the study was an estimation of the possibility of using hyperelastic material models to fit experimental data obtained in the tensile test for the swine skin tissue. The uniaxial tensile tests of samples taken from the abdomen and back of a pig was carried out. The mechanical properties of the skin such as the mean Young's modulus, the mean maximum stress and the mean maximum elongation were calculated. The experimental data have been used to identify the parameters in specific strain-energy functions given in seven constitutive models of hyperelastic materials: neo-Hookean, Mooney-Rivlin, Ogden, Yeoh, Martins, Humphrey and Veronda-Westmann. An analysis of errors in fitting of theoretical and experimental data was done. Comparison of load -displacement curves for the back and abdomen regions of skin taken showed a different scope of both the mean maximum loading forces and the mean maximum elongation. Samples which have been prepared from the abdominal area had lower values of the mean maximum load compared to samples from the spine area. The reverse trend was observed during the analysis of the values of elongation. An analysis of the accuracy of model fitting to the experimental data showed that, the least accurate were the model of neo- -Hookean, model of Mooney-Rivlin for the abdominal region and model of Veronda-Westmann for the spine region. An analysis of seven hyperelastic material models showed good correlations between the experimental and the theoretical data for five models.

  2. In vitro human skin irritation test for evaluation of medical device extracts.

    PubMed

    Casas, J W; Lewerenz, G M; Rankin, E A; Willoughby, J A; Blakeman, L C; McKim, J M; Coleman, K P

    2013-12-01

    The aim of this study was to determine if the EpiDerm™ reconstructed human skin model (MatTek Corp.) could be an acceptable alternative to the ISO 10993-required rabbit skin irritation test for assessing medical device biocompatibility. Eleven medical device polymers were tested. Four extracts were prepared per polymer, two each with saline and sesame oil; half were spiked with two R-38 irritants, lactic acid for saline extracts and heptanoic acid for the sesame oil extracts. Tissue viability was assessed by MTT reduction and the proinflammatory response was assessed by IL-1α release. LOAELs of 2% for lactic acid in saline and 0.7% for heptanoic acid in sesame oil were determined. A cell viability reduction of >50% was indicative of skin irritation. Cells exposed to saline extracts spiked with 3.25% lactic acid had significantly reduced mean cell viabilities (12.6-17.2%). Cells exposed to sesame oil extracts spiked with 1.25% heptanoic acid also exhibited reduced mean cell viabilities (25.5%-41.7%). All spiked cells released substantial amounts of IL-1α (253.5-387.4pg/ml) signifying a proinflammatory response. These results indicate that the EpiDerm™ model may be a suitable in vitro replacement for the assessment of the irritation potential of medical device extracts.

  3. Non-occlusive topical exposure of human skin in vitro as model for cytotoxicity testing of irritant compounds.

    PubMed

    Lönnqvist, Susanna; Briheim, Kristina; Kratz, Gunnar

    2016-02-01

    Testing of irritant compounds has traditionally been performed on animals and human volunteers. Animal testing should always be restricted and for skin irritancy mice and rabbits hold poor predictive value for irritant potential in humans. Irritant testing on human volunteers is restricted by the duration subjects can be exposed, and by the subjectivity of interpreting the visual signs of skin irritation. We propose an irritant testing system using viable human full thickness skin with the loss of cell viability in the exposed skin area as end point measurement. Skin was exposed to sodium dodecyl sulfate (SDS) at 20% concentration by non-occluded topical exposure to establish a positive control response and subsequent test compounds were statistically compared with the 20% SDS response. Cell viability and metabolism were measured with 3-(4,5-dimethyl-thiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay. The model presents correlation between increased concentration of SDS and decreased viability of cells in the exposed skin area (R(2) = 0.76). We propose the model to be used for cytotoxicity testing of irritant compounds. With fully intact barrier function, the model comprises all cells present in the skin with quantifiable end point measurement.

  4. Aero-allergens in canine atopic dermatitis in southeastern Australia based on 1000 intradermal skin tests.

    PubMed

    Mueller, R S; Bettenay, S V; Tideman, L

    2000-06-01

    To determine the most relevant aero-allergens involved in canine atopic dermatitis in southeastern Australia and provide information about these aero-allergens to the general practitioner. Dogs presented to the Animal Skin & Allergy Clinic with history and clinical signs of atopic dermatitis were injected intradermally with 38 different allergens and negative and positive control. Intradermal skin tests in 1000 dogs were retrospectively evaluated. One third of all patients reacted to the house dust mite Dermatophagoides farinae. Allergens reacting in more than 15% of the patients were wheat (Triticum aestivum), sweet vernal (Anthoxanthum odoratum), English couch (Agropyron repens), yellow dock (Rumex crispus), Mexican tea (Chenopodium ambrosioides), plantain (Plantago lanceolata), melaleuca (Melaleuca quinquenervia) and peppercorn (Schimus spp). House dust mites are the most common allergens in canine atopic dermatitis in southeastern Australia and D farinae is involved most frequently. However, a number of grass, weed and tree pollens also are involved regularly.

  5. Assessment of a Protein Cocktail-Based Skin Test for Bovine Tuberculosis in a Double-Blind Field Test in Cattle

    PubMed Central

    Xin, Ting; Jia, Hong; Ding, Jiabo; Li, Pingjun; Yang, Hongjun; Hou, Shaohua; Yuan, Weifeng; Guo, Xiaoyu; Wang, Haichun; Liang, Qianqian; Li, Ming

    2013-01-01

    Bovine tuberculosis (bTB) is a worldwide zoonosis caused mainly by Mycobacterium bovis. The traditional diagnostic method used often is the tuberculin skin test, which uses bovine purified protein derivatives (PPD-B). However, it is difficult to maintain uniformity of PPD-B from batch to batch, and it shares common antigens with nonpathogenic environmental mycobacteria. To overcome these problems, M. bovis-specific antigens that showed good T cell stimulation, such as CFP-10, ESAT-6, Rv3615c, etc., have been used in the skin test, but there have been no large-scale clinical studies on these antigens. In this study, two combinations (CFP-10/ESAT-6/TB10.4 protein cocktail and CFP-10/ESAT-6/Rv3872/MPT63 protein cocktail) were developed and used as stimuli in the skin test. Cattle were double-blind tested to assess the efficiency of the protein cocktail-based skin tests. The results showed that the CFP-10/ESAT-6/TB10.4 protein cocktail-based skin test can differentiate TB-infected cattle from Mycobacterium avium-infected ones and that it shows a high degree of agreement with the traditional tuberculin skin test (κ = 0.8536) and gamma interferon (IFN-γ) release assay (κ = 0.8154). Compared to the tuberculin skin test, the relative sensitivity and relative specificity of the CFP-10/ESAT-6/TB10.4-based skin test were 87% and 97%, respectively., The relative sensitivity and relative specificity of the CFP-10/ESAT-6/TB10.4-based skin test were 93% and 92%, respectively, on comparison with the IFN-γ release assay. The correlation between the increases in skin thickness observed after the inoculation of stimuli was high (PPD-B versus CFP-10/ESAT-6/TB10.4, Spearman r of 0.8435). The correlation between the optical density at 450 nm (OD450) obtained after blood stimulation with PPD-B and the increase in skin thickness observed after inoculation of the CFP-10/ESAT-6/TB10.4 protein cocktail was high (Spearman r = 0.7335). Therefore, the CFP-10/ESAT-6/TB10.4-based skin test

  6. Wearing test with 2 different types of latex gloves with and without the use of a skin protection cream.

    PubMed

    Allmers, H

    2001-01-01

    72 subjects reporting symptoms indicating Type I hypersensitivity reactions to natural rubber latex (NRL) gloves were included in this study. 44 of them had a positive prick test to NRL. They underwent wearing tests using 2 types of NRL gloves with high (n=63) and low (n=70) allergen contents. Unigloves Malaysia with a high allergen content caused positive skin reactions in 47% of SPT-positive and no IgE-negative subjects. After application of Hand Sense skin protection cream, the frequency of positive skin responses in wearing tests decreased to 30% in prick-test-positive subjects. The Biogel Diagnostic gloves with low allergen caused hypersensitivity with and without Hand Sense in 2 cases (5%) of the prick-test-positive. 60% of all test participants had a positive prick test to NRL. No prick-test-negative subjects showed any urticaria during the glove-wearing test. Our study demonstrates that high allergen contents in latex gloves frequently elicit skin responses in NRL-sensitized subjects. Since other skin protection creams have shown to increase allergic symptoms, it is encouraging to report that Hand Sense skin cream may hamper the uptake of allergens from gloves, thus decreasing allergic reactions.

  7. The EpiDerm test protocol for the upcoming ECVAM validation study on in vitro skin irritation tests--an assessment of the performance of the optimised test.

    PubMed

    Kandárová, Helena; Liebsch, Manfred; Gerner, Ingrid; Schmidt, Elisabeth; Genschow, Elke; Traue, Dieter; Spielmann, Horst

    2005-08-01

    During the past decade, several validation studies have been conducted on in vitro methods for discriminating between skin irritating and non-irritating chemicals. The reconstructed human skin models, EpiDerm and EPISKIN, provided the most promising results. Based on experience of the similar performance of the two skin models, it was suggested that a common test protocol and prediction model should be developed for the prediction of skin irritation potential with the two models. When the EPISKIN protocol was applied with the EpiDerm model, an acceptable specificity (80%) was achieved, whereas the sensitivity (60%) was low. In 2003, the EPISKIN protocol was further refined by extending the post-incubation period following exposure to test chemicals. This extension and additional technical improvements to the EpiDerm protocol were evaluated with 19 chemicals from the prevalidation study. With the new test design, high sensitivity (80%) and specificity (78%) were obtained. The statistical probability for correct classifications was high, so the test was considered to be ready for formal validation. However, since test optimisation had been conducted with the same test chemicals as were used in the ECVAM prevalidation study, it was decided that the optimisation of the protocol had to be verified with a new set of chemicals. Thus, in the current study, 26 additional chemicals (10 rabbit irritants and 16 non-irritants), which had previously been selected and tested by LOREAL with EPISKIN, were evaluated in three independent experiments with EpiDerm. With this unbalanced testing set, a specificity of 94%, and a sensitivity of 60% were obtained, while the positive and negative predictivity and accuracy remained almost unchanged (around 80%) in comparison to the in vivo rabbit data. Overall, 45 chemicals (20 irritants and 25 non-irritants) were tested according to the final protocol. The resulting high positive (82%) and negative predictive values (79%) confirmed the

  8. Comparison of sensitivity of QuantiFERON-TB gold test and tuberculin skin test in active pulmonary tuberculosis.

    PubMed

    Khalil, Kanwal Fatima; Ambreen, Asma; Butt, Tariq

    2013-09-01

    To compare the sensitivity of tuberculin skin test (TST) and quantiFERON-TB gold test (QFT-G) in active pulmonary tuberculosis. Analytical study. Department of Pulmonology, Fauji Foundation Hospital, Rawalpindi, from July 2011 to January 2012. QuantiFERON-TB gold test (QFT-G) was evaluated and compared it with tuberculin skin test (TST) in 50 cases of active pulmonary tuberculosis, in whom tuberculous infection was suspected on clinical, radiological and microbiological grounds. Sensitivity was determined against postive growth for Mycobacterium tuberculosis. Out of 50 cases, 43 were females and 7 were males. The mean age was 41.84 ± 19.03 years. Sensitivity of QFT-G was 80% while that of TST was 28%. QFT-G has much higher sensitivity than TST for active pulmonary tuberculosis. It is unaffected by prior BCG administration and prior exposure to atypical mycobacteria. A positive QFT-G result can be an adjunct to diagnosis in patients having clinical and radiological data compatible with pulmonary tuberculosis.

  9. Derivation and application of mathematical model for well test analysis with variable skin factor in hydrocarbon reservoirs

    NASA Astrophysics Data System (ADS)

    Liu, Pengcheng; Li, Wenhui; Xia, Jing; Jiao, Yuwei; Bie, Aifang

    2016-06-01

    Skin factor is often regarded as a constant in most of the mathematical model for well test analysis in oilfields, but this is only a kind of simplified treatment with the actual skin factor changeable. This paper defined the average permeability of a damaged area as a function of time by using the definition of skin factor. Therefore a relationship between a variable skin factor and time was established. The variable skin factor derived was introduced into existing traditional models rather than using a constant skin factor, then, this newly derived mathematical model for well test analysis considering variable skin factor was solved by Laplace transform. The dimensionless wellbore pressure and its derivative changed with dimensionless time were plotted with double logarithm and these plots can be used for type curve fitting. The effects of all the parameters in the expression of variable skin factor were analyzed based on the dimensionless wellbore pressure and its derivative. Finally, actual well testing data were used to fit the type curves developed which validates the applicability of the mathematical model from Sheng-2 Block, Shengli Oilfield, China.

  10. Antibiotic-induced immediate type hypersensitivity is a risk factor for positive allergy skin tests for neuromuscular blocking agents.

    PubMed

    Hagau, Natalia; Gherman, Nadia; Cocis, Mihaela; Petrisor, Cristina

    2016-01-01

    Skin tests for neuromuscular blocking agents (NMBAs) are not currently recommended for the general population undergoing general anaesthesia. In a previous study we have reported a high incidence of positive allergy tests for NMBAs in patients with a positive history of non-anaesthetic drug allergy, a larger prospective study being needed to confirm those preliminary results. The objective of this study was to compare the skin tests results for patients with a positive history of antibiotic-induced immediate type hypersensitivity reactions to those of controls without drug allergies. Ninety eight patients with previous antibiotic hypersensitivity and 72 controls were prospectively included. Skin tests were performed for atracurium, pancuronium, rocuronium, and suxamethonium. We found 65 positive skin tests from the 392 tests performed in patients with a positive history of antibiotic hypersensitivity (1 6.58%) and 23 positive skin tests from the 288 performed in controls (7.98%), the two incidences showing significant statistical difference (p = 0.0011). The relative risk for having a positive skin test for NMBAs for patients versus controls was 1.77 (1.15-2.76). For atracurium, skin tests were more often positive in patients with a positive history of antibiotic hypersensitivity versus controls (p = 0.02). For pancuronium, rocuronium and suxamethonium the statistical difference was not attained (p-values 0.08 for pancuronium, 0.23 for rocuronium, and 0.26 for suxamethonium). Patients with a positive history of antibiotic hypersensitivity seem to have a higher incidence of positive skin tests for NMBAs. They might represent a group at higher risk for developing intraoperative anaphylaxis compared to the general population. Copyright © 2015 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

  11. Unexpected high responses to tuberculin skin-test in farmed red deer: implications for tuberculosis control.

    PubMed

    Queiros, J; Alvarez, J; Carta, T; Mateos, A; Ortiz, J A; Fernández-de-Mera, I G; Martín-Hernando, M P; Gortázar, C

    2012-05-01

    Tuberculosis (TB) in deer is a serious zoonotic disease of worldwide distribution. Detection of infected animals is usually performed using single or comparative skin-testing (SST/CST), although false responses due to sensitization to other mycobacteria may occur, hampering diagnostic specificity. We describe the evolution of the responses to the SST, CST and to an in-house serological assay in a red deer farm subjected to regular TB testing in southern Spain in an attempt to understand the dynamics of possible non-specific reactions occurring under field conditions. We performed 2288 skin-tests and ELISAs in nine sampling periods between May 2009 and January 2011. In May 2010, a strong increase in skin fold thickness in response to avian purified protein derivative (PPD) (mean=4.0mm, 95% CI=3.5-4.5) and bovine PPD (mean=1.8mm, 95% CI=1.6-2.0) was observed in yearling deer hinds (n=150), compared to values recorded for the same individuals in November 2009 (avian PPD: mean=0.7 mm, 95% CI=0.6-0.8 and bovine PPD: mean=0.7 mm, 95% CI=0.6-0.7) and in January 2011 (avian PPD: mean=2.2mm, 95% CI=1.9-2.4 and bovine PPD: mean=1.1mm, 95% CI=1.0-1.2). Using SST, 54 animals (36%) of the yearlings tested in May 2010 would have been classified as positive reactors, while none of them was positive in the CST. The five animals with highest skin fold increases to mycobacterial antigens were culled and subjected to post-mortem analysis, which confirmed the absence of Mycobacterium tuberculosis complex (MTBC) infection but demonstrated the presence of environmental mycobacteria and closely related bacteria in four out of the five analyzed animals. Our results demonstrated how non-specific responses to mycobacterial antigens can adversely affect the specificity of TB diagnosis based on the SST. Thus, once TB infection has been ruled out using confirmatory techniques, application of comparative diagnostic tests is highly advisable to maximize test specificity and avoid the slaughter

  12. Does effect of BCG vaccine decrease with time since vaccination and increase tuberculin skin test reaction?

    PubMed

    Subramani, R; Datta, Manjula; Swaminathan, S

    2015-10-01

    The protective efficacy of BCG was studied for over 15 years, from 1968, in South India. A secondary analysis of data was performed to investigate the relationship between Bacille Calmette-Guérin (BCG) and tuberculosis (TB) disease and between BCG and positive tuberculin skin test for different time periods among children aged less than 10 years. A randomized controlled trial was conducted, where 281,161 persons were allocated to receive BCG 0.1mg, BCG 0.01mg or placebo. Tuberculin skin test was performed at baseline and at 4 years after BCG vaccination. Surveys were conducted every 2.5 years to detect all new cases of culture-positive/smear-positive TB occurring in the community over a 15-year period. Relative risk (RR) was obtained from the ratio of incidence among the vaccinated and the placebo groups. Among those children vaccinated with 0.1mg of BCG, the RR for TB was 0.56 (95% CI: 0.32-0.87, P=0.01) at 12.5 years but increased to 0.73 later. Similar pattern was seen with 0.01mg. The increase in the number of skin test positives with 0.1mg of BCG was 57.8%, 49.4% and 34% for cut-off points at ≥10mm, ≥12mm and ≥15mm, respectively. The study suggests that the effect of BCG may decrease since vaccination and the tuberculin positive was higher at post-vaccination test period due to BCG.

  13. Autologous Serum and Plasma Skin Tests in Chronic Spontaneous Urticaria: A Reappraisal

    PubMed Central

    Kumaran, Muthu Sendhil; Mangal, Sonia; Narang, Tarun; Parsad, Davinder

    2017-01-01

    Aim: The objective of this study was to assess autologous serum skin test (ASST) vs autologous plasma skin test (APST) response in chronic spontaneous urticaria (CSU) patients and study the significance of intensity of positive responses in relation to clinicoepidemiological parameters. Materials and Methods: One hundred CSU patients and 100 age and sex-matched controls were recruited. The demographic and clinical features were recorded in all patients and routine investigations were performed. ASST and APST tests were performed as per the standard guidelines. Results: The mean duration of illness was 4.85 ± 5.07 years, 90% patients were APST (+), 68% ASST (+), and 22 patients were only APST (+). Positive predictive value (PPV) of ASST and APST was 90.7% and 95.7%, respectively. A significant inverse association was seen between thyroid status and serum IgE levels with APST and ASST positivity. Conclusion: APST appears to have better PPV and high intensity of positive response on autologous tests, and correlates with ANA positivity and angioedema. PMID:28405547

  14. Interferon gamma release assays and tubercolin skin test performance in different settings of HIV immunodeficiency.

    PubMed

    Parrella, Roberto; Esposito, Vincenzo; Onofrio, Mirella; Parrella, Giovanni; Viglietti, Rosaria; Sangiovanni, Vincenzo; Gargiulo, Miriam; Di Martino, Filomena; Del Giudice, Annalisa; Santoro, Giulia; Bernardo, Mariano; Carleo, Maria Aurora; Chirianni, Antonio

    2015-01-01

    HIV infection is a risk factor for re-activation of latent tubercolosis infection (LTBI). In recent years new blood tests for the detection of TB infection have been developed: Quantiferon TB Gold in Tube and TSPOT TB, which are interferon-γ releasing assays (IGRAs), have improved the identification of LTBI. In our study we have compared IGRAs and TST in HIV-positive patients with different settings of immunodeficiency. 98 consecutive HIV patients were recruited. They underwent a blood draw, a chest radiography and a tuberculin skin test. The HIV infection setting was detected and IGRAs were carried-out. Five patients showed a complete correspondence of TST, TSPOT-TB and QFT-IT. Discordant results were observed in patients testing positive to IGRAs but negative to TST. Only 2 patients showed positive TST and negative IGRAs. Our study showed a poor concordance between tuberculin skin test and IGRAs, mainly in patients with a low CD4 cell count. Copyright © 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  15. Development and testing of a wearable Integrated Thermometer sensor for skin contact thermography.

    PubMed

    Giansanti, D; Maccioni, G

    2007-06-01

    The need of wearable devices for the thermal monitoring is rising. These devices could be used during medical continuous monitoring, for instance in breast cancer investigation, or for the monitoring of vascular, dermatological and rheumatic disorders, in viability studies, and during physical exercises. We had designed and constructed a wearable device for skin-contact thermography that uses integrated silicon sensors. The bench test validation was performed by means of a commercial oven for the static bench test and a properly designed phantom for the dynamic bench test. The thermal resolution was better than 0.03 degrees C and the spatial resolution equal to 1.6 x 10(-5)m2. We then investigated its performance in a medical application, suited for clinical testing, in which volunteers were subject to a maximal rate of thermal skin variation equal to 3.1 degrees C/0.25 h. We also compared the results with those obtained by means of an Infrared-Digital-Video-Camera. Results of the comparison showed a maximal error always lower than 0.14 degrees C.

  16. Validation of the cephalosporin intradermal skin test for predicting immediate hypersensitivity: a prospective study with drug challenge.

    PubMed

    Yoon, S-Y; Park, S Y; Kim, S; Lee, T; Lee, Y S; Kwon, H-S; Cho, Y S; Moon, H-B; Kim, T-B

    2013-07-01

    Cephalosporin is a major offending agent in terms of drug hypersensitivity along with penicillin. Cephalosporin intradermal skin tests (IDTs) have been widely used; however, their validity for predicting immediate hypersensitivity has not been studied. This study aimed to determine the predictive value of cephalosporin intradermal skin testing before administration of the drug. We prospectively conducted IDTs with four cephalosporins, one each of selected first-, second-, third-, or fourth-generation cephalosporins: ceftezol; cefotetan or cefamandole; ceftriaxone or cefotaxime; and flomoxef, respectively, as well as with penicillin G. After the skin test, whatever the result, one of the tested cephalosporins was administered intravenously and the patient was carefully observed. We recruited 1421 patients who required preoperative cephalosporins. Seventy-four patients (74/1421, 5.2%) were positive to at least one cephalosporin. However, none of responders had immediate hypersensitivity reactions after a challenge dose of the same or different cephalosporin, which were positive in the skin test. Four patients who suffered generalized urticaria and itching after challenge gave negative skin tests for the corresponding drug. The IDT for cephalosporin had a sensitivity of 0%, a specificity of 97.5%, a negative predictive value of 99.7%, and a positive predictive value (PPV) of 0%, when challenged with the same drugs that were positive in the skin test. Routine skin testing with a cephalosporin before its administration is not useful for predicting immediate hypersensitivity because of the extremely low sensitivity and PPV of the skin test (CRIS registration no. KCT0000455). © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. The ECVAM international validation study on in vitro tests for acute skin irritation: selection of test chemicals.

    PubMed

    Eskes, Chantra; Cole, Thomas; Hoffmann, Sebastian; Worth, Andrew; Cockshott, Amanda; Gerner, Ingrid; Zuang, Valérie

    2007-12-01

    The ECVAM-funded skin irritation validation study (SIVS) was initiated in 2003, with the aim to evaluate whether the EpiDerm, EPISKIN and the SIFT alternative methods were able to reliably identify skin irritant and non-irritant chemicals, and could therefore be candidates for replacing the rabbit Draize test for skin irritation. The primary goal of the study was to evaluate the predictive capacity of the assays with regard to the EU classification system, which employs the risk phrases, "R38", for skin irritants, and "no label" for non-irritants. A secondary objective was the retrospective analysis of the data, to assess whether the in vitro tests would be able to discriminate between strong irritants (category 2), mild irritants (category 3) and non-irritants (no category), as defined by the OECD and United Nations proposal for a Globally Harmonised System (GHS) for the classification and labelling of dermal irritancy. A Chemicals Selection Sub-Committee (CSSC) was appointed to identify test chemicals to be used in the SIVS, for which existing, high quality in vivo data were available, with which to correlate the in vitro measurements. Since chemicals from the European Centre for the Ecotoxicology and Toxicology of Chemicals (ECETOC) database of reference chemicals for skin irritation/skin corrosion had been extensively used in preceding studies, the CSSC made use of novel sources for potential test chemicals. The first source of chemicals screened was the New Chemicals Database (NCD), which is the central archive within the EU notification scheme for 'new' commercial chemicals. Data registered in the NCD originate from standard assays, submitted in compliance with the legislation which regulates the marketing of industrial chemicals, and are subject to quality assurance by the competent authorities of the EU Member States. In addition, to obtain 'existing' chemicals which were readily available from major manufacturing and/or distribution sources, additional

  18. Adaptation of the KeratinoSens™ skin sensitisation test to animal-product-free cell culture.

    PubMed

    Belot, Nathalie; Sim, Bushra; Longmore, Christopher Longmore; Roscoe, Lottie; Treasure, Carol

    2017-03-16

    Skin sensitisation is the process by which a substance leads to an allergic reaction following skin contact. The process has been described as an adverse outcome pathway (AOP), including several key events, from skin penetration and covalent protein binding, to keratinocyte activation, dendritic cell activation and T-lymphocyte proliferation. The in vitro assay KeratinoSens™ measures the activation of keratinocytes. It is fully accepted at a regulatory level (OECD TG 442d) and appropriate for compliance with a range of legislation including the EU Cosmetics Regulation, REACH, and the CLP Regulation. Currently, many in vitro methods use animal-derived components in the cell culture systems. Many stakeholders in the cosmetics industry have both scientific and ethical concerns relating to this issue and have stated a strong preference for fully human in vitro test systems. We have adapted the KeratinoSensTM method to animal product-free conditions, and carried out an in-house validation with 21 reference substances, including those listed in the Performance Standards associated with OECD TG442d. The modified method was shown to be totally equivalent to the Validated Reference Method (VRM), with comparable values for accuracy (85.7%), sensitivity (84.6%) and specificity (87.5%), and all acceptance criteria being met. In Europe, data generated by the adapted method may be used in REACH submissions, and we are now seeking approval to list the adaptation in OECD TG 442d, enabling formal compliance with a range of global regulations.

  19. Water immersion decreases sympathetic skin response during color-word Stroop test.

    PubMed

    Sato, Daisuke; Yamazaki, Yudai; Takahashi, Akari; Uetake, Yoshihito; Nakano, Saki; Iguchi, Kaho; Baba, Yasuhiro; Nara, Rio; Shimoyama, Yoshimitsu

    2017-01-01

    Water immersion alters the autonomic nervous system (ANS) response in humans. The effect of water immersion on executive function and ANS responses related to executive function tasks was unknown. Therefore, this study aimed to determine whether water immersion alters ANS response during executive tasks. Fourteen healthy participants performed color-word-matching Stroop tasks before and after non-immersion and water immersion intervention for 15 min in separate sessions. The Stroop task-related skin conductance response (SCR) was measured during every task. In addition, the skin conductance level (SCL) and electrocardiograph signals were measured over the course of the experimental procedure. The main findings of the present study were as follows: 1) water immersion decreased the executive task-related sympathetic nervous response, but did not affect executive function as evaluated by Stroop tasks, and 2) decreased SCL induced by water immersion was maintained for at least 15 min after water immersion. In conclusion, the present results suggest that water immersion decreases the sympathetic skin response during the color-word Stroop test without altering executive performance.

  20. Water immersion decreases sympathetic skin response during color–word Stroop test

    PubMed Central

    Yamazaki, Yudai; Takahashi, Akari; Uetake, Yoshihito; Nakano, Saki; Iguchi, Kaho; Baba, Yasuhiro; Nara, Rio; Shimoyama, Yoshimitsu

    2017-01-01

    Water immersion alters the autonomic nervous system (ANS) response in humans. The effect of water immersion on executive function and ANS responses related to executive function tasks was unknown. Therefore, this study aimed to determine whether water immersion alters ANS response during executive tasks. Fourteen healthy participants performed color–word-matching Stroop tasks before and after non-immersion and water immersion intervention for 15 min in separate sessions. The Stroop task-related skin conductance response (SCR) was measured during every task. In addition, the skin conductance level (SCL) and electrocardiograph signals were measured over the course of the experimental procedure. The main findings of the present study were as follows: 1) water immersion decreased the executive task-related sympathetic nervous response, but did not affect executive function as evaluated by Stroop tasks, and 2) decreased SCL induced by water immersion was maintained for at least 15 min after water immersion. In conclusion, the present results suggest that water immersion decreases the sympathetic skin response during the color–word Stroop test without altering executive performance. PMID:28742137

  1. Key nasal symptoms predicting a positive skin test in allergic rhinitis and patient characteristics according to ARIA classification.

    PubMed

    Chaiyasate, Saisawat; Roongrotwattanasiri, Kannika; Fooanant, Supranee; Sumitsawan, Yupa

    2009-03-01

    To find predicting symptom(s) in patients with a positive skin test, and identify patient characteristics according to ARIA classification. Four hundred and thirty four rhinologic patients were retrospectively studied. Nasal obstruction, rhinorrhea, itching, sneezing, and smell dysfunction were assessed. Patients were also classified according to the ARIA guideline. Of 434 patients, 277 (63.8%) were skin prick test positive. There was no statistical difference in sex, but the mean age of the positive skin test group was lower than that in the negative group (p < 0.05). Intermittent or persistent symptoms and total symptom score were not significantly different. Severe nasal itching was more common in the positive group (p = 0.04). The impact of symptoms was similar between the two groups, except for self-reported comorbidity, which was higher in the negative group (p = 0.039). There were no predicting symptoms and no difference in the symptom characteristics for the patients with positive skin test.

  2. Assessment of skin test with varicella-zoster virus antigen for predicting the risk of herpes zoster.

    PubMed

    Okuno, Y; Takao, Y; Miyazaki, Y; Ohnishi, F; Okeda, M; Yano, S; Kumihashi, H; Gomi, Y; Maeda, K; Ishikawa, T; Mori, Y; Asada, H; Iso, H; Yamanishi, K

    2013-04-01

    The Shozu Herpes Zoster (SHEZ) Study was designed to clarify the incidence of and predictive and immunological factors for herpes zoster in a defined community-based Japanese population. As part of this series, a total of 5683 residents aged ≥50 years received a varicella-zoster virus (VZV) skin test with VZV antigen, and 48 h later, the erythema and oedema were assessed by measuring the longest diameter. The diameters of both the erythema and oedema decreased with the increasing age of the subject. Sixty-three subjects contracted herpes zoster within a year after receiving the VZV skin test. Analysis of the herpes zoster incidence rate vs. the skin test reaction revealed that the shorter the diameter of erythema or oedema, the greater the likelihood of herpes zoster. These results demonstrated that the VZV skin test is an excellent surrogate marker for predicting the risk of herpes zoster.

  3. The contribution of blood flow to the skin temperature responses during a cold sensitivity test.

    PubMed

    Davey, Martha; Eglin, Clare; House, James; Tipton, Michael

    2013-09-01

    The presumption in a cold sensitivity test (CST) used for cold injuries is that the skin temperature (T sk) observed reflects the return of blood flow to the extremity following a local cold challenge. We questioned this assumption. Six non-cold injured participants undertook two CSTs in 30 °C air. The control (CON) CST involved 12 min gentle exercise prior to immersing the foot into 15 °C water for 2 min followed by 15 min of spontaneous rewarming. The occlusion (OCC) CST was the same except that blood flow to the foot was occluded during the rewarming period. These results were compared to CSTs from six individuals with non-freezing cold injury and moderate-severe cold sensitivity (CS) and a non-perfused human digit model (NPDM). Before immersion, great toe skin blood flow (SkBF) was similar in CON and OCC conditions [255 (107) laser Doppler units (LDU)] and was higher than CS [59 (52) LDU]. During rewarming, SkBF in CON returned to 104 % of the pre-immersion value and was higher than both OCC and CS. Great toe T sk before immersion was lower in CS [28.5 (2.1) °C] compared to CON [34.7 (0.4) °C], OCC [34.6 (0.9) °C] and NPDM [35.0 (0.4) °C]. During rewarming skin/surface temperature in OCC, CS and NPDM were similar and all lower than CON. SkBF does contribute to the skin rewarming profile during a CST as a faster rate of rewarming was observed in CON compared to either OCC or NPDM. The lower T sk in CS may be due to a reduced basal SkBF.

  4. The sensitization potential of sunscreen after ablative fractional skin resurfacing using modified human repeated insult patch test.

    PubMed

    Boonchai, Waranya; Sathaworawong, Angkana; Wongpraparut, Chanisada; Wanitphakdeedecha, Rungsima

    2015-10-01

    Ablative fractional skin resurfacing has become popular and proven to be useful in treating scars, photoaging and wrinkles. Although post-inflammatory hyperpigmentation (PIH) is the most common complication especially in dark-skinned patients like Asian. Several modalities have been used to overcome the PIH. To determine the sensitization potential of sunscreen applied immediately after ablative fractional skin resurfacing. Sixty volunteers were recruited. Of these 30 subjects were from previous ablative fractional skin resurfacing study who applied broad-spectrum sunscreen containing anti-inflammatory agent starting on the first day after resurfacing and another 30 non-resurfacing subjects had applied the same sunscreen on the intact skin. All subjects were patch/photopatch tested for sensitization study by using modified human repeated insult patch test (HRIPT). There were significantly higher sensitization rate of UV-filter, octocrylene and the sunscreen in resurfacing group than in non-resurfacing group. Early application of sunscreen after ablative fractional skin resurfacing has increased the incidence of sensitization potential of sunscreen. The sunscreen is recommended to start using from D3 after fractional ablative skin resurfacing to ensure the complete recovery of skin barrier and minimize the risk of sensitization.

  5. Opisthorchis felineus negatively associates with skin test reactivity in Russia-EuroPrevall-International Cooperation study.

    PubMed

    Fedorova, O S; Janse, J J; Ogorodova, L M; Fedotova, M M; Achterberg, R A; Verweij, J J; Fernández-Rivas, M; Versteeg, S A; Potts, J; Minelli, C; van Ree, R; Burney, P; Yazdanbakhsh, M

    2017-07-01

    Most studies on the relationship between helminth infections and atopic disorders have been conducted in (sub)tropical developing countries where exposure to multiple parasites and lifestyle can confound the relationship. We aimed to study the relationship between infection with the fish-borne helminth Opishorchis felineus and specific IgE, skin prick testing, and atopic symptoms in Western Siberia, with lifestyle and hygiene standards of a developed country. Schoolchildren aged 7-11 years were sampled from one urban and two rural regions. Skin prick tests (SPT) and specific IgE (sIgE) against food and aeroallergens were measured, and data on allergic symptoms and on demographic and socioeconomic factors were collected by questionnaire. Diagnosis of opisthorchiasis was based on PCR performed on stool samples. Of the 732 children included, 34.9% had opisthorchiasis. The sensitization to any allergen when estimated by positive SPT was 12.8%, while much higher, 24.0%, when measured by sIgE. Atopic symptoms in the past year (flexural eczema and/or rhinoconjunctivitis) were reported in 12.4% of the children. SPT was positively related to flexural eczema and rhinoconjunctivitis, but not to wheezing. Opisthorchiasis showed association with lower SPT response, as well as borderline association with low IgE reactivity to any allergen. However, the effect of opisthorchiasis on SPT response was not mediated by IgE, suggesting that opisthorchiasis influences SPT response through another mechanism. Opisthorchiasis also showed borderline association with lower atopic symptoms. There is a negative association between a chronic helminth infection and skin prick test reactivity even in a developed country. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Autologous serum and plasma skin test to predict 2-year outcome in chronic spontaneous urticaria

    PubMed Central

    Sangasapaviliya, Atik

    2016-01-01

    Background Autologous serum skin test (ASST) and autologous plasma skin test (APST) are simple methods to diagnose autoimmune chronic urticaria. However, the association data of ASST or APST with disease severity and long-term outcome are still unclear. Objective The results of ASST and APST might be used to predict urticaria symptom severity and long-term outcomes among chronic spontaneous urticaria (CSU) patients. Methods We evaluated the prevalence of reactive ASST and APST in 128 CSU patients. The patients were characterized by 4 groups: negative, ASST positive, APST positive, and both ASST and APST positive. We observed remission rate among the CSU patients during 2 years. Results Forty-four of 128 CSU patients (34%) had negative autologous skin test. The CSU patients with positive ASST, positive APST, and both positive ASST and APST were 47 (37%), 6 (5%), and 31 (24%), respectively. No significant difference was found between the groups according to urticaria severity score (USS) and dermatology life quality index (DLQI). Mean wheal diameter of ASST showed positive correlation with DLQI. Also, mean wheal diameter of APST showed positive correlation with USS and DLQI. Both the positive ASST and APST groups had a high proportion of 4-fold dose of H1-antihistamine than the positive ASST (p = 0.03) and negative groups (p = 0.0009). The rate of remission over 2 years in the negative, positive ASST, positive APST, and both positive ASST and APST groups were 81.1%, 62.3%, 60%, and 46.1%, respectively. The urticaria remission rate in patients in the negative group was significantly higher compared with both positive ASST and APST groups (odds ratio, 5.0; 95% confidence interval, 1.61–15.44; p = 0.006). Conclusion ASST and APST results could predict remission rates among patients with CSU. Our results suggested investigating ASST and APST among CSU patients before starting treatment. PMID:27803883

  7. Immediate hypersensitivity to penicillins with negative skin tests--the value of specific IgE.

    PubMed

    Silva, R; Cruz, L; Botelho, C; Castro, E; Cadinha, S; Castel-Branco, M G; Rodrigues, J

    2009-08-01

    The determination of specific IgE in patients with history of penicillins hypersensitivity is simple, safe and widely available. The positive and negative predictive values of this determination, however, are not yet established. In order to evaluate them, we performed specific IgE determination and diagnostic drug challenges in a group of 22 patients with a clear history of immediate penicillins hypersensitivity but negative skin tests. In this sample, the positive and negative predictive values were 29% and 87%, respectively. This seems to indicate that a positive specific IgE is not enough to confirm the diagnosis, and further study is necessary.

  8. Testing Human Skin and Respiratory Sensitizers—What Is Good Enough?

    PubMed Central

    Malmborg, Anki; Borrebaeck, Carl A. K.

    2017-01-01

    Alternative methods for accurate in vitro assessment of skin and respiratory sensitizers are urgently needed. Sensitization is a complex biological process that cannot be evaluated accurately using single events or biomarkers, since the information content is too restricted in these measurements. On the contrary, if the tremendous information content harbored in DNA/mRNA could be mined, most complex biological processes could be elucidated. Genomic technologies available today, including transcriptional profiling and next generation sequencing, have the power to decipher sensitization, when used in the right context. Thus, a genomic test platform has been developed, denoted the Genomic Allergen Rapid Detection (GARD) assay. Due to the high informational content of the GARD test, accurate predictions of both the skin and respiratory sensitizing capacity of chemicals, have been demonstrated. Based on a matured dendritic cell line, acting as a human-like reporter system, information about potency has also been acquired. Consequently, multiparametric diagnostic technologies are disruptive test principles that can change the way in which the next generation of alternative methods are designed. PMID:28125016

  9. Skin prick testing with standardized extracts from 3 different manufacturers. A comparative randomized study.

    PubMed

    Nielsen, N H; Dirksen, A; Mosbech, H; Launbjerg, J; Biering, I; Søborg, M

    1992-01-01

    The aim of this study was to compare skin reactivity to routine allergen prick test with panels of allergens, supplied by three different manufacturers. The allergens comprised ten aero-allergens commonly used for skin prick test in Northern Europe, and included pollen, dander, house dust mites, and moulds. Two hundred consecutive patients were tested. The methods for standardization of allergen extracts, declaration of allergenic potency, and recommended lancets differed. The equipment were Soluprick SQ (Allergologisk Laboratorium A/S, Denmark) (ALK), Alphatest (Dome/Hollister-Stier, U.K.) (DHS), and Phazet (Pharmacia, Sweden) (PHA). The coefficient of variation for the allergen coated PHA (same lancet was applied twice) was 0.31, and for ALK and DHS allergen extracts 0.13 and 0.18, respectively. The frequencies of patients with positive reactions to the various allergens were generally similar, although DHS appeared to elicit less positive reactions to Timothy, dog, and Dermatophagoides pteronnyssinus. For the individual physician, it may be important to know the allergenic activity of the different allergens in his routine panel compared to the activity in other similar panels.

  10. Implementation of an Infectious Disease Fellow-Managed Penicillin Allergy Skin Testing Service.

    PubMed

    Heil, Emily L; Bork, Jacqueline T; Schmalzle, Sarah A; Kleinberg, Michael; Kewalramani, Anupama; Gilliam, Bruce L; Buchwald, Ulrike K

    2016-09-01

    Background.  A large percentage of patients presenting to acute care facilities report penicillin allergies that are associated with suboptimal antibiotic therapy. Penicillin skin testing (PST) can clarify allergy histories but is often limited by access to testing. We aimed to implement an infectious diseases (ID) fellow-managed PST program and to assess the need for PST via national survey. Methods.  We conducted a prospective observational study of the implementation of an ID fellow-managed penicillin allergy skin testing service. The primary outcome of the study was to assess the feasibility and acceptability of an ID fellow-managed PST service and its impact on the optimization of antibiotic selection. In addition, a survey of PST practices was sent out to all ID fellowship program directors in the United States. Results.  In the first 11 months of the program, 90 patients were assessed for PST and 76 patients were tested. Of the valid tests, 96% were negative, and 84% with a negative test had antibiotic changes; 63% received a narrower spectrum antibiotic, 80% received more effective therapy, and 61% received more cost-effective therapy. The majority of survey of respondents (n = 50) indicated that overreporting of penicillin allergy is a problem in their practice that affects antibiotic selection but listed inadequate personnel and time as the main barriers to PST. Conclusions.  Inpatient PST can be successfully managed by ID fellows, thereby promoting optimal antibiotic use in patients reporting penicillin allergies. This model can increase access to PST at institutions without adequate access to allergists while also providing an important educational experience to ID trainees.

  11. Activation of blood coagulation in plasma from chronic urticaria patients with negative autologous plasma skin test.

    PubMed

    Asero, R; Cugno, M; Tedeschi, A

    2011-02-01

    Skin reactivity to the intradermal injection of autologous serum (autologous serum skin test - ASST) and/or plasma (autologous plasma skin test - APST) is thought to identify chronic urticaria (CU) patients with an autoimmune/autoreactive disease. Immune-mediated inflammation and coagulation are strictly linked, and coagulation activation has been described in CU patients as shown by the elevation of plasma prothrombin fragment F1+2 and, in severe cases, of d-dimer as well. The aim of this study was to evaluate whether the coagulation cascade is activated in APST-negative CU patients as it has been described in CU patients with an autoreactive disease. A total of 43 adults with CU (M/F 15/28; mean age 43.5 years; 16 APST-negative patients and 27 APST-positive) and 30 healthy subjects were studied. Prothrombin fragment F1+2, d-dimer and C-reactive protein (CRP) plasma levels were measured by ELISA. Prothrombin fragment F1+2 and d-dimer were elevated in seven of 16 APST-negative CU patients. The activation of the coagulation cascade was associated with disease severity. Men were more prevalent in idiopathic than in autoreactive CU patients (M/F: 10/6 vs. 5/22; P<0.001). In patients with APST-negative CU, mean F1 + 2 level [242.8 ± 33.7 pmol/L (ESM)] was higher than in normal controls (151.8 ± 9.09 pmol/L; P=0.002) but lower than in autoreactive patients (526.2 ± 97.8 pmol/L; P=0.05). Similarly, mean d-dimer level was higher than in normal controls (484.2 ± 148.3 ng/mL vs. 229.5 ± 16.7 ng/mL; P=0.03) but lower than in autoreactive patients (1142.2 ± 317.4 ng/mL; P=0.05). In contrast, mean CRP was lower than in autoreactive patients (1.06 ± 0.32 μg/mL vs. 3.09 ± 0.74 μg/mL; P=0.02) but not different from normal subjects (0.78 ± 0.09 μg/mL; NS). Autologous plasma skin test-negative CU prevails in men; in these patients the coagulation cascade is activated although with a lower intensity than in patients with autoreactive disease. © 2010 The Authors. Journal

  12. The longest wheal diameter is the optimal measurement for the evaluation of skin prick tests.

    PubMed

    Konstantinou, George N; Bousquet, Philippe-Jean; Zuberbier, Torsten; Papadopoulos, Nikolaos G

    2010-01-01

    Mean diameter or longest diameter are the 2 most frequently used parameters for wheal response assessment after skin prick testing (SPT). We aimed to compare these 2 parameters taking as gold standard the surface of the wheal skin response. Patients suspected of having an allergic reaction against inhalant allergens have been skin prick tested using the Pan-European GA(2)LEN SPT panel. Fifteen minutes later, macroscopically evident wheal and flare reactions were marked with a pen and transferred to paper with a transparent scotch tape. Each paper-transferred wheal was scanned with an ordinary scanner, and its surface-corresponding maximum perpendicular diameters and longest diameters were measured using a computer software application for image recognition, developed for this purpose. Correlation coefficients (Spearman's rho) between surfaces and respective mean (rho(mean)) or longest (rho(longest)) diameters were calculated and subsequently compared. 1,554 SPTs were performed in 74 patients. In 264, a macroscopically evident wheal and flare response was observed. Both mean and longest diameters correlated significantly with the wheal surfaces. However, rho(longest) was statistically significantly larger than rho(mean) when the surface of the wheal was >17 mm(2) (rho(longest) > 0.860 vs. rho(mean) < 0.660; p < 0.05).Such a surface corresponds to a maximum diameter of approximately 7 mm and a mean diameter of approximately 6 mm. Thus, the larger the surface of the wheal, the more appropriate the usage of the longest diameter. The longest wheal diameter alone seems to be a better surrogate marker of the wheal surface in comparison with the mean diameter. In addition, it is easier and faster to measure. Therefore, we propose this as the optimal methodology to evaluate SPTs. 2009 S. Karger AG, Basel.

  13. Bayesian integrated testing strategy to assess skin sensitization potency: from theory to practice.

    PubMed

    Jaworska, Joanna; Dancik, Yuri; Kern, Petra; Gerberick, Frank; Natsch, Andreas

    2013-11-01

    Frameworks to predict in vivo effects by integration of in vitro, in silico and in chemico information using mechanistic insight are needed to meet the challenges of 21(st) century toxicology. Expert-based approaches that qualitatively integrate multifaceted data are practiced under the term 'weight of evidence', whereas quantitative approaches remain rare. To address this gap we previously developed a methodology to design an Integrated Testing Strategy (ITS) in the form of a Bayesian Network (BN). This study follows up on our proof of concept work and presents an updated ITS to assess skin sensitization potency expressed as local lymph node assay (LLNA) potency classes. Modifications to the ITS structure were introduced to include better mechanistic information. The parameters of the updated ITS were calculated from an extended data set of 124 chemicals. A detailed validation analysis and a case study were carried out to demonstrate the utility of the ITS for practical application. The improved BN ITS predicted correctly 95% and 86% of chemicals in a test set (n = 21) for hazard and LLNA potency classes, respectively. The practical value of using the BN ITS is far more than a prediction framework when all data are available. The BN ITS can develop a hypothesis using subsets of data as small as one data point and can be queried on the value of adding additional tests before testing is commenced. The ITS represents key steps of the skin sensitization process and a mechanistically interpretable testing strategy can be developed. These features are illustrated in the manuscript via practical examples.

  14. Tuberculosis and tuberculin skin test reactivity in pediatric patients with celiac disease.

    PubMed

    Urganci, Nafiye; Kalyoncu, Derya

    2017-02-01

    The aim of the study was to determine tuberculin skin test reactivity and associated factors in pediatric patients with celiac disease (CD). Tuberculin skin test (TST) was performed on 28 patients with CD aged from 1 year to 15 years (mean, 6.64±4.8) and 28 healthy age and sex-matched children. The association between TST reactivity and parameters such as age, gender, malnutrition, clinical presentation, compliance to gluten free diet and response to hepatitis A and B vaccinations were determined. No difference was observed in TST reactivity (induration size) between the patients with CD and healthy controls. Thirty-two percent (9/28) of the patients were anergic, and one-third of these nine patients had malnutrition. No significant difference was observed between TST-positive and TST-negative patients in terms of age, gender, malnutrition, compliance to gluten-free diet and response to hepatitis A and B vaccinations (P>0.05). One of 11 patients with positive TST had tuberculosis disease and 10 had latent tuberculosis infection (LTBI), whereas none of the controls had LTBI or tuberculosis disease (P=0.0007). Although based on a small number of cases, it seems that children with CD are more susceptible to tuberculosis than healthy children. TST can be used to identify BCG-vaccinated children with CD who are probably infected with M. tuberculosis, similarly to healthy children.

  15. How biophysical in vivo testing techniques can be used to characterize full thickness skin equivalents.

    PubMed

    Houcine, A; Delalleau, A; Heraud, S; Guiraud, B; Payre, B; Duplan, H; Delisle, M-B; Damour, O; Bessou-Touya, S

    2016-08-01

    The reliability of the biophysical properties of skin equivalents (SEs) remains a challenge for medical applications and for product efficacy tests following the European Directive 2003/15/EC2 on the prohibition of animal experiments for cosmetic products. We propose to adapt the biophysical in vivo testing techniques to compare full thickness model growth vs. time. The interest in using such techniques lies in possible comparisons between in vivo and in vitro skin as well as monitoring samples over the culture time. High frequency ultrasound technique, optical coherence tomography (OCT), and laser scanning microscopy were used to analyze SEs morphology at days D42 and D60 whereas their microstructure was assessed through transmission electron microscopy and classical histology. A correlation between these observations and mechanical measurements has been proposed so as to underline the consequence of both the development of the dermis elastic fibers and the epidermis differentiation. Ultrasounds measurements show a highly homogeneous dermis whereas the OCT technique clearly distinguishes the stratum corneum and the living epidermis. The increase in the thicknesses of these layers as well as the growth in elastin and collagen fibers results in strong modifications of the samples mechanical properties. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Skin test hypersensitivity study of a cross-linked, porcine collagen implant for aesthetic surgery.

    PubMed

    Shoshani, David; Markovitz, Elana; Cohen, Yael; Heremans, Annie; Goldlust, Arie

    2007-12-01

    The use of bovine collagen implants for dermal contour correction is associated with a 3% to 5% incidence of hypersensitivity, which necessitates pretreatment screening by an intradermal skin test. The objective was to determine the incidence of hypersensitivity with the recently developed cross-linked, porcine collagen implant, EVOLENCE (ColBar LifeScience Ltd.), which is used intradermally for correction of rhytids and scars. Enrolled subjects (n=530) received an intradermal injection of 0.1 mL EVOLENCE implant in the left forearm and a second injection in the right forearm after 2 weeks. Injection sites were assessed clinically at 30 minutes and 72 hours after each injection and at 30 days after the second injection. Serum anticollagen antibody determinations were performed at screening and at the end of the study. Study assessments were completed by 519 subjects. No significant erythematous reactions suggestive of positive hypersensitivity were observed. Most subjects did not display antibodies against porcine Type I collagen at any time, and those who did showed no changes in levels during the study. The single-sided 95% upper confidence limit for the possibility of moderate-to-severe erythematous reactions with the EVOLENCE implant was determined as 0.58% of subjects. Because the EVOLENCE implant has a low potential for hypersensitivity, intradermal skin testing before its use appears unnecessary.

  17. Enhanced anti-mycobacterial immunity in children with erythema nodosum and a positive tuberculin skin test.

    PubMed

    Nicol, Mark P; Kampmann, Beate; Lawrence, Patricia; Wood, Kathy; Pienaar, Sandy; Pienaar, David; Eley, Brian; Levin, Michael; Beatty, David; Anderson, Suzanne T B

    2007-09-01

    Erythema nodosum (EN) may follow a variety of infections, but in regions with a high prevalence of tuberculosis, is frequently associated with a positive tuberculin skin test (TST) and tuberculosis infection. We aimed to investigate the immunological differences between patients with EN as a manifestation of primary tuberculosis, and those with progressive pulmonary tuberculosis (PTB) or asymptomatic infection. We studied the inflammatory response to both mycobacterial and non-mycobacterial antigens in 11 children with EN associated with a positive TST, 22 children with culture-confirmed tuberculosis, and 53 healthy skin test-positive children. In addition, we evaluated functional anti-mycobacterial immunity using an ex vivo assay of mycobacterial growth restriction in five children with EN and 15 with PTB. Patients with EN were distinguished by enhanced mycobacterial growth restriction on the functional assay, which was associated with a markedly increased production of IFNgamma in response to stimulation with purified protein derivative of Mycobacterium tuberculosis. Children presenting with EN and a positive TST show evidence of responses associated with enhanced anti-mycobacterial immunity.

  18. Intraoperative anaphylaxis to sugammadex and a protocol for intradermal skin testing.

    PubMed

    Sadleir, P H M; Russell, T; Clarke, R C; Maycock, E; Platt, P R

    2014-01-01

    Sugammadex is a selective binding agent for aminosteroid neuromuscular blockers whose use is increasing in anaesthetic practice. We present three cases of severe anaphylaxis coincident with sugammadex administration. Subsequent intradermal testing confirmed sugammadex as the triggering agent, with all patients having positive skin responses to a 1:100 dilution of the standard 100 mg/ml solution and two out of three having a positive response to a 1:1000 dilution. As all patients were administered sugammadex to reverse neuromuscular blockade with rocuronium, we considered that sugammadex-rocuronium complexes were a potential unique allergen. In the two patients who were additionally tested with a rocuronium-sugammadex (3.6:1 molecular ratio) mixture, the wheal-and-flare response was significantly attenuated.

  19. Development of an in vitro dendritic cell-based test for skin sensitizer identification.

    PubMed

    Neves, Bruno Miguel; Rosa, Susana Carvalho; Martins, João Demétrio; Silva, Ana; Gonçalo, Margarida; Lopes, Maria Celeste; Cruz, Maria Teresa

    2013-03-18

    The sensitizing potential of chemicals is currently assessed using animal models. However, ethical and economic concerns and the recent European legislative framework triggered intensive research efforts in the development and validation of alternative methods. Therefore, the aim of this study was to develop an in vitro predictive test based on the analysis and integration of gene expression and intracellular signaling profiles of chemical-exposed skin-derived dendritic cells. Cells were treated with four known sensitizers and two nonsensitizers, and the effects on the expression of 20 candidate genes and the activation of MAPK, PI3K/Akt, and NF-κB signaling pathways were analyzed by real-time reverse transcription polymerase chain reaction and Western blotting, respectively. Genes Trxr1, Hmox1, Nqo1, and Cxcl10 and the p38 MAPK and JNK signaling pathways were identified as good predictor variables and used to construct a dichotomous classifier. For validation of the model, 12 new chemicals were then analyzed in a blind assay, and from these, 11 were correctly classified. Considering the total of 18 compounds tested here, 17 were correctly classified, representing a concordance of 94%, with a sensitivity of 92% (12 of 13 sensitizers identified) and a specificity of 100% (5 of 5 nonsensitizers identified). Additionally, we tested the ability of our model to discriminate sensitizers from nonallergenic but immunogenic compounds such as lipopolysaccharide (LPS). LPS was correctly classified as a nonsensitizer. Overall, our results indicate that the analysis of proposed gene and signaling pathway signatures in a mouse fetal skin-derived dendritic cell line represents a valuable model to be integrated in a future in vitro test platform.

  20. Multiple Skin Colored Nodules on both Legs in Patient with Positive QuantiFERON®-TB Gold Test

    PubMed Central

    Choi, Mi Soo; Hong, Seung Phil; Park, Byung Cheol

    2017-01-01

    Nodular tuberculid (NT) was originally described by Jordaan et al. in 2000 in 4 patients from South Africa. It appeared as nodules on the legs; the pathologic changes were situated in the deep dermis and adjacent subcutaneous fat. A 34-year-old woman visited our hospital with subcutaneous skin-colored or slightly erythematous round to oval nodules. Skin biopsies revealed granulomatous inflammation at the dermo-subcutaneous junction with vasculitis. Chest X-ray, tuberculosus (TB)-polymerase chain reaction and TB culture of the skin specimen were normal. A QuantiFERON®-TB Gold test (QUIAGEN, Germany) was positive, which suggested a diagnosis of latent TB infection. The patient was treated with anti-TB medication and her condition has not recurred. Herein, we report a case of a patient with latent TB diagnosed by a positive QuantiFERON®-TB Gold test whose skin lesions had the clinical and histopathologic features of NT. PMID:28223755

  1. Multiple Skin Colored Nodules on both Legs in Patient with Positive QuantiFERON®-TB Gold Test.

    PubMed

    Choi, Mi Soo; Hong, Seung Phil; Park, Byung Cheol; Kim, Myung Hwa

    2017-02-01

    Nodular tuberculid (NT) was originally described by Jordaan et al. in 2000 in 4 patients from South Africa. It appeared as nodules on the legs; the pathologic changes were situated in the deep dermis and adjacent subcutaneous fat. A 34-year-old woman visited our hospital with subcutaneous skin-colored or slightly erythematous round to oval nodules. Skin biopsies revealed granulomatous inflammation at the dermo-subcutaneous junction with vasculitis. Chest X-ray, tuberculosus (TB)-polymerase chain reaction and TB culture of the skin specimen were normal. A QuantiFERON®-TB Gold test (QUIAGEN, Germany) was positive, which suggested a diagnosis of latent TB infection. The patient was treated with anti-TB medication and her condition has not recurred. Herein, we report a case of a patient with latent TB diagnosed by a positive QuantiFERON®-TB Gold test whose skin lesions had the clinical and histopathologic features of NT.

  2. Skin sensitisation: the Colipa strategy for developing and evaluating non-animal test methods for risk assessment.

    PubMed

    Maxwell, Gavin; Aeby, Pierre; Ashikaga, Takao; Bessou-Touya, Sandrine; Diembeck, Walter; Gerberick, Frank; Kern, Petra; Marrec-Fairley, Monique; Ovigne, Jean-Marc; Sakaguchi, Hitoshi; Schroeder, Klaus; Tailhardat, Magali; Teissier, Silvia; Winkler, Petra

    2011-01-01

    Allergic contact dermatitis is a delayed-type hypersensitivity reaction induced by small reactive chemicals (haptens). Currently, the sensitising potential and potency of new chemicals is usually characterised using data generated via animal studies, such as the local lymph node assay (LLNA). There are, however, increasing public and political concerns regarding the use of animals for the testing of new chemicals. Consequently, the development of in vitro, in chemico or in silico models for predicting the sensitising potential and/or potency of new chemicals is receiving widespread interest. The Colipa Skin Tolerance task force currently collaborates with and/or funds several academic research groups to expand our understanding of the molecular and cellular events occurring during the acquisition of skin sensitisation. Knowledge gained from this research is being used to support the development and evaluation of novel alternative approaches for the identification and characterisation of skin sensitizing chemicals. At present three non-animal test methods (Direct Peptide Reactivity Assay (DPRA), Myeloid U937 Skin Sensitisation Test (MUSST) and human Cell Line Activation Test (hCLAT)) have been evaluated in Colipa interlaboratory ring trials for their potential to predict skin sensitisation potential and were recently submitted to ECVAM for formal pre-validation. Data from all three test methods will now be used to support the study and development of testing strategy approaches for skin sensitiser potency prediction. This publication represents the current viewpoint of the cosmetics industry on the feasibility of replacing the need for animal test data for informing skin sensitisation risk assessment decisions.

  3. Irritation and allergy patch test analysis of topical treatments commonly used in wound care: evaluation on normal and compromised skin.

    PubMed

    Trookman, Nathan S; Rizer, Ronald L; Weber, Teresa

    2011-03-01

    Topical agents indicated for the treatment of superficial wounds have the potential to cause irritation or allergic contact dermatitis, particularly when applied to an impaired skin barrier. We sought to compare the irritancy potential of 5 topical wound care products commonly used in dermatologic practice on normal and compromised skin. Agents tested included Aquaphor Healing Ointment (AHO) (Beiersdorf Inc, Wilton, CT); bacitracin; Biafine Topical Emulsion (BTE) (OrthoNeutrogena, Los Angeles, CA); Neosporin (Poly/Bac/Neo) (Johnson & Johnson, New Brunswick, NJ); and Polysporin (Poly/Bac) (Johnson & Johnson). Study 1 assessed cumulative irritation using a modified human repeat insult patch test on normal back skin with an induction phase (test materials applied under occlusive patch 9 times at 48- to 72-hour intervals) and a challenge phase (test materials applied to original and naïve sites for 48 hours, 12-24 days postinduction). Irritation was graded for erythema and type IV allergy skin responses. Study 2 assessed the acute irritation potential of agents on tape-stripped ("wounded") back skin. Test sites were graded for erythema, transepidermal water loss, and skin color (Chroma Meter a∗) (Minolta, Osaka, Japan) at 48 and 72 hours poststripping. In study 1, cumulative irritation testing in 108 subjects classified AHO, bacitracin, Poly/Bac/Neo, and Poly/Bac as "mild," and BTE as "probably mild." In study 2 at 72 hours, mean clinical grading scores were significantly higher for BTE and Poly/Bac/Neo than AHO. Transepidermal water loss and colorimeter a∗ values were significantly lower for AHO and bacitracin compared with BTE. No allergic contact dermatitis was seen in either study. Patch test studies demonstrated that BTE showed the greatest irritancy potential in both normal and compromised skin whereas AHO showed the least. Copyright © 2010 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  4. Assessment of the human epidermal model LabCyte EPI-MODEL for In vitro skin corrosion testing according to the OECD test guideline 431.

    PubMed

    Katoh, Masakazu; Hamajima, Fumiyasu; Ogasawara, Takahiro; Hata, Ken-Ichiro

    2010-06-01

    A new OECD test guideline 431 (TG431) for in vitro skin corrosion tests using human reconstructed skin models was adopted by OECD in 2004. TG431 defines the criteria for the general function and performance of applicable skin models. In order to confirm that the new reconstructed human epidermal model, LabCyte EPI-MODEL is applicable for the skin corrosion test according to TG431, the predictability and repeatability of the model for the skin corrosion test was evaluated. The test was performed according to the test protocol described in TG431. Based on the knowledge that LabCyte EPI-MODEL is an epidermal model as well as EpiDerm, we decided to adopt the the Epiderm prediction model of skin corrosion for the LabCyte EPI-MODEL, using twenty test chemicals (10 corrosive chemicals and 10 non-corrosive chemicals) in the 1(st) stage. The prediction model results showed that the distinction of non-corrosion to corrosion corresponded perfectly. Therefore, it was judged that the prediction model of EpiDerm could be applied to the LabCyte EPI-MODEL. In the 2(nd) stage, the repeatability of this test protocol with the LabCyte EPI-MODEL was examined using twelve chemicals (6 corrosive chemicals and 6 non-corrosive chemicals) that are described in TG431, and these results recognized a high repeatability and accurate predictability. It was concluded that LabCyte EPI-MODEL is applicable for the skin corrosive test protocol according to TG431.

  5. Comparison of mantoux and tine tuberculin skin tests in BCG-vaccinated children investigated for tuberculosis.

    PubMed

    Pan, Wenli; Matizirofa, Lyness; Workman, Lesley; Hawkridge, Tony; Hanekom, Willem; Mahomed, Hassan; Hussey, Gregory; Hatherill, Mark

    2009-11-30

    Tuberculin skin tests (TSTs) are long-established screening methods for tuberculosis (TB). We aimed to compare agreement between the intradermal Mantoux and multipuncture percutaneous Tine methods and to quantify risk factors for a positive test result. 1512 South African children younger than 5 years of age who were investigated for tuberculosis (TB) during a Bacille Calmette Guerin (BCG) trial were included in this analysis. Children underwent both Mantoux and Tine tests. A positive test was defined as Mantoux >or=15 mm or Tine >or= Grade 3 for the binary comparison. Agreement was evaluated using kappa (binary) and weighted kappa (hierarchical). Multivariate regression models identified independent risk factors for TST positivity. The Mantoux test was positive in 430 children (28.4%) and the Tine test in 496 children (32.8%, p<0.0001), with observed binary agreement 87.3% (kappa 0.70) and hierarchical agreement 85.0% (weighted kappa 0.66). Among 173 children culture-positive for Mycobacterium tuberculosis, Mantoux was positive in 49.1% and Tine in 54.9%, p<0.0001 (kappa 0.70). Evidence of digit preference was noted for Mantoux readings at 5 mm threshold intervals. After adjustment for confounders, a positive culture, suggestive chest radiograph, and proximity of TB contact were risk factors for a positive test using both TST methods. There were no independent associations between ethnicity, gender, age, or over-crowding, and TST result. The Tine test demonstrated a higher positive test rate than the Mantoux, with substantial agreement between TST methods among young BCG-vaccinated children. TB disease and exposure factors, but not demographic variables, were independent risk factors for a positive result using either test method. These findings suggest that the Tine might be a useful screening tool for childhood TB in resource-limited countries.

  6. Beyond skin testing: state of the art and new horizons in food allergy diagnostic testing.

    PubMed

    Caubet, Jean-Christoph; Sampson, Hugh A

    2012-02-01

    Food allergy affects approximately 1% to 10.8% of the general population, and its prevalence seems to be increasing. An accurate diagnosis is particularly important because a misdiagnosis could lead to life-threatening reactions or to unnecessary restrictive diets. However, allergy tests currently used in clinical practice have limited accuracy, and an oral food challenge, considered as the gold standard, is often required to confirm or exclude a food allergy. This article reviews several promising novel approaches for the diagnosis of food allergy, such as new molecular diagnostic technologies and functional assays, along with their potential clinical applications.

  7. Comparison of interferon-gamma release assay versus tuberculin skin test for tuberculosis screening in inflammatory bowel disease.

    PubMed

    Schoepfer, Alain M; Flogerzi, Beatrice; Fallegger, Silvia; Schaffer, Thomas; Mueller, Stefan; Nicod, Laurent; Seibold, Frank

    2008-11-01

    Reactivation of latent tuberculosis (TB) in inflammatory bowel disease (IBD) patients treated with antitumor necrosis factor-alpha medication is a serious problem. Currently, TB screening includes chest x-rays and a tuberculin skin test (TST). The interferon-gamma release assay (IGRA) QuantiFERON-TB Gold In-Tube (QFT-G-IT) shows better specificity for diagnosing TB than the skin test. This study evaluates the two test methods among IBD patients. Both TST and IGRA were performed on 212 subjects (114 Crohn's disease, 44 ulcerative colitis, 10 indeterminate colitis, 44 controls). Eighty-one percent of IBD patients were under immunosuppressive therapy; 71% of all subjects were vaccinated with Bacille Calmette Guérin; 18% of IBD patients and 43% of controls tested positive with the skin test (P < 0.0001). Vaccinated controls tested positive more often with the skin test (52%) than did vaccinated IBD patients (23%) (P = 0.011). Significantly fewer immunosuppressed patients tested positive with the skin test than did patients not receiving therapy (P = 0.007); 8% of patients tested positive with the QFT-G-IT test (14/168) compared to 9% (4/44) of controls. Test agreement was significantly higher in the controls (P = 0.044) compared to the IBD group. Agreement between the two test methods is poor in IBD patients. In contrast to the QFT-G-IT test, the TST is negatively influenced by immunosuppressive medication and vaccination status, and should thus be replaced by the IGRA for TB screening in immunosuppressed patients having IBD.

  8. Clinical and Demographic Stratification of Test Performance: A Pooled Analysis of Five Laboratory Diagnostic Methods for American Cutaneous Leishmaniasis

    PubMed Central

    Boggild, Andrea K.; Ramos, Ana P.; Espinosa, Diego; Valencia, Braulio M.; Veland, Nicolas; Miranda-Verastegui, Cesar; Arevalo, Jorge; Low, Donald E.; Llanos-Cuentas, Alejandro

    2010-01-01

    We evaluated performance characteristics of five diagnostic methods for cutaneous leishmaniasis. Patients who came to the Leishmania Clinic of Hospital Nacional Cayetano Heredia in Lima, Peru, were enrolled in the study. Lesion smears, culture, microculture, polymerase chain reaction (PCR), and leishmanin skin test (LST) were performed. A total of 145 patients with 202 lesions were enrolled: 114 patients with 161 lesions fulfilled criteria for cutaneous leishmaniasis. Sensitivity and specificity were 57.8% (95% confidence interval [CI] = 50.2–65.4%) and 100.0% for culture, 78.3% (95% CI = 71.9–84.7%) and 100.0% for microculture, 71.4% (95% CI = 64.4–78.4%) and 100.0% for smears, 78.2% (95% CI = 70.6–85.8%) and 77.4% (95% CI = 62.7–92.1%) for LST, and 96.9% (95% CI = 94.2–99.6%) and 65.9% (95% CI = 51.4–80.4%) for PCR. PCR was more sensitive than the other assays (P < 0.001). Sensitivities of culture, smears, and LST varied by lesion duration and appearance. PCR offers performance advantages over other assays, irrespective of patient age, sex, lesion duration, or appearance. That clinical factors influence performance of non-molecular assays offers clinicians a patient-focused approach to diagnostic test selection. PMID:20682880

  9. Comparative assessment of the acute skin irritation potential of detergent formulations using a novel human 4-h patch test method.

    PubMed

    Robinson, Michael K; Kruszewski, Francis H; Al-Atrash, Jenan; Blazka, Mark E; Gingell, Ralph; Heitfeld, Fred A; Mallon, David; Snyder, Neil K; Swanson, Judith E; Casterton, Phillip L

    2005-12-01

    Predictive skin irritation test methods, which do not require use of animals, are needed for the pre-market assessment of detergent formulations. The utility of a novel and ethical human acute skin irritation patch test method, originally developed for chemical skin irritation assessment, was evaluated. In this IRB-approved method, subjects were patched under occlusion for increasing periods of time up to 4h in duration. The total incidence of positive skin reactions for test products was compared to a positive control (20% aqueous sodium dodecyl sulfate [SDS]). Acutely irritating formulas were defined as those showing a significantly increased or equal incidence of positive responders compared with that of SDS. The time of exposure required for 50% of subjects to show a positive skin reaction (TR50 value) was calculated for each product and enabled test product comparisons within and between studies. Using this approach, 24 detergent formulations of various types were tested in seven individual studies. The skin irritation profiles were generally consistent within product types, which could be categorized as follows (by decreasing irritancy): mold/mildew removers (average TR50 = 0.37 h) > disinfectants/sanitizers (0.64 h) > fabric softener concentrate (1.09 h) = aluminum wash (1.20 h) > 20% SDS (1.81 h) > liquid laundry detergents (3.48 h) > liquid dish detergents (4.16 h) = liquid fabric softeners (4.56 h) = liquid hand soaps (4.58 h) = shampoos (5.40 h) = hard surface cleaners (6.34 h) > powder automatic dish detergents (>16 h) = powder laundry detergents (>16 h). In addition to formulation effects, some seasonal effects were noted; particularly greater winter-time reactivity to 20% SDS and the hard surface cleaner and liquid laundry formulations. These results demonstrate the utility of this patch test method for the comparative skin irritation assessment of these different product types.

  10. Effects of different base agents on prediction of skin irritation by sodium lauryl sulfate using patch testing and repeated application test.

    PubMed

    Horita, Kotomi; Horita, Daisuke; Tomita, Hiroyuki; Yasoshima, Mitsue; Yagami, Akiko; Matsunaga, Kayoko

    2017-03-06

    Animal testing for cosmetics was banned in the European Union (EU) in 2013; therefore, human tests to predict and ensure skin safety such as the patch test or usage test are now in demand in Japan as well as in the EU. In order to investigate the effects of different bases on the findings of tests to predict skin irritation, we performed patch testing (PT) and the repeated application test (RAT) using sodium lauryl sulfate (SLS), a well-known irritant, dissolved in 6 different base agents to examine the effects of these bases on skin irritation by SLS. The bases for PT were distilled water, 50% ethanol, 100% ethanol, a gel containing 50% ethanol, white petrolatum, and hydrophilic cream. The concentrations of SLS were 0.2% and 0.5%. Twelve different base combinations were applied to the normal back skin of 19 individuals for 24h. RAT was performed with distilled water, 50% ethanol, 100% ethanol, a gel containing 50% ethanol, white petrolatum, and hydrophilic cream containing SLS at concentrations of 0.2%, 2%, and 5%, being applied to the arms of the same PT subjects. The test preparation of each base was applied at the same site, with 0.2% SLS being used in the first week, 2% SLS in the following week, and 5% SLS in the final week. The results of PT revealed that skin irritation scores varied when SLS at the same concentration was dissolved in a different base. The results of RAT showed that although skin irritation appeared with every base at a concentration of 5%, the positive rate was approximately the same. In conclusion, our results suggest that skin irritation elicited in PT depends on the base, while in RAT, it does not depend on the type of base employed.

  11. A new reconstructed human epidermis for in vitro skin irritation testing.

    PubMed

    Pedrosa, Tatiana do Nascimento; Catarino, Carolina Motter; Pennacchi, Paula Comune; Assis, Sílvia Romano de; Gimenes, Fabrícia; Consolaro, Márcia Edilaine Lopes; Barros, Silvia Berlanga de Moraes; Maria-Engler, Silvya Stuchi

    2017-08-01

    Different models of reconstructed human epidermis (RHE) are currently validated to assess skin irritation in vitro and ultimately to the animal replacement of the Draize test. The development of a new RHE model is a challenge for many laboratories, representing a potential gain of autonomy and improvement of technological knowledge. The Organization for Economic Co-operation and Development (OECD) encourages the development of new models and, for this purpose, offers a thorough guideline on quality control parameters (OECD TG 439 performance standards). This work aimed to develop an RHE model (i.e. USP-RHE) for in vitro skin irritation assays, following the OECD TG 439. The developed model presents a well-differentiated epidermis similar to the Validated Reference Methods (VRM) and to native human epidermis. Quality parameters, i.e. optical density of negative control, tissue integrity and barrier function, were similar to VRM and in accordance with OECD TG 439. Moreover, the USP-RHE model was shown to have 85,7% of specificity (6/7), 100% of sensitivity (6/6) and 92,3% of accuracy (12/13) when compared to in vivo UN GHS classification. The within-laboratory reproducibility was 92.3% (12/13). Thus, we demonstrated that USP-RHE model attends to all OECD TG 439 performance standards and is ready to be used by private and public laboratories and companies for future validation studies. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Frequency-selective quantification of skin perfusion behavior during allergic testing using photoplethysmography imaging

    NASA Astrophysics Data System (ADS)

    Blanik, Nikolai; Blazek, Claudia; Pereira, Carina; Blazek, Vladimir; Leonhardt, Steffen

    2014-03-01

    Diagnosis of allergic immediate-type reactions is dependent on the visual assessment of the attending physician. With our novel non-obtrusive, camera-based photoplethysmography imaging (PPGI) setup, perfusion in the allergic testing area can be quantified and results displayed with spatial resolution in functional mappings. Thereby, each PPGI camera pixel can be assumed to be a classical (skin-based) reflective mode PPG sensor. An algorithm for post-processing of collected PPGI video sequences was developed to transfer black-and-white PPGI images into virtual 3D perfusion maps. For the first time, frequency selected perfusion quantification was assessed. For the presented evaluation, PPGI data from our clinical study were used [1]. For this purpose, different concentrations of histamine dilutions were administered to 27 healthy volunteers. Our results show clear trends in an increase in heartbeat synchronous perfusion rhythms and, simultaneously, a decrease of lower frequency vasomotor rhythms in these areas. These results, published for the first time, allow new insight into the distribution of skin perfusion dynamics and demonstrate the intuitive clinical usability of the proposed system.

  13. Skin biopsy and quantitative sensory testing do not predict response to lidocaine patch in painful neuropathies.

    PubMed

    Herrmann, David N; Pannoni, Valerie; Barbano, Richard L; Pennella-Vaughan, Janet; Dworkin, Robert H

    2006-01-01

    Predictors of response to neuropathic pain treatment in patients with painful distal sensory neuropathies are lacking. The 5% lidocaine patch is believed to exert its effects on neuropathic pain via a local stabilizing effect on cutaneous sensory afferents. As such, it provides a model to assess whether the status of epidermal innervation as determined by skin biopsy or quantitative sensory testing (QST) of small- and large-diameter sensory afferents might serve as predictors of response to topical, locally active treatment. In this study we assessed associations between epidermal nerve fiber (ENF) densities, sensory nerve conduction studies (NCS), QST, and response to a 5% lidocaine patch in patients with painful distal sensory neuropathies. We observed no association between distal leg epidermal and subepidermal innervation and response to the lidocaine patch. Several patients with complete loss of distal leg ENF showed a response to the lidocaine patch. Similarly we observed no consistent association between treatment response and QST for vibration, cooling, warm, heat-pain, and cold-pain thresholds, or distal sensory NCS. Thus, distal-leg skin biopsy, QST, and sensory NCS cannot be used to identify patients with painful polyneuropathy likely to respond to a lidocaine patch in clinical practice. Further studies are required to clarify precisely the mechanism and site of action of the lidocaine patch in patients with peripheral neuropathic pain.

  14. pH changes in the dermis during the course of the tuberculin skin test.

    PubMed Central

    Harrison, D K; Spence, V A; Beck, J S; Lowe, J G; Walker, W F

    1986-01-01

    The response of six healthy young adults to tuberculin skin testing was studied. Five subjects developed a typical delayed-type hypersensitivity reaction to PPD with a local rise in skin temperature, and the sixth showed a less intense response; a considerable increase in blood flow velocity was seen in all reactions. All subjects showed a fall in pH in the dermis during the course of the reaction: in four subjects the pH minimum occurred at the time when the changes of erythema and induration were most prominent, in one subject the pH fall preceded the maximal clinical changes, and in the remaining subject a substantial fall in pH occurred with only transient erythema. It was concluded that the local tissue acidosis had resulted from the greatly increased metabolic demand of the lymphocytes and monocytes attracted into the dermis as part of the type IV delayed-type hypersensitivity reaction, and that the concurrent reactive hyperaemia was insufficient to clear the acidic metabolic products of the greatly increased cell population. Images Figure 1 PMID:3804375

  15. Histamine 50-Skin-Prick Test: A Tool to Diagnose Histamine Intolerance

    PubMed Central

    Kofler, Lukas; Ulmer, Hanno; Kofler, Heinz

    2011-01-01

    Background. Histamine intolerance results from an imbalance between histamine intake and degradation. In healthy persons, dietary histamine can be sufficiently metabolized by amine oxidases, whereas persons with low amine oxidase activity are at risk of histamine toxicity. Diamine oxidase (DAO) is the key enzyme in degradation. Histamine elicits a wide range of effects. Histamine intolerance displays symptoms, such as rhinitis, headache, gastrointestinal symptoms, palpitations, urticaria and pruritus. Objective. Diagnosis of histamine intolerance until now is based on case history; neither a validated questionnaire nor a routine test is available. It was the aim of this trial to evaluate the usefullness of a prick-test for the diagnosis of histamine intolerance. Methods. Prick-testing with 1% histamine solution and wheal size-measurement to assess the relation between the wheal in prick-test, read after 20 to 50 minutes, as sign of slowed histamine degradation as well as history and symptoms of histamine intolerance. Results. Besides a pretest with 17 patients with HIT we investigated 156 persons (81 with HIT, 75 controls): 64 out of 81 with histamine intolerance(HIT), but only 14 out of 75 persons from the control-group presented with a histamine wheal ≥3 mm after 50 minutes (P < .0001). Conclusion and Clinical Relevance. Histamine-50 skin-prickt-test offers a simple tool with relevance. PMID:23724226

  16. What we miss if standard panel is used for skin prick testing?

    PubMed

    Cavkaytar, Ozlem; Buyuktiryaki, Betul; Sag, Erdal; Soyer, Ozge; Sekerel, Bulent E

    2015-09-01

    Although standard skin prick test (SPT) panels are crucial for routine investigation of sensitization in daily clinical practice, it has limitations in terms of missing allergens. To find out sensitization rates (SR)s to additional panel of allergens and their relative contributions in allergic diseases. SPTs with a battery of aeroallergens [tree pollen (A.glutinosa, C.arizonica, J.communis, T.platyphyllos, R.pseudoacacia), weed pollen (R.acetosa, U.dioica, A.artemisifolia), smut mix, yeast mix, storage mites (SM) (B.tropicalis, L.destructor, T.putrescentiae, A.siro), mouse and budgerigar epithelia], were performed to 318 participants (6-18 years) who were previously identified to be sensitized to at least one of the aeroallergens found in standard battery. Forty percent of participants were sensitized to at least one additional aerollergen. Three most frequent sensitizations were to B.tropicalis (11.3%), R.pseudoacacia (9.7%) and L.destructor (8.2%). SR for tree pollen increased from 6.9% to 19.8%, for mites increased from 26.3% to 31.6% and for moulds increased from 5.3% to 9.4% with addition of respective group of other allergens to battery. Furthermore, higher rates for additional tree pollen sensitization was found among patients with "only AR" (21%) compared to patients with "only asthma" (4.6%, p =0.006), contrarily higher rates for SM sensitization was found among patients with "only asthma" (20%) compared to patients with "only AR" (3.2%, p =0.003) CONCLUSIONS: Though some of sensitizations may occur due to cross-reactivity, almost 40% of sensitized children were also co-sensitized to the additional allergens tested. Physicians should consider further steps when a negative or inconsistent result is achieved through a standard skin test panel.

  17. Evaluating lotion transfer from products to skin using the behind-the-knee test.

    PubMed

    Farage, Miranda A

    2010-05-01

    Adding lotions or emollients to the surface of a variety of paper products confers a number of benefits to the skin of consumers. A modification of the 'behind-the-knee (BTK)' test model was used as a means of measuring the effectiveness of lotion transfer to the skin. Two series of feminine protection pads were prepared: (1) identically constructed pads differing only in the amount of lotion applied to the surface and (2) pads of various compositions to compare the influence of other product characteristics. For the first series, pads were applied for 3 h using the BTK protocol, and lotion transfer was evaluated. For the second series of products, two sample pads were applied consecutively for 3 h each, and lotion transfer was evaluated a both time points (e.g., 3 and 6 h). In addition, a clinical in-use study was used to evaluate lotion transfer for the second product series. In the BTK model using pads of identical composition, lotion transfer was a function of the amount of lotion placed on the pad. However, results from the second product series indicated that when pads were prepared using different absorbant materials (supreabsorbent gelling material, or AGM and cellulose), pads with the AGM core transferred lotion more effectively than pads with a cellulose core. Other product characteristics, i.e., pad thickness and lotion configuration, did not detectibly influence lotion transfer. The results of an in-use clinical study conducted on the second series of test products were directionally similar to those from the BTK, but statistical significance was not reached. An adaptation of the BTK test method provides an effective means of evaluating the transfer of lotion formulations from feminine protection pads at a fraction of the cost of clinical in-use studies.

  18. Validity of a behavioural measure of heat stress and a skin tent test for dehydration in working horses and donkeys.

    PubMed

    Pritchard, J C; Barr, A R S; Whay, H R

    2006-09-01

    Dehydration and heat stress are serious welfare issues for equids working in developing countries. There is a lack of any standardised method or validated interpretation of the skin tent test in horses and donkeys. Owners of dehydrated and heat-stressed animals often depend on veterinary examination for identification of these conditions, leading to delays in treatment and unnecessary reliance on external sources to effect welfare improvement. To validate a standardised skin tent test for dehydration and a behavioural measure of heat stress in working equids; and to examine the effect of heat stress and dehydration on tripping and staggering behaviour. The study was carried out on 130 working horses and donkeys in Pakistan. Associations between skin tent and blood parameters (packed cell volume [PCV], serum total protein [TP], serum osmolality), clinical parameters, resting and drinking behaviour were examined. Heat stress behaviour (increased respiratory rate and depth, head nodding, flared nostrils, apathy) was observed in conjunction with rectal temperature. Tripping and staggering were assessed using a simple obstacle course. In both species, heat stress behaviour was significantly associated with increased rectal temperature (P<0.001). A positive skin tent test was not significantly associated with PCV or TP, although in donkeys it was significantly associated with lower serum osmolality (P<0.001). More animals age >15 years had a positive skin tent than those in younger age groups (P = 0.037). Very thin horses were more likely to have a positive skin tent than those in thin or moderate condition (P = 0.028). There was no significant correlation between skin tent and tripping or staggering in either species. Heat stress behaviour is related to increased body temperature in working horses and donkeys. Owners may use this to make judgements regarding rest and cooling, precluding the need to seek veterinary attention. The skin tent test for dehydration used in

  19. Development and preliminary testing of a standardized method for quantifying excess water in over-hydrated skin using evaporimetry.

    PubMed

    Fader, M; Clark-O'Neill, S R; Wong, W K R; Runeman, B; Farbrot, A; Cottenden, A M

    2011-03-01

    Although evaporimetry (the measurement of water vapour flux density from the skin) has often been used to study the impact on skin hydration of using products such as baby diapers and incontinence pads, it is difficult to interpret results and to compare data from different studies because of the diversity of unvalidated methodologies used. The aim of this work was to develop a robust methodology for measuring the excess water in over-hydrated skin and test it on volar forearm and hip skin which had been occluded with saline soaked patches. Three repeat measurements were made on the volar forearm and the hip of five young (31-44 years) and six older (67-85 years) women and moderately good within-subject repeatability was found for both skin sites for both subject groups. Measurements taken from the hip were significantly higher (P = 0.001) than those from the arm and had larger coefficients of variation (3.5-22.1%) compared to arms (3.0-14.0%). There were no significant differences between young and older skin, implying that women for future studies could be recruited without regard to age. This is the first time that a robust evaporimetric methodology for quantifying excess water in over-hydrated skin has been described and validated, and it will form a solid basis for future work.

  20. The Efficiacy of Sternocleidomastoid Muscle Flap on Frey's Syndrome via a Novel Test: Galvanic Skin Response.

    PubMed

    Demirci, Ugur; Basut, Oguz; Noyan, Behzat; Demir, Uygar Levent; Afsin Ozmen, O; Kasapoglu, Fikret; Hakan Coskun, H; Onart, Selcuk

    2014-01-01

    The aim of this study was to evaluate the effects of sternocleidomastoid (SCM) muscle flap on preventing Frey's syndrome by using, Galvanic skin responses (GSR). Fourty-three patients who underwent superficial parotidectomy were randomly divided into two groups and their GSR were recorded. SCM muscle flap was applied over the surgical area only in one group. Six months after the surgery, GSRs were remeasured. In addition, the patients completed a questionnaire regarding their complaints about clinical Frey's syndrome. Four patients had symptoms of clinical Frey's syndrome. Postoperative GSR measurements revealed no significant difference between two sides in flap group (p = 0.426) but higher in without flap group (p = 0.003). The patients with clinical Frey syndrome had significantly higher GSR values than the remaining patients. The SCM muscle flap was an effective method in preventing Frey's syndrome. Moreover, GSR test was highly sensitive and specific for diagnosis.

  1. Rat epidermal keratinocyte organotypic culture (ROC) as a model for chemically induced skin irritation testing

    SciTech Connect

    Pappinen, Sari . E-mail: sari.pappinen@uku.fi; Pasonen-Seppaenen, Sanna; Suhonen, Marjukka; Tammi, Raija; Urtti, Arto

    2005-11-01

    The potential of rat epidermal keratinocyte (REK) organotypic culture (ROC) with proper stratum corneum barrier as a model for screening skin irritants was evaluated. The test chemicals were selected from ECETOC database (1995) and the observed in vitro irritation potential was compared to ECETOC in vivo primary irritation index (PII), to EU risk phrases, and to the harmonized OECD criteria. Chemicals were applied onto the stratum corneum surface of ROC for 30 min and samples were taken from the underlying medium at 4 and 8 h after exposure. Cell membrane integrity (determined by LDH assay) and pro-inflammatory effect (determined by IL-1{alpha} release) were verified at both time points and correlated to PII values. The best correlation (R {sup 2} = 0.831) was seen with LDH leakage test. Based on obtained data, chemicals were classified according to criteria defined by EU and OECD. From 12 chemicals, only two were incorrectly classified according to OECD criteria when using LDH leakage and IL-1{alpha} release as irritation markers. At the end of experiment, chemical-treated ROC cultures were fixed and histological changes were assessed. Typical signs for irritation were lightly stained cytoplasm, condensed nuclei, cellular vacuolization, eosinophilic cytoplasms, and blebbing. These irritation effects of chemicals were graded visually into four classes (A-D). The extent of morphological perturbations of the cultures mostly correlated with PII. The present results indicate the validity of the ROC model in predicting skin irritation potential of chemicals and show that the use of set of irritation markers with different mechanistic responses gives more information on irritation than if only one marker was used.

  2. Xenobiotic metabolizing enzyme activities in cells used for testing skin sensitization in vitro.

    PubMed

    Fabian, E; Vogel, D; Blatz, V; Ramirez, T; Kolle, S; Eltze, T; van Ravenzwaay, B; Oesch, F; Landsiedel, R

    2013-09-01

    For ethical and regulatory reasons, in vitro tests for scoring potential toxicities of cosmetics are essential. A test strategy for investigating potential skin sensitization using two human keratinocytic and two human dendritic cell lines has been developed (Mehling et al. Arch Toxicol 86:1273–1295, 2012). Since prohaptens may be metabolically activated in the skin, information on xenobiotic metabolizing enzyme (XME) activities in these cell lines is of high interest. In this study, XME activity assays, monitoring metabolite or cofactor, showed the following: all three passages of keratinocytic (KeratinoSens® and LuSens) and dendritic (U937 und THP-1) cells displayed N-acetyltransferase 1 (NAT1) activities (about 6–60 nmol/min/mg S9-protein for acetylation of para-aminobenzoic acid). This is relevant since reactive species of many cosmetics are metabolically controlled by cutaneous NAT1. Esterase activities of about 1–4 nmol fluorescein diacetate/min/mg S9-protein were observed in all passages of investigated keratinocytic and about 1 nmol fluorescein diacetate/min/mg S9-protein in dendritic cell lines. This is also of practical relevance since many esters and amides are detoxified and others activated by cutaneous esterases. In both keratinocytic cell lines, activities of aldehyde dehydrogenase (ALDH) were observed (5–17 nmol product/min/mg cytosolic protein). ALDH is relevant for the detoxication of reactive aldehydes. Activities of several other XME were below detection, namely the investigated cytochrome P450-dependent alkylresorufin O-dealkylases 7-ethylresorufin O-deethylase, 7-benzylresorufin O-debenzylase and 7-pentylresorufin O-depentylase (while NADPH cytochrome c reductase activities were much above the limit of quantification), the flavin-containing monooxygenase, the alcohol dehydrogenase as well as the UDP glucuronosyl transferase activities.

  3. Treatment of eosinophilic esophagitis with specific food elimination diet directed by a combination of skin prick and patch tests.

    PubMed

    Spergel, Jonathan M; Andrews, Timothy; Brown-Whitehorn, Terri F; Beausoleil, Janet L; Liacouras, Chris A

    2005-10-01

    Eosinophilic esophagitis (EE) is a recently described disorder identified in patients with symptoms suggestive of gastroesophageal reflux disease (GERD) but unresponsive to conventional reflux therapies. Therapies have included corticosteroids, elemental diet, and diet restriction. We report our experience with skin prick and atopy patch testing and food elimination diets in patients diagnosed as having EE. To identify food antigens that cause EE and the characteristics of patients who respond to food elimination vs those who are unresponsive. Patients diagnosed as having EE had restricted diets based on skin prick and atopy patch testing results. Additional biopsies were performed after 4 to 8 weeks of restricted diet. Demographics, atopic tendencies, and food antigens were identified retrospectively in our food allergy database. A total of 146 patients diagnosed as having EE were evaluated with skin prick and atopy patch testing. Thirty-nine patients had unequivocal demonstration of food causing EE, with normalization of biopsy results on elimination and reoccurrence on reintroduction. An additional 73 patients, for a total 112 (77%) of 146 patients, had resolution of their EE as demonstrated by biopsy results. Fifteen (10%) of 146 patients were nonresponders manifested by no significant reduction in esophageal eosinophils despite restricted diet based on skin prick and atopy patch testing. Egg, milk, and soy were identified most frequently with skin prick testing, whereas corn, soy, and wheat were identified most frequently with atopy patch testing. In more than 75% of patients with EE, both symptoms and esophageal inflammation can be significantly improved with dietary elimination of foods. Skin prick and atopy patch testing can help identify foods in most patients.

  4. Comparison between sensitivity of autologous skin serum test and autologous plasma skin test in patients with Chronic Idiopathic Urticaria for detection of antibody against IgE or IgE receptor (FcεRIα).

    PubMed

    Sajedi, Vahid; Movahedi, Masoud; Aghamohammadi, Asghar; Aghamohamadi, Asghar; Gharagozlou, Mohammad; Ghareguzlou, Mohammad; Shafiei, Alireza; Soheili, Habib; Sanajian, Nahal

    2011-06-01

    Intradermal injection of autologous serum and plasma elicit a cutaneous reactivity in almost 45-60% of patients with Chronic Idiopathic Urticaria (CIU). This reactivity is associated with the presence of auto antibodies against IgE or IgE receptors. This study was carried out to compare the cutaneous reactivity of autologous serum and plasma skin tests in a series of patients with CIU for diagnosis of auto antibodies against IgE or IgE receptor. Fifty eight patients with CIU were injected intradermally with autologous serum and plasma (anticoagulated by citrate). Histamine was used as positive control and normal saline as negative control. The study group was checked by routine laboratory tests (CBC, U/A etc), allergens with skin prick tests, and serum IgE level, and auto antibodies against thyroid as well. Duration of urticaria was another factor which was assessed.There was no significant difference between positive ASST and positive APST patients for the above mentioned tests. 77.6% of the patients were Positive for APST and 65.5% were ASST positive. Duration of urticaria was longer in patients with positive ASST and APST than ASST and APST negative patients, although the difference was not statistically significant.Autologus serum skin test (ASST) and autologous plasma skin test (APST) could be used for estimation of duration and severity of urticaria and planning for the treatment.

  5. [Canine visceral leishmaniasis diagnosis by immunohistochemistry and PCR in skin tissues in association with IFAT and ELISA-test].

    PubMed

    de Queiroz, Nina M G P; de Assis, Juliana; Oliveira, Trícia M F S; Machado, Rosângela Z; Nunes, Cáris M; Starke-Buzetti, Wilma A

    2010-01-01

    The purpose of the present study was to evaluate the immunohistochemistry (IMHC) and PCR (Polymerase Chain Reaction) tests for Canine Visceral Leishmaniasis (CVL) diagnosis and compare the results with serological tests such as the indirect fluorescence antibody test (IFAT), ELISA and a parasitological test (microscopic direct examination of the parasite stained with haematoxylin and eosin--HE). For this study, samples of healthy or lesion skin tissues were obtained from 34 CVL naturally infected dogs classified in three groups: asymptomatic, oligosymptomatic and polisymptomatic. Not only lesion (56.5%) but also healthy skins (31.8%) were positives by IMHC and confirmed by PCR in 97.8% of skin samples. In asymptomatic group, 87.5% dogs were negatives by serological tests, but positives by IMHC in 50% and by PCR in 100%. In oligosymptomatic group, 100%, 85.7% and 28.6% of dogs were positives, respectively by PCR, serological and IMHC tests. In addition, 91.7% of polisymptomatic dogs were serum positive and had intact parasites in the skin. In general, PCR showed higher positivity (100%). The efficiency of each test varied with the evolution of the disease. IMHC may be used to confirm the results of the serology and PCR in inconclusive cases after HE and IMHC. The association of techniques proposed in this study may increase the positivity and contributed to the control of this canine disease.

  6. Stress and anxiety effects on positive skin test responses in young adults with allergic rhinitis.

    PubMed

    Heffner, Kathi L; Kiecolt-Glaser, Janice K; Glaser, Ronald; Malarkey, William B; Marshall, Gailen D

    2014-07-01

    Anxiety and psychological stress affect allergy-related immune function. How these relations influence the evaluations of patients with allergic rhinitis is unknown. To examine whether anxiety and stress exposure affect skin prick test (SPT) responses to common allergens for which patients with atopy showed no prior positive SPT response. Patients with allergic rhinitis, evidenced by clinical history and SPT results, were admitted twice to a hospital research unit for 4 hours. In a crossover design, SPT wheals were assessed before and after the Trier Social Stress Test and then the following morning; for comparison, SPT wheals were assessed before and after a laboratory session without a stressor. Analyses focused on wheal responses for common allergens that tested negative (wheal size <3 mm larger than saline) from SPTs performed at multiple baseline assessments. After the Trier Social Stress Test, more anxious patients with atopy had a higher incidence of positive SPT reactions to antigens that previously tested negative. Anxiety was unrelated to positive SPT incidence under nonstressful conditions. Based on clinical symptom reports, newly positive SPT reactions after the stressor were apparently corrections of previously false-negative SPT reactions. The SPT wheal responses for allergens previously testing negative were enhanced after a stressor. Histamine (positive control) or saline (negative control) SPT responses were not affected. A laboratory stressor affected allergen SPT responses in more anxious patients with allergic rhinitis. In addition to clinical history, assessment of anxiety and current stress at the time of the SPT may provide valuable information about a patient's allergic status and aid in clinical decision making. Copyright © 2014 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  7. Skin autoreactivity in Hashimoto's thyroiditis patients without urticaria: autologous serum skin test positivity correlation with thyroid antibodies, sonographical volume and grading.

    PubMed

    Turkoglu, Zafer; Zindanci, Ilkin; Turkoglu, Ozlem; Can, Burce; Kavala, Mukaddes; Tamer, Gonca; Ulucay, Vasfiye; Akyer, Erdal

    2012-01-01

    Recent studies have shown an association between anti-thyroid antibodies and autologous serum skin test (ASST) positive urticaria patients. However, a connection between thyroid and this reliable skin test for mast cell autoreactivity, ASST, has not been reported yet. We investigated ASST in patients with Hashimoto's thyroiditis (HT) without urticaria and compared the results with laboratory and sonographical findings of HT. 154 HT patients, 100 healthy volunteers without HT as a first control group and 46 patients with multinodular goitre but without autoimmune thyroid disease as a second control group underwent testing with ASST. ASST was applied to these groups according to two criteria, first as ASST(new): autologous serum red wheal response 1.5 mm bigger than negative control; second as ASST(old): serum red wheal response 5 mm bigger than negative control accepted as positive. Free triiodothyronine (fT3), free thyroxine (fT4), thyroid-stimulating hormone (TSH), thyroid peroxidase antibody (anti-TPO) and thyroglobulin antibody (anti-Tg) levels were measured. ASST(old), ASST(new) scored positive in 51.3-60.4% of HT patients, with statistically significant differences. Thyroid volume grades were inversely proportional with ASST(old) and (new) positivity. Moderate (+) titers of anti-Tg in ASST(old) and (new) (+) cases were significantly higher than the same titers of anti-Tg in ASST(old) and (new) (-) cases. The prevalence of ASST positivity in HT patients was not affected by the following factors: gender, age at screening, laboratory measurements of thyroid function tests, anti-TPO antibodies and thyroid ultrasound (US) echogenicity. Positivity of ASST in HT has shown that there is a skin mast cell autoreactivity in HT patients independent of autoreactive chronic urticaria (ACU).

  8. Utilization of the QuantiFERON-TB Gold Test in a Two-Step Process with the Tuberculin Skin Test To Evaluate Health Care Workers for Latent Tuberculosis▿

    PubMed Central

    Abdalhamid, Baha; Hinrichs, Steven H.; Garrett, Jodi L.; O'Neill, Jean M.; Hansen-Cain, Kristine M.; Armbrust, Amy A.; Iwen, Peter C.

    2010-01-01

    A cost analysis of combining a tuberculin skin test (TST) and the QuantiFERON-TB Gold test (QFT-GT) to detect latent tuberculosis in newly hired health care workers was performed. An approximately 50% reduction in the cost of additional care was realized when workers with positive TST results were subsequently screened using the QFT-GT. PMID:20573876

  9. Relevance of cat and dog sensitization by skin prick testing in childhood eczema and asthma.

    PubMed

    Hon, Kam Lun E Lun; Tsang, Kathy Yin Ching; Leung, Ting Fan

    2017-06-14

    Household animal dander has been implicated as aeroallergen in childhood atopic diseases. Many parents seek healthcare advice if household pet keeping may be detrimental in atopic eczema (AE) and atopies. We investigated if skin sensitization by cat/dog dander was associated with disease severity and quality of life in children with AE. Demographics, skin prick test (SPT) results, disease severity (Nottingham eczema severity score NESS), Children Dermatology Life Quality Index (CDLQI), blood IgE and eosinophil counts of a cohort of AE patients were reviewed. 325 AE patients followed at a pediatric dermatology clinic were evaluated. Personal history of asthma was lowest (20%) in the dog-dander-positive-group but highest (61%) in both-cat-and-dog-dander-positive group (p=0.007). Unlike dust mite or food sensitization, the incidence of cat or dog sensitization was low. Binomial logistic regression ascertained that cat-dander sensitization was associated with increasing age (adjusted odds ratio [aOR], 1.056; 95% Confidence Interval [CI], 1.006 to 1.109; p=0.029), dust-mite sensitization (aOR, 4.625; 95% CI, 1.444 to 14.815; p=0.010), food-allergen sensitization (aOR, 2.330; 95% CI, 1.259 to 4.310; p=0.007) and keeping-cat-ever (aOR, 7.325; 95% CI, 1.193 to 44.971; p=0.032); whereas dog-dander sensitization was associated with dust-mite sensitization (aOR, 9.091; 95% CI, 1.148 to 71.980; p=0.037), food-allergen sensitization (aOR, 3.568; 95% CI, 1.341 to 9.492; p=0.011) and keeping-dog-ever (aOR, 6.809; 95% CI, 2.179 to 21.281; p=0.001). However, neither cat nor dog sensitization were associated with asthma, allergic rhinitis, parental or sibling atopic status, disease severity or quality of life. Physicians should advise parents that there is no direct correlation between AE severity, quality of life, asthma or allergic rhinitis with skin sensitization to cats or dogs. Sensitized patients especially those with concomitant asthma and severe symptoms may consider non

  10. Assessment of latent tuberculosis infection in Takayasu arteritis with tuberculin skin test and Quantiferon-TB Gold test.

    PubMed

    Karadag, Omer; Aksu, Kenan; Sahin, Abdurrahman; Zihni, Figen Yargucu; Sener, Burcin; Inanc, Nevsun; Kalyoncu, Umut; Aydin, Sibel Zehra; Ascioglu, Sibel; Ocakci, Pinar Talu; Bilgen, Sule Apras; Keser, Gokhan; Inal, Vedat; Direskeneli, Haner; Calguneri, Meral; Ertenli, Ihsan; Kiraz, Sedat

    2010-09-01

    A possible relationship between Takayasu arteritis (TA) and tuberculosis (TB) has been suggested. An increased frequency of tuberculin skin test (TST) was observed in TA patients. Quantiferon-TB Gold test (QFT) is a new in vitro assay measuring interferon-gamma response to M. tuberculosis antigens and helpful in diagnosing latent TB infection. The aim of this study was to investigate latent TB infection among TA patients by the use of both TST and QFT Gold test. Ninety-four (male/female: 7/87) TA patients fulfilling ACR 1990 TA criteria from three different university hospitals in Turkey and 107 control subjects without inflammatory diseases were included in the study. Data about medical history (TA and TB) were collected for both groups. TST and QFT were performed. TST values > or =5 mm for TA patients and > or =15 mm for controls was accepted as TST positivity. Even though TA group was older (40 +/- 12 vs. 32 +/- 8, P < 0.001), there was no significant difference between TA patients and controls regarding demographic characteristics. Six TA patients and one control had a history of previous TB infection (P = 0.054). Although TST positivity was higher in TA group [55 patients (62.5%) vs. 24 controls (41.4%), P = 0.008], QFT positivity was similar between two groups [21 patients (22.3%) vs. 24 controls (22.4%), P > 0.05]. QFT was negative in two of six TA patients with previous TB history. Rate of latent TB infection in TA patients measured with QFT is no more than controls. QFT seems to be a good and favorable test compared with TST in detecting LTBI in TA.

  11. Differences among heat-treated, raw, and commercial peanut extracts by skin testing and immunoblotting.

    PubMed

    Maleki, Soheila J; Casillas, Adrian M; Kaza, Ujwala; Wilson, Brian A; Nesbit, Jacqueline B; Reimoneqnue, Chantrel; Cheng, Hsiaopo; Bahna, Sami L

    2010-12-01

    Peanut allergenicity has been reported to be influenced by heat treatment, yet the commonly available extracts for skin prick testing (SPT) are derived from raw extracts. To assess the effect of heat treatment on the SPT reactivity and specific IgE binding to peanut. Three commercial extracts and 3 laboratory-prepared extracts, including raw, roasted, and boiled, were used for SPT in 19 patients with suspected peanut allergy and in 4 individuals who eat peanut without any symptoms. Serum samples were obtained to measure total IgE in addition to specific IgE binding to the study extracts by immunoblotting. Peanut allergy was confirmed with challenge test unless the individual had a convincing history of a severe reaction. Eleven study participants were considered peanut allergic based on a strong history or positive challenge test result. SPT with the prepared and commercial reagents showed that the boiled extract had the highest specificity (67% vs 42%-63% for the other extracts). The prepared extracts showed similar SPT sensitivity (81%). Three patients with a history of severe reaction and elevated specific IgE levels to peanut to the 3 study extracts had variable SPT reactivity to 1 or more of the commercial extracts. IgE binding to Ara h 2 was found in nearly all patients, regardless of their clinical reactivity. None of the extracts tested showed optimal diagnostic reliability regarding both sensitivity and specificity. Perhaps testing should be performed with multiple individual extracts prepared by different methods. Copyright © 2010 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  12. Skin sensitizers induce antioxidant response element dependent genes: application to the in vitro testing of the sensitization potential of chemicals.

    PubMed

    Natsch, Andreas; Emter, Roger

    2008-03-01

    Tests for skin sensitization are required prior to the market launch of new cosmetic ingredients and in vitro tests are needed to replace the current animal tests. Protein reactivity is the common feature of skin sensitizers and it is a crucial question whether a cellular in vitro assay can detect protein reactivity of diverse test chemicals. The signaling pathway involving the repressor protein Keap1 and the transcription factor nuclear factor-erythroid 2-related factor 2, which binds to the antioxidant response element (ARE) in the promoter of many phase II detoxification genes, is a potential cellular marker because Keap1 had been shown to be covalently modified by electrophiles which leads to activation of ARE-dependent genes. To evaluate whether this regulatory pathway can be used to develop a predictive cellular in vitro test for sensitization, 96 different chemicals of known skin sensitization potential were added to Hepa1C1C7 cells and the induction of the ARE-regulated quinone reductase (QR) activity was determined. In parallel, 102 chemicals were tested on the reporter cell line AREc32, which contains an eightfold repeat of the ARE sequence upstream of a luciferase gene. Among the strong/extreme skin sensitizers 14 out of 15 and 30 out of 34 moderate sensitizers induced the ARE-dependent luciferase activity and in many cases this response was paralleled by an induction of QR activity in Hepa1C1C7 cells. Sixty percent of the weak sensitizers also induced luciferase activity, and the overall accuracy of the assay was 83 percent. Only four of 30 tested nonsensitizers induced low levels of luciferase activity, indicating a high specificity of the assay. Thus, measurement of the induction of this signaling pathway provides an interesting in vitro test to screen for the skin sensitization potential of novel chemicals.

  13. Prevalence of sensitization to aeroallergens in California patients with respiratory allergy. Allergy Skin Test Project Team.

    PubMed

    Galant, S; Berger, W; Gillman, S; Goldsobel, A; Incaudo, G; Kanter, L; Machtinger, S; McLean, A; Prenner, B; Sokol, W; Spector, S; Welch, M; Ziering, W

    1998-09-01

    The number of allergy skin tests required to evaluate patients with respiratory allergy has recently been challenged by the managed care community. The purpose of this study was to determine which aeroallergens are prevalent in patients with respiratory allergy (allergic rhinitis and bronchial asthma) in California. Utilizing aeroallergens thought to be relevant from recent aerobiologic and botanic data, 141 allergic and 17 asymptomatic control subjects were tested for the prevalence of 103 allergens. A standardized prick puncture technique and standardized interpretation of wheal/flare responses were utilized using the same lot of allergen for 13 allergy practices distributed throughout California. Frequency curves based on prevalence were established to determine the number of tests required to give up to 90% of positive responses for tree, weed and grass pollen, mold spores, and miscellaneous allergens which included house dust mite, cat, dog, and cockroach allergens. Positive responses in allergic subjects for grasses ranged from 46% to 54%, for weeds 19% to 37%, and for trees 10% to 42%. For molds the range was from 11% to 22%. The response rate for Dermatophagoides pteronyssinus was 53%, for Dermatophagoides farinae 42%, for cat pelt 39% and cat hair 37%, for cockroach 23% and dog dander 19%. Asymptomatic control subjects responded to only 4% of all allergens tested. Ninety percent of all positive tests required three miscellaneous allergens (house dust mite, cat, and cockroach), 9 molds, 2 grasses, 16 weeds, and 27 trees for a total of 57 allergens (56% of total tested). There was no clear relationship between locale and specific allergen response, probably related to the limited number of subjects tested and variability within the same geographic region. Several seldom tested tree and weed allergens showed a higher prevalence rate than several commonly tested for allergens. This preliminary study suggests that approximately 57 aeroalleroens might be

  14. The ECVAM international validation study on in vitro tests for acute skin irritation: report on the validity of the EPISKIN and EpiDerm assays and on the Skin Integrity Function Test.

    PubMed

    Spielmann, Horst; Hoffmann, Sebastian; Liebsch, Manfred; Botham, Phil; Fentem, Julia H; Eskes, Chantra; Roguet, Roland; Cotovio, José; Cole, Thomas; Worth, Andrew; Heylings, Jon; Jones, Penny; Robles, Catherine; Kandárová, Helena; Gamer, Armin; Remmele, Marina; Curren, Rodger; Raabe, Hans; Cockshott, Amanda; Gerner, Ingrid; Zuang, Valérie

    2007-12-01

    ECVAM sponsored a formal validation study on three in vitro tests for skin irritation, of which two employ reconstituted human epidermis models (EPISKIN, EpiDerm), and one, the skin integrity function test (SIFT), employs ex vivo mouse skin. The goal of the study was to assess whether the in vitro tests would correctly predict in vivo classifications according to the EU classification scheme, "R38" and "no label" (i.e. non-irritant). 58 chemicals (25 irritants and 33 non-irritants) were tested, having been selected to give broad coverage of physico-chemical properties, and an adequate distribution of irritancy scores derived from in vivo rabbit skin irritation tests. In Phase 1, 20 of these chemicals (9 irritants and 11 non-irritants) were tested with coded identities by a single lead laboratory for each of the methods, to confirm the suitability of the protocol improvements introduced after a prevalidation phase. When cell viability (evaluated by the MTT reduction test) was used as the endpoint, the predictive ability of both EpiDerm and EPISKIN was considered sufficient to justify their progression to Phase 2, while the predictive ability of the SIFT was judged to be inadequate. Since both the reconstituted skin models provided false predictions around the in vivo classification border (a rabbit Draize test score of 2), the release of a cytokine, interleukin-1alpha (IL-1alpha), was also determined. In Phase 2, each human skin model was tested in three laboratories, with 58 chemicals. The main endpoint measured for both EpiDerm and EPISKIN was cell viability. In samples from chemicals which gave MTT assay results above the threshold of 50% viability, IL-1alpha release was also measured, to determine whether the additional endpoint would improve the predictive ability of the tests. For EPISKIN, the sensitivity was 75% and the specificity was 81% (MTT assay only); with the combination of the MTT and IL-1alpha assays, the sensitivity increased to 91%, with a

  15. Sensitivity and specificity of the agar-gel-immunodiffusion test, ELISA and the skin test for detection of paratuberculosis in United States Midwest sheep populations.

    PubMed

    Robbe-Austerman, Suelee; Gardner, Ian A; Thomsen, Bruce V; Morrical, Daniel G; Martin, Barbara M; Palmer, Mitchell V; Thoen, Charles O; Ewing, Chad

    2006-01-01

    Our objective was to estimate the sensitivity and specificity of the agar-gel-immunodiffusion test (AGID), the ELISA, and the skin test for the detection of Mycobacterium avium subspecies paratuberculosis (MAP) in sheep using Bayesian methods without a gold standard. Fourteen flocks (2 465 sheep) were used. Five flocks (450 sheep) were considered MAP non-infected and 9 flocks (2 015 sheep) had sheep infected with MAP. Sheep were skin tested and blood was collected for AGID and ELISA testing. Results were analyzed using a Bayesian 3-test in 1-population model fitted in WinBUGS. The model allowed for dependence (correlation) between the two serologic tests, but these two tests were assumed to be conditionally independent of the skin test. The estimated specificity was 99.5% (95% PI of 98.9-99.9%) for the AGID; 99.3% (98.4-99.8%) for the ELISA using an optical density measured cutoff of 0.20; 99.2% (98.1-99.8%) using a cutoff of 0.15; 97.5% (95.8-98.7%) using a cutoff of 0.10; and 98.7% (97.3-99.5%) for the skin test. The estimated sensitivities were 8.3% (6.2-10.7%) for the AGID; 8.0% (6.0-10.4%), 10.6% (8.3-13.1%), and 16.3% (13.5-19.4%) for the ELISA using the cutoffs 0.20, 0.15, and 0.10 respectively; and 73.3% (62.3-85.8%) for the skin test. The skin test was specific in non-infected populations and sensitive in infected populations, although in some cases a positive skin test might represent MAP exposure rather than infection. The AGID and ELISA were specific but lacked sensitivity. The AGID and ELISA consistently identified two different populations of infected sheep with only moderate overlap between positive test results.

  16. Applicability of in vitro tests for skin irritation and corrosion to regulatory classification schemes: substantiating test strategies with data from routine studies.

    PubMed

    Kolle, Susanne N; Sullivan, Kristie M; Mehling, Annette; van Ravenzwaay, Bennard; Landsiedel, Robert

    2012-12-01

    Skin corrosion or irritation refers to the production of irreversible or reversible damage to the skin following the application of a test substance, respectively. Traditionally, hazard assessments are conducted using the in vivo Draize skin test, but recently in vitro tests using reconstructed human epidermis (RhE) models have gained regulatory acceptance. In this study, skin corrosion (SCT) and irritation tests (SIT) using a RhE model were implemented to reduce the number of in vivo tests required by regulatory bodies. One hundred and thirty-four materials were tested from a wide range of substance classes included 46 agrochemical formulations. Results were assessed according to UN GHS, EU-CLP, ANVISA and US EPA classification schemes. There was high correlation between the two in vitro tests. Assessment of the SCT sensitivity was not possible due to the limited number of corrosives in the data set; SCT specificity and accuracy were 89% for all classification systems. Accuracy (63-76%) and sensitivity (53-67%) were low in the SIT. Specificity and concordance for agrochemical formulations alone in both the SCT and SIT were comparable to the values for the complete data set (SCT: 91% vs. 89% specificity, 91% vs. 89% accuracy and SIT: 64-88% vs. 70-85% specificity, 56-75% vs. 63-76% accuracy). Copyright © 2012 Elsevier Inc. All rights reserved.

  17. The predictive value of skin prick testing for challenge-proven food allergy: a systematic review.

    PubMed

    Peters, Rachel L; Gurrin, Lyle C; Allen, Katrina J

    2012-06-01

    Immunoglobulin E-mediated (IgE) food allergy affects 6-8% of children, and the prevalence is believed to be increasing. The gold standard of food allergy diagnosis is oral food challenges (OFCs); however, they are resource-consuming and potentially dangerous. Skin prick tests (SPTs) are able to detect the presence of allergen-specific IgE antibodies (sensitization), but they have low specificity for clinically significant food allergy. To reduce the need for OFCs, it has been suggested that children forgo an OFC if their SPT wheal size exceeds a cutoff that has a high predictability for food allergy. Although data for these studies are almost always gathered from high-risk populations, the 95% positive predictive values (PPVs) vary substantially between studies. SPT thresholds with a high probability of food allergy generated from these studies may not be generalizable to other populations, because of highly selective samples and variability in participant's age, test allergens, and food challenge protocol. Standardization of SPT devices and allergens, OFC protocols including standardized cessation criteria, and population-based samples would all help to improve generalizability of PPVs of SPTs.

  18. Helminths and skewed cytokine profiles increase tuberculin skin test positivity in Warao Amerindians.

    PubMed

    Verhagen, L M; Hermans, P W M; Warris, A; de Groot, R; Maes, M; Villalba, J A; del Nogal, B; van den Hof, S; Mughini Gras, L; van Soolingen, D; Pinelli, E; de Waard, J H

    2012-11-01

    The immune regulatory mechanisms involved in the acquisition of Mycobacterium tuberculosis infection in children are largely unknown. We investigated the influence of parasitic infections, malnutrition and plasma cytokine profiles on tuberculin skin test (TST) positivity in Warao Amerindians in Venezuela. Pediatric household contacts of sputum smear-positive tuberculosis (TB) cases were enrolled for TST, chest radiograph, plasma cytokine analyses, QuantiFERON-TB Gold In-Tube (QFT-GIT) testing and stool examinations. Factors associated with TST positivity were studied using generalized estimation equations logistic regression models. Of the 141 asymptomatic contacts, 39% was TST-positive. After adjusting for age, gender and nutritional status, TST positivity was associated with Trichuris trichiura infections (OR 3.5, 95% CI 1.1-11.6) and low circulating levels of T helper 1 (Th1) cytokines (OR 0.51, 95% CI 0.33-0.79). Ascaris lumbricoides infections in interaction with Th2- and interleukin (IL)-10-dominated cytokine profiles were positively associated with TST positivity (OR 3.1, 95% CI 1.1-8.9 and OR 2.4, 95% CI 1.04-5.7, respectively). A negative correlation of QFT-GIT mitogen responses with Th1 and Th2 levels and a positive correlation with age were observed (all p < 0.01). We conclude that helminth infections and low Th1 cytokine plasma levels are significantly associated with TST positivity in indigenous Venezuelan pediatric TB contacts.

  19. Association between tuberculin skin test result and clinical presentation of tuberculosis disease.

    PubMed

    Auld, Sara C; Click, Eleanor S; Heilig, Charles M; Miramontes, Roque; Cain, Kevin P; Bisson, Gregory P; Mac Kenzie, William R

    2013-10-04

    The tuberculin skin test (TST) is used to test for latent tuberculosis (TB) infection and support the diagnosis of active TB. However, little is known about the relationship between the TST result and the clinical presentation of TB disease. We analyzed US TB surveillance data, 1993-2010, and used multinomial logistic regression to calculate the association between TST result (0-4 mm [negative], 5-9 mm, 10-14 mm, and  ≥ 15 mm) and clinical presentation of disease (miliary, combined pulmonary and extrapulmonary, extrapulmonary only, non-cavitary pulmonary, and cavitary pulmonary). For persons with pulmonary disease, multivariate logistic regression was used to calculate the odds of having acid-fast bacilli (AFB) positive sputum. There were 64,238 persons with culture-confirmed TB included in the analysis, which was stratified by HIV status and birthplace (US- vs. foreign-born). Persons with a TST ≥ 15 mm were less likely to have miliary or combined pulmonary and extrapulmonary disease, but more likely to have cavitary pulmonary disease than non-cavitary pulmonary disease. Persons with non-cavitary pulmonary disease with a negative TST were significantly more likely to have AFB positive sputum. Clinical presentation of TB disease differed according to TST result and persons with a negative TST were more likely to have disseminated disease (i.e., miliary or combined pulmonary and extrapulmonary). Further study of the TST result may improve our understanding of the host-pathogen relationship in TB disease.

  20. The prevalence of antibiotic skin test reactivity in a pediatric population.

    PubMed

    Kamboj, Sonia; Yousef, Ejaz; McGeady, Stephen; Hossain, Jobayer

    2011-01-01

    Although adverse drug reactions (ADRs) are not uncommon, true allergic (i.e., immunologic) reactions are infrequent. Estimates are that only 10% of reported "penicillin (PCN)-allergic" patients have true allergic drug reactions. Most studies of PCN-related ADR have been conducted in adult populations and suggest that the majority of adult patients presenting with PCN allergy history can safely receive the drug. The goal of this study was to examine the outcome of provocative drug challenges to antibiotics in a pediatric population and correlate outcomes with predictive factors. Through chart review, we identified 96 pediatric patients with history of an ADR to antibiotics who underwent skin testing (ST) and/or graded challenges to PCN (n = 52), cephalosporins (n = 7), azithromycin (AZT; n = 24), or clindamycin (n = 4). Of these children with an ADR, 87 (90.6%) tolerated provocative drug challenges and 9 (9.4%) were instructed to continue drug avoidance because of positive ST or failed challenge. Eight of the nine patients continued drug avoidance due to positive PCN ST (n = 4) or ADR during drug PCN challenge (n = 4). All AZT and cephalosporin challenges had negative outcomes, and only one patient did not proceed with the clindamycin challenge after a positive ST. True "antibiotic allergy" denoted by positive ST or failed challenge in patients with a history of ADR occurred in <10% of children included in this study, suggesting that without such testing nearly 90% might be treated with alternative antibiotics unnecessarily.

  1. Skin Prick Test Analysis in Allergic Rhinitis Patients: A Preliminary Study in Abuja, Nigeria

    PubMed Central

    Ibekwe, T. S.

    2016-01-01

    Allergic rhinitis (AR) is prevalent in Nigeria, though little information exists on the allergen. We assessed the clinical features of AR patients in our environment based on the allergic rhinitis impact on asthma (ARIA) classification. Only patients with positive skin prick test (SPT) were recruited. Seventy-four patients participated in the study. AR and asthma comorbidity were observed in 13.5%. The proportion of “sneezers-runners” was higher than “blockers” with significantly more “sneezers-runners” having persistent AR (P = 0.007). No relationship was established between these predominant symptoms and the aeroallergens used in this study. Intermittent mild and moderate/severe AR were evident in 13.5% and 31.1%, while persistent mild and moderate/severe were seen in 20.3% and 35.1%, respectively. House dust mites allergen yielded the highest number of positive responses (22.6%) followed by tree pollen (16.8%). No relationship was observed between the allergens tested and AR severity. Majority of patients were oligosensitive (33.8%) and polysensitive (35.1%) and were not significantly associated with AR severity (P = 0.07). Most AR patients presenting for treatment in Abuja, Nigeria, had moderate-severe persistent AR and showed similar SPT sensitization pattern with countries having similar climatic conditions. Sensitization patterns were not related to ARIA classification or predominant AR symptoms. PMID:27247577

  2. Cytotoxicity testing of silver-containing burn treatments using primary and immortal skin cells.

    PubMed

    Boonkaew, Benjawan; Kempf, Margit; Kimble, Roy; Cuttle, Leila

    2014-12-01

    A novel burn wound hydrogel dressing has been previously developed which is composed of 2-acrylamido-2-methylpropane sulfonic acid sodium salt with silver nanoparticles (silver AMPS). This study compared the cytotoxicity of this dressing to the commercially available silver products; Acticoat™, PolyMem Silver(®) and Flamazine™ cream. Human keratinocytes (HaCaT and primary HEK) and normal human fibroblasts (NHF) were exposed to dressings incubated on Nunc™ polycarbonate inserts for 24, 48 and 72h. Four different cytotoxicity assays were performed including; Trypan Blue cell count, MTT, Celltiter-Blue™ and Toluidine Blue surface area assays. The results were expressed as relative cell viability compared to an untreated control. The cytotoxic effects of Acticoat™ and Flamazine™ cream were dependent on exposure time and cell type. After 24h exposure, Acticoat™ and Flamazine™ cream were toxic to all tested cell lines. Surprisingly, HaCaTs treated with Acticoat™ and Flamazine™ had an improved ability to survive at 48 and 72h while HEKs and NHFs had no improvement in survival with any treatment. The novel silver hydrogel and PolyMem Silver(®) showed low cytotoxicity to all tested cell lines at every time interval and these results support the possibility of using the novel silver hydrogel as a burn wound dressing. Researchers who rely on HaCaT cells as an accurate keratinocyte model should be aware that they can respond differently to primary skin cells.

  3. Multiple skin testing of Kenyan schoolchildren with a series of new tuberculins.

    PubMed Central

    Paul, R. C.; Stanford, J. L.; Misljenóvic, O.; Lefering, J.

    1975-01-01

    This study on Kenyan schoolchildren aims to elucidate the effect of contact with environmental mycobacteria on the development of specific delayed hypersensitivity. A series of 12 skin test reagents was employed; eleven of them were prepared from extracts of living mycobacteria and the last was the P.P.D. RT 23. Eight of the new tuberculins were prepared from mycobacteria recovered from the East African environment. A total of 8641 tests were carried out on 4320 children between the ages of 6 and 17 years in four townships. Two of these townships were in fertile agricultural areas and two were in the desert. Just over 80% of the children had received BCG immunization The results obtained showed that increasing age, geographical locality and BCG immunization all had a profound effect, and socioeconomic background had some effect, on the pattern of reactivity to the various reagents. The rationale behind the use of the series of new tuberculins and the results obtained with them are discussed in relation to the interacting effects of the factors complicating these results. PMID:1058246

  4. [Prevalence of positive skin tests to indoor allergens in preschooler children with respiratory allergy in Merida, Yucatan, Mexico].

    PubMed

    Baeza Bacab, Manuel Antonio; Dávila Velázquez, Jorge Rubén; Loeza Medina, Sergio Ramón

    2005-01-01

    Infantile asthma and rhinitis are commonly thought to be caused by indoor allergens but preschooler children are not commonly skin tested. To know the frequency of skin test reactivity to indoor allergens in allergic preschooler children. We evaluated 176 children (103 females/73 males) between 2 and 5 years old with respiratory allergy. All of the children tested had at least one positive skin test (house dust mite, cockroach, dog, feathers, and cat). Seventy seven children had allergic rhinitis (44%), 68 had asthma and rhinitis (39%), and 31 had only asthma (18%). One hundred thirty two (75%) of the children were skin test positive to house dust mite, 91 (52%) to cockroach, 31 (18%) to dog, 25 (14%) to feathers, and 24 (14%) to cat. Furthermore, the frequency of sensitization to house dust mite has an increase associated with the age of the patients with a significant difference at 5 years old (odds ratio=11.63, I.C. 95%=3.83-37.10; p <0.001). The most frequent indoor allergen was house dust mite, with a trend directly proportional to age of the patients.

  5. Optimizing the use of a skin prick test device on children.

    PubMed

    Buyuktiryaki, Betul; Sahiner, Umit Murat; Karabulut, Erdem; Cavkaytar, Ozlem; Tuncer, Ayfer; Sekerel, Bulent Enis

    2013-01-01

    Studies comparing skin prick test (SPT) devices have revealed varying results in performance and there is little known about their use on children. We performed 2 complementary studies to test the sensitivity, reproducibility and acceptability of commercially available SPT devices (Stallerpoint, Antony, France) using different application techniques. In the first part, histamine/saline was put on as a drop by use of a vial (V), and in the second part it was transferred from a well with the aid of the test device (W). The techniques were as follows: apply vertical pressure (Stallerpoint-VP or Stallerpoint-WP), apply vertical pressure with 90° clockwise rotation (Stallerpoint-VC or Stallerpoint-WC) and apply vertical pressure with 90° clockwise and counter-clockwise rotations (Stallerpoint-VCC or Stallerpoint-WCC). For comparison, ALK Lancet was used with a technique of 'drop and apply vertical pressure'. In the first part, sensitivities of the Stallerpoint-VC (96.6%), Stallerpoint-VCC (95.5%) and ALK Lancet (93.2%) techniques were superior (p < 0.001) to the other Stallerpoint-VP and Stallerpoint-WP techniques (76.1 and 46.6%). Intrapatient coefficient of variation (CV) values were 15.0, 18.9, 15.4, 22.4 and 48.5%, respectively. Interpatient CV ranged between 22.8 and 55.1%. In the second part, the Stallerpoint-WC (98.8%), WCC (97.5%) and ALK Lancet (98.8%) techniques yielded high sensitivities, whereas the sensitivity of Stallerpoint-WP (28.7%) was very low. There were false-positive reactions in the Stallerpoint-VCC and WCC techniques. In children, the SPT technique was found to be as important as the testing device. Stallerpoint-VC and WC techniques are reliable, tolerable and comparable with the ALK Lancet technique. Copyright © 2013 S. Karger AG, Basel.

  6. Safety and Efficacy Assessment of Two New Leprosy Skin Test Antigens: Randomized Double Blind Clinical Study

    PubMed Central

    Rivoire, Becky L.; Groathouse, Nathan A.; TerLouw, Stephen; Neupane, Kapil Dev; Ranjit, Chaman; Sapkota, Bishwa Raj; Khadge, Saraswoti; Kunwar, Chatra B.; Macdonald, Murdo; Hawksworth, Rachel; Thapa, Min B.; Hagge, Deanna A.; Tibbals, Melinda; Smith, Carol; Dube, Tina; She, Dewei; Wolff, Mark; Zhou, Eric; Makhene, Mamodikoe; Mason, Robin; Sizemore, Christine; Brennan, Patrick J.

    2014-01-01

    Background New tools are required for the diagnosis of pre-symptomatic leprosy towards further reduction of disease burden and its associated reactions. To address this need, two new skin test antigens were developed to assess safety and efficacy in human trials. Methods A Phase I safety trial was first conducted in a non-endemic region for leprosy (U.S.A.). Healthy non-exposed subjects (n = 10) received three titrated doses (2.5 µg, 1.0 µg and 0.1 µg) of MLSA-LAM (n = 5) or MLCwA (n = 5) and control antigens [Rees MLSA (1.0 µg) and saline]. A randomized double blind Phase II safety and efficacy trial followed in an endemic region for leprosy (Nepal), but involved only the 1.0 µg (high dose) and 0.1 µg (low dose) of each antigen; Tuberculin PPD served as a control antigen. This Phase II safety and efficacy trial consisted of three Stages: Stage A and B studies were an expansion of Phase I involving 10 and 90 subjects respectively, and Stage C was then conducted in two parts (high dose and low dose), each enrolling 80 participants: 20 borderline lepromatous/lepromatous (BL/LL) leprosy patients, 20 borderline tuberculoid/tuberculoid (BT/TT) leprosy patients, 20 household contacts of leprosy patients (HC), and 20 tuberculosis (TB) patients. The primary outcome measure for the skin test was delayed type hypersensitivity induration. Findings In the small Phase I safety trial, reactions were primarily against the 2.5 µg dose of both antigens and Rees control antigen, which were then excluded from subsequent studies. In the Phase II, Stage A/B ramped-up safety study, 26% of subjects (13 of 50) showed induration against the high dose of each antigen, and 4% (2 of 50) reacted to the low dose of MLSA-LAM. Phase II, Stage C safety and initial efficacy trial showed that both antigens at the low dose exhibited low sensitivity at 20% and 25% in BT/TT leprosy patients, but high specificity at 100% and 95% compared to TB patients. The high dose of both antigens

  7. Medical clowns ease anxiety and pain perceived by children undergoing allergy prick skin tests.

    PubMed

    Goldberg, A; Stauber, T; Peleg, O; Hanuka, P; Eshayek, L; Confino-Cohen, R

    2014-10-01

    Intervention of medical clowns (MC) during various medical procedures performed in children has been used to relieve anxiety and pain. Their role in allergy skin testing has never been evaluated. To evaluate whether MC can diminish pain and anxiety perceived by children undergoing allergy skin prick tests (SPT). In a prospective, randomized, controlled, and blinded study, children undergoing SPT were or were not accompanied by MC. All parents and children ≥8 years completed the State-Trait Anxiety Inventory (STAI) before and after SPT. Videotapes recorded during the procedure were scored for anxiety (m-YPAS) for all children and for pain (FLACC) for children 2-7 years old by a psychologist who was unaware of the MC's presence. After SPT, children ≥8 years completed a visual analog score (VAS) for pain. Ninety-one children (mean age 8.2 years, M/F = 54/37) were recruited of whom 45 were accompanied by clowns. A significant reduction in state-STAI was found in the clowns group, in both parents and children, when compared with the regular group (26.9 ± 6.6 and 32.3 ± 10.0; P = 0.004, and 27.1 ± 4.2 and 34.3 ± 7.6; P = 0.002, respectively). Both m-YPAS and FLACC were reduced in the clowns group compared with the regular one. In the clowns group, m-YPAS positively correlated with both VAS and FLACC (P = 0.000 and 0.002, respectively). m-YPAS was positively correlated with FLACC in the regular group (P = 0.000). Medical clowns significantly decrease the level of anxiety perceived by both children undergoing allergy SPT and their parents, as well as the pain perceived by young children. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. A feasibility study of Q-sort to determine recall of skin test results and environmental remediation education.

    PubMed

    Townsend, Kristen; Corry, James M; Quigley, Beth Hogan; George, Maureen

    2012-02-01

    Allergic asthma is common in urban minority children and evidence suggests that remediation tailored to the child's allergic profile is the most effective management strategy. The purpose of this pilot study therefore was to examine the caregiver's recall of their child's skin test results and the accuracy of planned remediation ∼4 months after testing. Caregivers were asked to recall their child's skin test results ∼4 months after their skin testing but before any follow-up visit. A Q-sort was then used to determine the knowledge of the recommended remediation. In this Q-sort, caregivers placed 52 cards, each representing one intervention for an indoor allergen, on a response board that prioritized the interventions. At the conclusion of the Q-sort, caregivers received feedback on the accuracy of their recall and prioritization. African American caregivers (5 females; mean age 33.6) of 5 children (4 males; mean age 7.8) were enrolled. No caregiver's recall of skin test results was concordant with the actual results for type or number of allergens. Caregiver's accuracy in prioritizing strategies was 33-100% for cat dander, 40-70% for molds, 70-87% for dust mite allergens, and 100% for the one dog allergic child. Subjects preferred Q-sort to traditional methods of receiving remediation education. Caregivers do not accurately recall skin test results and this may, in part, impede their ability to implement appropriate interventions. A low-literacy game-style approach is a novel strategy to provide complex teaching that warrants further investigation.

  9. EVALUATION OF DIAGNOSTIC ACCURACY OF THE COMPARATIVE TUBERCULIN SKIN TEST IN REHABILITANT BORNEAN ORANGUTANS (PONGO PYGMAEUS).

    PubMed

    Dench, Rosalie; Sulistyo, Fransiska; Fahroni, Agus; Philippa, Joost

    2015-12-01

    The tuberculin skin test (TST) has been the mainstay of tuberculosis (TB) testing in primates for decades, but its interpretation in orangutans (Pongo spp.) is challenging, because many animals react strongly, without evidence of infection with Mycobacterium tuberculosis complex. One explanation is cross-reactivity with environmental nontuberculous mycobacteria (NTM). The use of a comparative TST (CTST), comparing reactivity to avian (representing NTM) and bovine (representing tuberculous mycobacteria) tuberculins aids in distinguishing cross-reactivity due to sensitization by NTM from shared antigens. The specificity of the TST can be increased with the use of CTST. We considered three interpretations of the TST in rehabilitant Bornean orangutans ( Pongo pygmaeus ) using avian purified protein derivative (APPD; 25,000 IU/ml) and two concentrations of bovine purified protein derivative (BPPD; 100,000 and 32,500 IU/ml). The tests were evaluated for their ability to identify accurately seven orangutans previously diagnosed with and treated for TB from a group of presumed negative individuals (n = 288 and n = 161 for the two respective BPPD concentrations). BPPD at 32,500 IU/ml had poor diagnostic capacity, whereas BPPD at 100,000 IU/ml performed better. The BPPD-only interpretation had moderate sensitivity (57%) and poor specificity (40%) and accuracy (41%). The comparative interpretation at 72 hr had similar sensitivity (57%) but improved specificity (95%) and accuracy (94%). However, best results were obtained by a comparative interpretation incorporating the 48- and 72-hr scores, which had good sensitivity (86%), specificity (95%) and accuracy (95%). These data reinforce recommendations that a CTST be used in orangutans and support the use of APPD at 25,000 IU/ml and BPPD at 100,000 IU/ml. The highest score at each site from the 48- and 72-hr checks should be considered the result for that tuberculin. If the bovine result is greater than the avian result, the

  10. Intralesional injection of mumps or Candida skin test antigens: a novel immunotherapy for warts.

    PubMed

    Johnson, S M; Roberson, P K; Horn, T D

    2001-04-01

    Warts are common and induce physical and emotional discomfort. Numerous therapies exist, yet none is optimal. Despite theoretical advantages, immunotherapeutic modalities are often neglected as first-line wart therapies. To compare treatment with intralesional skin test antigen injection of 1 wart vs cryotherapy of all warts. Pilot study. University dermatology outpatient clinic. A total of 115 consecutive patients with at least 1 nongenital wart. Patients with warts were tested for immunity to mumps and Candida using commercial antigens. Nonresponders received cryotherapy and immune individuals received cryotherapy or intralesional injection of 1 antiserum. Thirty-four (30%) of the 115 patients did not respond to the test injections and 81 (70%) had detectable immunity. Of the immune group, 26 (32%) received cryotherapy, 45 (56%) received intralesional mumps antiserum, and 10 (12%) received intralesional Candida antiserum. Of the anergic patients, 28 (82%) were treated with cryotherapy; 6 (18%) refused cryotherapy. Of the 39 patients who were treated with immunotherapy and completed the protocol, 29 (74%) had complete clearing of the treated wart. Fourteen (78%) of 18 patients with complete resolution of their immunotherapy-treated wart also had resolution of untreated, distant warts. Intralesional injection of mumps or Candida antigens into warts of immune individuals represents effective treatment. Observation of clearing of anatomically distinct and distant warts suggests acquisition of human papillomavirus-directed immunity in some patients. We conclude that this novel approach to immunotherapy may serve as first-line treatment in immune individuals with multiple or large warts and as second-line treatment in immune patients for whom cryotherapy fails.

  11. Evaluation of commercial skin prick test solutions for selected occupational allergens.

    PubMed

    van Kampen, V; de Blay, F; Folletti, I; Kobierski, P; Moscato, G; Olivieri, M; Quirce, S; Sastre, J; Walusiak-Skorupa, J; Kotschy-Lang, N; Müsken, H; Mahler, V; Schliemann, S; Ochmann, U; Sültz, J; Worm, M; Sander, I; Zahradnik, E; Brüning, T; Merget, R; Raulf-Heimsoth, M

    2013-01-01

    Skin prick testing (SPT) is an important step in the diagnosis of IgE-mediated occupational allergic diseases. The outcome of SPT is related to the quality of allergen extracts. Thus, the aim of the study was to assess different commercially available SPT solutions for selected occupational allergens. SPT was performed in 116 bakers, 47 farmers and 33 subjects exposed to natural rubber latex (NRL), all with work-related allergic symptoms. The SPT solutions from different manufacturers (n = 3-5) for wheat flour, rye flour, soy, cow hair/dander, storage mites (Tyrophagus putrescentiae, Lepidoglyphus destructor, Acarus siro) and NRL were analysed with respect to their protein and antigen contents. SPT was carried out in 16 allergy centres in six European countries using standardized procedures. Specific IgE values were used as the gold standard to calculate the sensitivity and specificity of SPT solutions. The optimal cut-point for each SPT solution was determined by Youden Index. Protein and antigen contents and patterns of the SPT solutions varied remarkably depending on the manufacturer. While SPT solutions for wheat flour and soy reached overall low sensitivities, sensitivities of other tested SPT solutions depended on the manufacturer. As a rule, solutions with higher protein and antigen content showed higher sensitivities and test efficiencies. There is a wide variability of SPT solutions for occupational allergens, and the sensitivity of several solutions is low. Thus, improvement and standardization of SPT solutions for occupational allergens is essential. © 2013 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.

  12. Display of Antigens on Polyester Inclusions Lowers the Antigen Concentration Required for a Bovine Tuberculosis Skin Test.

    PubMed

    Parlane, Natalie A; Chen, Shuxiong; Jones, Gareth J; Vordermeier, H Martin; Wedlock, D Neil; Rehm, Bernd H A; Buddle, Bryce M

    2015-10-28

    The tuberculin skin test is the primary screening test for the diagnosis of bovine tuberculosis (TB), and use of this test has been very valuable in the control of this disease in many countries. However, the test lacks specificity when cattle have been exposed to environmental mycobacteria or vaccinated with Mycobacterium bovis bacille Calmette-Guérin (BCG). Recent studies showed that the use of three or four recombinant mycobacterial proteins, including 6-kDa early secretory antigenic target (ESAT6), 10-kDa culture filtrate protein (CFP10), Rv3615c, and Rv3020c, or a peptide cocktail derived from those proteins, in the skin test greatly enhanced test specificity, with minimal loss of test sensitivity. The proteins are present in members of the pathogenic Mycobacterium tuberculosis complex but are absent in or not expressed by the majority of environmental mycobacteria and the BCG vaccine strain. To produce a low-cost skin test reagent, the proteins were displayed at high density on polyester beads through translational fusion to a polyhydroxyalkanoate synthase that mediates the formation of antigen-displaying inclusions in recombinant Escherichia coli. Display of the proteins on the polyester beads greatly increased their immunogenicity, allowing for the use of very low concentrations of proteins (0.1 to 3 μg of mycobacterial protein/inoculum) in the skin test. Polyester beads simultaneously displaying all four proteins were produced in a single fermentation process. The polyester beads displaying three or four mycobacterial proteins were shown to have high sensitivity for detection of M. bovis-infected cattle and induced minimal responses in animals exposed to environmental mycobacteria or vaccinated with BCG.

  13. Reconstructed epidermis and full-thickness skin for absorption testing: influence of the vehicles used on steroid permeation.

    PubMed

    Schäfer-Korting, Monika; Mahmoud, Ashraf; Lombardi Borgia, Simone; Brüggener, Barbara; Kleuser, Burkhard; Schreiber, Sylvia; Mehnert, Wolfgang

    2008-09-01

    A protocol for percutaneous absorption studies has been validated, based on the use of reconstructed human epidermis (RHE) and aqueous solutions of test substances. However, it is often the case that it is more-complex formulations of drugs or chemicals which will make contact with the skin surface. To investigate whether RHE and the reconstructed full-thickness skin model (FT-model) can be used to predict uptake from formulations, we compared the permeation of hydrocortisone and testosterone when applied in emulsion form and as a solution containing the penetration enhancer, ethanol. Human and pig skin and a non-cornified alveolar model served as references. The results were compared with steroid release from the formulations. The permeation rates of the steroids were ranked as: alveolar model > RHE > FT-model, pig skin > human skin. In accordance with the rapid hydrocortisone release from the formulations, the permeation rates of this steroid exceeded those of testosterone. Only minor differences were observed when comparing the testosterone formulations, in terms of release and permeation. However, the ranking of the permeation of the hydrocortisone formulations was: solution > w/o emulsion > o/w emulsion, which permitted the elucidation of penetration enhancing effects, which is not possible with drug release studies. Differences in penetration were most obvious with native skin and reconstructed tissues, which exhibited a well-developed penetration barrier. In conclusion, RHE and skin preparations may be useful in the development of topical dermatics, and in the framework of hazard analysis of toxic compounds and their various formulations.

  14. Tuberculin skin test positivity without tuberculosis contact: A major challenge in childhood.

    PubMed

    Gedik, Ahmet Hakan; Cakir, Erkan; Donmez, Tugrul; Ari, Engin; Koksalan, Orhan Kaya

    2015-06-01

    Worldwide, tuberculin skin tests (TSTs) commonly give false positive results for those who had been given the Bacillus-Calmette-Guerin vaccine such as is routinely administered in Turkey. This study aimed to evaluate the patients referred to us who had positive TSTs despite lack of tuberculosis (TB) disease contacts. Between September 2011 and September 2012, 183 patients were prospectively evaluated for differential diagnosis of TST positivity despite lack of TB disease contact. They were then followed up by us to determine an accurate diagnosis. Among our patients' most common symptoms indicating a need for TST were chronic cough, productive cough or sputum expectoration, and recurrent or persistent wheezing. Chest x-rays were taken of all patients, and the findings were noted. Interferon gamma release assays were performed on 75% of the patients, of which 96% were negative for TB. The most common final diagnoses were asthma (44%), allergic rhinitis (13%), bronchopneumonia (11%) and reactive lymphadenitis (6.5%). Further evaluations for TB were required of 36 patients, and TB disease was established in 12 of them (6.5%). In patients who had had no known TB contact, the most common symptom indicating need for TST was chronic cough; the most common diagnoses were asthma and allergic rhinitis. Cavitary lesions, haemoptysis, persistent infiltration, pleural effusion and thoracic lymphadenopathy despite antibiotherapy should alert physicians to the possibility of TB. © 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  15. Two loci control tuberculin skin test reactivity in an area hyperendemic for tuberculosis.

    PubMed

    Cobat, Aurelie; Gallant, Caroline J; Simkin, Leah; Black, Gillian F; Stanley, Kim; Hughes, Jane; Doherty, T Mark; Hanekom, Willem A; Eley, Brian; Jaïs, Jean-Philippe; Boland-Auge, Anne; van Helden, Paul; Casanova, Jean-Laurent; Abel, Laurent; Hoal, Eileen G; Schurr, Erwin; Alcaïs, Alexandre

    2009-11-23

    Approximately 20% of persons living in areas hyperendemic for tuberculosis (TB) display persistent lack of tuberculin skin test (TST) reactivity and appear to be naturally resistant to infection by Mycobacterium tuberculosis. Among those with a positive response, the intensity of TST reactivity varies greatly. The genetic basis of TST reactivity is not known. We report on a genome-wide linkage search for loci that have an impact on TST reactivity, which is defined either as zero versus nonzero (TST-BINa) or as extent of TST in millimeters (TST-quantitative trait locus [QTL]) in a panel of 128 families, including 350 siblings, from an area of South Africa hyperendemic for TB. We detected a major locus (TST1) on chromosomal region 11p14 (P = 1.4 x 10(-5)), which controls TST-BINa, with a lack of responsiveness indicating T cell-independent resistance to M. tuberculosis. We also detected a second major locus (TST2) on chromosomal region 5p15 (P < 10(-5)), which controls TST-QTL or the intensity of T cell-mediated delayed type hypersensitivity (DTH) to tuberculin. Fine mapping of this region identified SLC6A3, encoding the dopamine transporter DAT1, as a promising gene for further studies. Our results pave the way for the understanding of the molecular mechanisms involved in resistance to M. tuberculosis infection in endemic areas (TST1) and for the identification of critical regulators of T cell-dependent DTH to tuberculin (TST2).

  16. Prevalence of positive tuberculosis skin tests during 5 years of screening in a Swiss remand prison.

    PubMed

    Ritter, C; Elger, B S

    2012-01-01

    Tuberculosis (TB) screening in prisons is recommended, but the appropriate methods remain controversial. Studies evaluating screening in remand prisons are scarce. Between 1997 and 2001, voluntary screening based on the tuberculin skin test (TST) was offered to all prisoners on entry into the largest remand prison in Switzerland. Prisoners with positive results underwent chest X-rays. We analysed this information collected in an anonymous database. A total of 4890 prisoners entered the prison and were eligible for screening; 3779 (77.3%) had TST performed on average 9 days after arrival: 46.9% were positive (induration ≥ 10 mm). Positive TST rates were similar over the 5 years. Women were more likely to have a negative TST (60.4%) than men (47.7%; P < 0.001, Pearson's (2) 16.5). Positive TSTs varied according to the prisoner's country of origin (64% for sub-Saharan Africa, 57% for Eastern Europe, 56% for North Africa, 51% for Asia and 34% for North and West Europe). The percentage of TST-positive subjects was high, and most did not receive preventive treatment for latent TB. The usefulness of systematic TST for all prisoners on entry is limited, as diagnosis of TB disease usually remains the priority in prisons.

  17. Testing a linear time invariant model for skin conductance responses by intraneural recording and stimulation.

    PubMed

    Gerster, Samuel; Namer, Barbara; Elam, Mikael; Bach, Dominik R

    2017-09-01

    Skin conductance responses (SCR) are increasingly analyzed with model-based approaches that assume a linear and time-invariant (LTI) mapping from sudomotor nerve (SN) activity to observed SCR. These LTI assumptions have previously been validated indirectly, by quantifying how much variance in SCR elicited by sensory stimulation is explained under an LTI model. This approach, however, collapses sources of variability in the nervous and effector organ systems. Here, we directly focus on the SN/SCR mapping by harnessing two invasive methods. In an intraneural recording experiment, we simultaneously track SN activity and SCR. This allows assessing the SN/SCR relationship but possibly suffers from interfering activity of non-SN sympathetic fibers. In an intraneural stimulation experiment under regional anesthesia, such influences are removed. In this stimulation experiment, about 95% of SCR variance is explained under LTI assumptions when stimulation frequency is below 0.6 Hz. At higher frequencies, nonlinearities occur. In the intraneural recording experiment, explained SCR variance is lower, possibly indicating interference from non-SN fibers, but higher than in our previous indirect tests. We conclude that LTI systems may not only be a useful approximation but in fact a rather accurate description of biophysical reality in the SN/SCR system, under conditions of low baseline activity and sporadic external stimuli. Intraneural stimulation under regional anesthesia is the most sensitive method to address this question. © 2017 The Authors. Psychophysiology published by Wiley Periodicals, Inc. on behalf of Society for Psychophysiological Research.

  18. The effect of allergic rhinitis with positive skin prick test on choroidal thickness.

    PubMed

    Yenigun, Alper; Elbay, Ahmet; Dogan, Remzi; Ozturan, Orhan; Ozdemir, Mehmet Hakan

    2017-03-06

    Allergic rhinitis is an inflammatory disease that develops through immunoglobulin E in the rhino-ocular mucosa due to allergy. The main symptoms are runny nose, nasal congestion, sneezing and itchy nose. This study was designed to investigate the effect of allergic rhinitis on choroidal thickness. This study was planned as a case-control study. This study performed in a tertiary referral center. The study included 61 patients with allergic rhinitis and 35 healthy subjects. Patients in both groups underwent skin prick test. In allergic rhinitis patients and healthy persons; subfoveal, temporal and nasal choroidal thickness measurement was performed. The choroidal thicknesses were measured without pupil dilation using the Spectralis Optical Coherence Tomography. In the subfoveal and temporal region, choroidal tissue was followed up significantly thicker in allergic rhinitis patients statistically compared to healthy persons (p = 0.031, p = 0.049). However, no significant difference was followed up between the nasal choroidal thickness measurements statistically (p = 0.54). Runny nose (67.2%), sneeze (65.5%), stuffiness (62.2%), itching of the nose (40.9%), and nasal discharge (21.3%) complaints were observed significantly higher in the group having allergic rhinitis. The effect of allergic rhinitis on choroidal thickness were assessed and compared with the control group. Our study revealed that there was significant association between increased choroidal thickness and allergic rhinitis. Allergic sensitivity may play an important role in increased choroidal thickness.

  19. Crude 4-methylcyclohexanemethanol (MCHM) did not cause skin irritation in humans in 48-h patch test.

    PubMed

    Monnot, Andrew D; Novick, Rachel M; Paustenbach, Dennis J

    2017-03-13

    Crude 4-methylcyclohexanemethanol (MCHM) is an industrial chemical used to wash and clean coal. On January 9th, 2014 approximately 10,000 gallons of a mixture containing crude MCHM were released into the Elk River near Charleston, West Virginia, contaminating the local water supply. Following the spill, residents reported numerous health complaints, and sought medical attention for ailments including rashes and itching. The relationship between the complaints and the spill were unknown, as such symptoms are reported frequently in the background. In this study, the primary irritation potential of crude MCHM was evaluated in 206 individuals who underwent 48 hour semi-occluded patch testing. MCHM concentrations assessed in this study were 1, 5, 15, and 100 ppm. No appreciable skin reactions were observed in individuals at any concentration. Three of the five concentrations evaluated were above the highest measured concentration of MCHM in the tap water of residents in West Virginia (3.7 ppm). The results of this study suggest that crude MCHM would not be a dermal irritant for the vast majority, if not all, potentially exposed persons at the concentrations in the water reported after the spill.

  20. Tuberculin skin test positivity in pediatric allogeneic BMT recipients and donors in Turkey.

    PubMed

    Tavil, Betul; Gulhan, Bora; Ozcelik, Ugur; Cetin, Mualla; Tezcan, Ilhan; Tuncer, Murat; Uckan, Duygu

    2007-06-01

    The preliminary study was performed to determine the frequency of tuberculin skin test (TST) positivity among 26 patients and their donors screened by TST to investigate whether tuberculin positivity of a recipient or donor influenced the rate of tuberculosis disease, transplant-related events, and to evaluate the effectiveness of isoniazide (INAH) prophylaxis administered to those with positive TST. The frequency of TST positivity was 23% (n = 6) among recipients and also 23% (n = 6) among donors. Two recipients and five donors with positive TST received INAH prophylaxis for six months. Our use of INAH prophylaxis in transplant patients was very conservative because of the risk of drug interaction. The transplantation procedure was not postponed for either recipient or donor TST positivity. Despite the high frequency of tuberculosis in our country, we have not detected any case of tuberculosis in our center, either among the purified protein derivative-screened (n = 26) or non-screened (n = 128) patients except for disseminated tuberculosis infection because of BCG vaccination in two patients with severe combined immunodeficiency. In conclusion, TST positivity in either recipient or donor may not be a contraindication for bone marrow transplantation and the procedure may not be postponed. Pretransplantation TST screening may be needed in countries where tuberculosis is common in the general population.

  1. Changes in Tuberculin Skin Test Positivity Over 20 Years in Periurban Shantytowns in Lima, Peru

    PubMed Central

    Martinez, Leonardo; Arman, Alyssa; Haveman, Nathan; Lundgren, Ashley; Cabrera, Lilia; Evans, Carlton A.; Pelly, Tom F.; Saito, Mayuko; Callacondo, David; Oberhelman, Richard; Collazo, Gisela; Carnero, Andrés M.; Gilman, Robert H.

    2013-01-01

    A cross-sectional, community-based study was performed in 2012 with 428 residents of periurban shantytowns in Lima, Peru to study risk factors for and changes in latent tuberculosis infection in age-stratified groups compared with our data from the same region in 1990 (N = 219) and 2005 (N = 103). Tuberculin skin test positivity in these communities was highly prevalent at 52% overall, increased with age (P < 0.01) and was similar to 2005 (53%) and 1990 (48%). From 1990 to 2012, the prevalence of tuberculin positivity decreased in 5–14 and 15–24 year old groups (to 17% and 34%, respectively, both P < 0.05). However, this may be explained by cessation of Bacille Calmette-Guérin revaccination during this period, because Bacille Calmette-Guérin revaccination doubled tuberculin positivity. Over the same 22-year period, tuberculin positivity in the ≥ 25 year old group remained high (71%, P = 0.3), suggesting that prevalent latent tuberculosis infection persists in the adult population despite improving medical care and socioeconomic development in this region. PMID:23878185

  2. Skin Temperature during Cold Pressor Test in Fibromyalgia: an Evaluation of the Autonomic Nervous System?

    PubMed

    Brusselmans, Griet; Nogueira, Hugo; De Schamphelaere, Elien; Devulder, Jacques; Crombez, Geert

    2015-01-01

    Fibromyalgia (FM) is a common chronic pain disorder characterized by whole-body pain and multiple symptoms. This study investigated potential dysfunctions of the Autonomic Nervous System (ANS) in FM patients through the measurement of the autonomic response during a cold-water test. 23 female patients with FM and 15 healthy female controls were recruited. First, FM patients filled out the following questionnaires: PainDETECT, American College of Rheumatology (ACR) criteria of FM, and Profile of Mood States (POMS). Healthy controls only filled out the POMS. Subsequently, all participants immersed their forearm into 1 degrees C cold-water as long as they could tolerate for a maximum of 120 seconds. A thermographic camera recorded skin temperature and its recuperation process. The two groups differed significantly regarding central body temperature, forearm thermography, and peripheral (forearm)-central (ear) temperature ratio. FM patients showed less tolerance to cold water than control participants. Although total temperature decrease, cool-down rate, recuperation between 0 and 20 minutes after withdrawal showed significant intergroup differences, thermal recovery followed similar patterns in both groups. Peculiar ANS baseline characteristics are seen in FM patients. Although those patients have reduced ability to sustain low temperatures, therefore limiting extrapolation of inter-group analysis, their thermal-adaptive responses were found different as compared to controls.

  3. Cigarette Smoking and Skin Prick Test in Patients With Allergic Rhinitis.

    PubMed

    Khazaei, Hossein Ali; Khazaei, Bahman; Dashtizadeh, Gholam Ali; Mohammadi, Mahdi

    2015-09-01

    Allergic Rhinitis (AR) is the most common allergic disease, affecting 30% of population around the world. The disease is predominantly associated with exposure to some aeroallergens like cigarette smoking. Skin Prick Test (SPT) is a method of detecting immediate allergic reactions and is applied for controlling disease and therapeutic modality. This study was designed to investigate the effect of cigarette smoking on SPT results among male and female individuals with AR disease. A total of 478 patients with AR admitted to the 2 main hospitals of Zahedan City from 2005 to 2012, were recruited in this analytic-descriptive study. Categories of smokers and never smokers were used based on patient's statements and their history of smoking. SPT was performed with panel of some allergens and results were recorded and analyzed statistically. Odds ratio and confidence interval method were calculated using univariate logistic regression. The results of this study indicated that 41.4% of patients with allergic rhinitis was smoker with ages ranged from 15 to 70 years. The result of this study also showed that smoking has no effect on SPT results of pollen and weeds aeroallergens conducted on male and female AR patients. However, male were significantly more sensitive than female in terms of sensitivity to the aspergillus, cladosporium, house dust mite, grasses, wheat, cockroach, and feather allergens. Our findings did not support the effect of cigarette smoking on SPT reactivity to pollen and weeds aeroallergens. However, male were significantly more sensitive than female in terms of sensitivity to some allergens.

  4. Modulation of atopy patch test reactions by topical treatment of human skin with a fatty acid-rich emollient.

    PubMed

    Billmann-Eberwein, C; Rippke, F; Ruzicka, T; Krutmann, J

    2002-01-01

    Measures directed at improving the skin barrier function are thought to be effective in preventing reexacerbation of atopic dermatitis, but direct proof of a prophylactic effect of emollients has been elusive. In the present study, the atopy patch test has been employed as a model for the initiation phase of atopic dermatitis in order to assess whether pretreatment of non-lesional skin with a fatty acid-rich emollient (Eucerin Omega Creme) has a prophylactic effect in patients with atopic dermatitis. Pretreatment of test sites with Eucerin Omega Creme either prevented or diminished the development of eczema, as compared with untreated control test sites in the same patients (n = 38). These studies indicate that the use of fatty acid-rich emollients prevents the development of atopic eczema. They also demonstrate that the atopy patch test can be used to assess the capacity of a given regimen to exert prophylactic effects in this disease. Copyright 2002 S. Karger AG, Basel

  5. Proposal of a skin tests based approach for the prevention of recurrent hypersensitivity reactions to iodinated contrast media.

    PubMed

    Della-Torre, E; Berti, A; Yacoub, M R; Guglielmi, B; Tombetti, E; Sabbadini, M G; Voltolini, S; Colombo, G

    2015-05-01

    The purpose of the present work is to evaluate the efficacy of an approach that combines clinical history, skin tests results, and premedication, in preventing recurrent hypersensitivity reactions to iodinated contrast media (ICM). Skin Prick tests, Intradermal tests, and Patch tests were performed in 36 patients with a previous reaction to ICM. All patients underwent a second contrast enhanced radiological procedure with an alternative ICM selected on the basis of the proposed approach. After alternative ICM re-injection, only one patient presented a mild NIR. The proposed algorithm, validated in clinical settings where repeated radiological exams are needed, offers a safe and practical approach for protecting patients from recurrent hypersensitivity reactions to ICM.

  6. Open source software implementation of an integrated testing strategy for skin sensitization potency based on a Bayesian network.

    PubMed

    Pirone, Jason R; Smith, Marjolein; Kleinstreuer, Nicole C; Burns, Thomas A; Strickland, Judy; Dancik, Yuri; Morris, Richard; Rinckel, Lori A; Casey, Warren; Jaworska, Joanna S

    2014-01-01

    An open-source implementation of a previously published integrated testing strategy (ITS) for skin sensitization using a Bayesian network has been developed using R, a free and open-source statistical computing language. The ITS model provides probabilistic predictions of skin sensitization potency based on in silico and in vitro information as well as skin penetration characteristics from a published bioavailability model (Kasting et al., 2008). The structure of the Bayesian network was designed to be consistent with the adverse outcome pathway published by the OECD (Jaworska et al., 2011, 2013). In this paper, the previously published data set (Jaworska et al., 2013) is improved by two data corrections and a modified application of the Kasting model. The new data set implemented in the original commercial software package and the new R version produced consistent results. The data and a fully documented version of the code are publicly available (http://ntp.niehs.nih.gov/go/its).

  7. Evaluation of finger skin temperature by cold provocation test for diagnosis of vibration induced white finger (VWF).

    PubMed

    Tomida, K; Morioka, I; Kaewboonchoo, O; Yamamoto, H; Miyai, N; Ishii, N; Miyashita, K

    1998-01-01

    Clinical data of workers (40-69 yrs) operating chain saws for a ten-year period from 1986 to 1995 were analyzed to assess the evaluation standard of finger skin temperature for a cold provocation test (10 degrees C 10 min). Screening points of finger skin temperature for screening 191 workers with a vibration induced white finger (VWF) were obtained from receiver operating characteristic (ROC) curves. The screening points at 5 min and 10 min after a cold provocation were approximately equal to 50th percentiles of 217 workers with no symptoms (NS group). The screening points of recovery rates at 5 min and 10 min after a cold provocation almost agreed with 50th percentiles in NS group. A new evaluation standard was prepared in reference to these screening points and finger skin temperatures by fraction in NS group. The new one will be useful for the health care of workers operating vibrating tools under present working conditions.

  8. Quantitative thermal sensory testing and sympathetic skin response in primary Restless legs syndrome - A prospective study on 57 Indian patients.

    PubMed

    Shukla, Garima; Goyal, Vinay; Srivastava, Achal; Behari, Madhuri

    2012-10-01

    Patients with restless leg syndrome present with sensory symptoms similar to peripheral neuropathy. While there is evidence of abnormalities of dopaminergic pathways, the peripheral nervous system has been studied infrequently. We studied conventional nerve conduction studies, quantitative thermal sensory testing and sympathetic skin response in 57 patients with primary restless leg syndrome. Almost two third patients demonstrated abnormalities in the detailed testing of the peripheral nervous system. Sbtle abnormalities of the peripheral nervous system may be more common than previously believed.

  9. Integrating a Rapid Diagnostic Test and Antimicrobial Stewardship: Optimizing Discharge Antibiotics in Skin and Soft Tissue Infections.

    PubMed

    Yu, Diana; Stach, Leslie; Newland, Jason G; Selvarangan, Rangaraj; Goldman, Jennifer

    2016-12-01

    A rapid test to detect methicillin resistance in Staphylococcus aureus through the penicillin-binding protein 2a antigen was introduced for pediatric patients hospitalized for purulent skin and soft tissue infections. Integration of this test with physician education and stewardship guidance improved targeted antibiotic use for infections caused by methicillin-susceptible S. aureus (44%-80%, P < 0.001), including when final culture results were not available.

  10. The Lancet Weight Determines Wheal Diameter in Response to Skin Prick Testing with Histamine

    PubMed Central

    Andersen, Hjalte H.; Elberling, Jesper; Arendt-Nielsen, Lars

    2016-01-01

    Background Skin prick test (SPT) is a common test for diagnosing immunoglobulin E-mediated allergies. In clinical routine, technicalities, human errors or patient-related biases, occasionally results in suboptimal diagnosis of sensitization. Objective Although not previously assessed qualitatively, lancet weight is hypothesized to be important when performing SPT to minimize the frequency of false positives, false negatives, and unwanted discomfort. Methods Accurate weight-controlled SPT was performed on the volar forearms and backs of 20 healthy subjects. Four predetermined lancet weights were applied (25 g, 85 g, 135 g and 265 g) using two positive control histamine solutions (1 mg/mL and 10 mg/mL) and one negative control (saline). A total of 400 SPTs were conducted. The outcome parameters were: wheal size, neurogenic inflammation (measured by superficial blood perfusion), frequency of bleeding, and the lancet provoked pain response. Results The mean wheal diameter increased significantly as higher weights were applied to the SPT lancet, e.g. from 3.2 ± 0.28 mm at 25 g to 5.4 ± 1.7 mm at 265 g (p<0.01). Similarly, the frequency of bleeding, the provoked pain, and the neurogenic inflammatory response increased significantly. At 265 g saline evoked two wheal responses (/160 pricks) below 3 mm. Conclusion and clinical relevance The applied weight of the lancet during the SPT-procedure is an important factor. Higher lancet weights precipitate significantly larger wheal reactions with potential diagnostic implications. This warrants additional research of the optimal lancet weight in relation to SPT-guidelines to improve the specificity and sensitivity of the procedure. PMID:27213613

  11. Association between tuberculin skin test result and clinical presentation of tuberculosis disease

    PubMed Central

    2013-01-01

    Background The tuberculin skin test (TST) is used to test for latent tuberculosis (TB) infection and support the diagnosis of active TB. However, little is known about the relationship between the TST result and the clinical presentation of TB disease. Methods We analyzed US TB surveillance data, 1993–2010, and used multinomial logistic regression to calculate the association between TST result (0–4 mm [negative], 5–9 mm, 10–14 mm, and ≥ 15 mm) and clinical presentation of disease (miliary, combined pulmonary and extrapulmonary, extrapulmonary only, non-cavitary pulmonary, and cavitary pulmonary). For persons with pulmonary disease, multivariate logistic regression was used to calculate the odds of having acid-fast bacilli (AFB) positive sputum. Results There were 64,238 persons with culture-confirmed TB included in the analysis, which was stratified by HIV status and birthplace (US- vs. foreign-born). Persons with a TST ≥ 15 mm were less likely to have miliary or combined pulmonary and extrapulmonary disease, but more likely to have cavitary pulmonary disease than non-cavitary pulmonary disease. Persons with non-cavitary pulmonary disease with a negative TST were significantly more likely to have AFB positive sputum. Conclusions Clinical presentation of TB disease differed according to TST result and persons with a negative TST were more likely to have disseminated disease (i.e., miliary or combined pulmonary and extrapulmonary). Further study of the TST result may improve our understanding of the host-pathogen relationship in TB disease. PMID:24093965

  12. The Lancet Weight Determines Wheal Diameter in Response to Skin Prick Testing with Histamine.

    PubMed

    Andersen, Hjalte H; Lundgaard, Anna Charlotte; Petersen, Anne S; Hauberg, Lise E; Sharma, Neha; Hansen, Sofie D; Elberling, Jesper; Arendt-Nielsen, Lars

    2016-01-01

    Skin prick test (SPT) is a common test for diagnosing immunoglobulin E-mediated allergies. In clinical routine, technicalities, human errors or patient-related biases, occasionally results in suboptimal diagnosis of sensitization. Although not previously assessed qualitatively, lancet weight is hypothesized to be important when performing SPT to minimize the frequency of false positives, false negatives, and unwanted discomfort. Accurate weight-controlled SPT was performed on the volar forearms and backs of 20 healthy subjects. Four predetermined lancet weights were applied (25 g, 85 g, 135 g and 265 g) using two positive control histamine solutions (1 mg/mL and 10 mg/mL) and one negative control (saline). A total of 400 SPTs were conducted. The outcome parameters were: wheal size, neurogenic inflammation (measured by superficial blood perfusion), frequency of bleeding, and the lancet provoked pain response. The mean wheal diameter increased significantly as higher weights were applied to the SPT lancet, e.g. from 3.2 ± 0.28 mm at 25 g to 5.4 ± 1.7 mm at 265 g (p<0.01). Similarly, the frequency of bleeding, the provoked pain, and the neurogenic inflammatory response increased significantly. At 265 g saline evoked two wheal responses (/160 pricks) below 3 mm. The applied weight of the lancet during the SPT-procedure is an important factor. Higher lancet weights precipitate significantly larger wheal reactions with potential diagnostic implications. This warrants additional research of the optimal lancet weight in relation to SPT-guidelines to improve the specificity and sensitivity of the procedure.

  13. Sub-categorisation of skin corrosive chemicals by the EpiSkin™ reconstructed human epidermis skin corrosion test method according to UN GHS: revision of OECD Test Guideline 431.

    PubMed

    Alépée, N; Grandidier, M H; Cotovio, J

    2014-03-01

    The EpiSkin™ skin corrosion test method was formally validated and adopted within the context of OECD TG 431 for identifying corrosive and non-corrosive chemicals. The EU Classification, Labelling and Packaging Regulation (EU CLP) system requires the sub-categorisation of corrosive chemicals into the three UN GHS optional subcategories 1A, 1B and 1C. The present study was undertaken to investigate the usefulness of the validated EpiSkin™ test method to identify skin corrosive UN GHS Categories 1A, 1B and 1C using the original and validated prediction model and adapted controls for direct MTT reduction. In total, 85 chemicals selected by the OECD expert group on skin corrosion were tested in three independent runs. The results obtained were highly reproducible both within (>80%) and between (>78%) laboratories when compared with historical data. Moreover the results obtained showed that the EpiSkin™ test method is highly sensitive (99%) and specific (80%) in discriminating corrosive from non-corrosive chemicals and allows reliable and relevant identification of the different skin corrosive UN GHS subcategories, with high accuracies being obtained for both UN GHS Categories 1A (83%) and 1B/1C (76%) chemicals. The overall accuracy of the test method to subcategorise corrosive chemicals into three or two UN GHS subcategories ranged from 75% to 79%. Considering those results, the revised OECD Test Guideline 431 permit the use of EpiSkin™ for subcategorising corrosive chemicals into at least two classes (Category 1A and Category 1B/1C). Copyright © 2013. Published by Elsevier Ltd.

  14. De-labelling self-reported penicillin allergy within the emergency department through the use of skin tests and oral drug provocation testing.

    PubMed

    Marwood, Joseph; Aguirrebarrena, Gonzalo; Kerr, Stephen; Welch, Susan A; Rimmer, Janet

    2017-04-05

    Self-reported penicillin allergy is common among patients attending the ED, but is a poor predictor of true immunoglobulin E-mediated hypersensitivity to penicillin. We hypothesise that with a combination of skin testing and drug provocation testing, selected patients can be safely de-labelled of their allergy. This prospective study enrolled a sample of patients presenting to an urban academic ED between 2011 and 2016 with a self-reported allergy to penicillin. Standardised skin prick and intradermal testing with amoxicillin and both major and minor determinants of penicillin was performed in the department. If negative, testing was followed by a graded oral challenge of amoxicillin over 9 days. The primary end point was the allergy status of participants at the end of the study. A total of 100 patients (mean age 42; standard deviation 14 years; 54% women) completed the testing. Of these, 81% (95% confidence interval 71.9-88.2) showed no hypersensitivity to penicillin and were labelled non-allergic. The majority (16/19) of allergies were confirmed by skin testing, with three suspected allergies detected by the oral challenge. Women were more likely than men to have a true penicillin allergy, with odds ratio of 4.0 (95% confidence interval 1.23-13.2). There were no serious adverse events. Selected patients in the ED who self-report an allergy to penicillin can be safely tested there for penicillin allergy, using skin tests and oral drug provocation testing. This testing allows a significant de-labelling of penicillin allergy, with the majority of these patients able to tolerate penicillin without incident. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  15. Rocuronium and cisatracurium-positive skin tests in non-allergic volunteers: determination of drug concentration thresholds using a dilution titration technique.

    PubMed

    Berg, C M; Heier, T; Wilhelmsen, V; Florvaag, E

    2003-05-01

    Muscle relaxants are believed to be responsible for 2/3 of the cases of anaphylactic reactions during anesthesia. This assumption is based mainly on positive skin tests obtained in individuals that have experienced anesthesia-related anaphylaxis. A positive skin test is supposed to be associated with mast cell degranulation of vasoactive amines. In the present study we tested the frequency of positive skin tests with two commonly used muscle relaxants, rocuronium and cisatracurium, in a selected group of volunteers with low potential for allergic reactions. Thirty healthy volunteers without known allergy or previous exposure to muscle relaxants were studied. Low potential for allergic reactions was determined prior to inclusion in the study, using various allergy tests. Each individual was tested with intradermal and skin prick tests, and molar drug concentration thresholds for positive skin reactions were determined using a dilution titration technique. The presence or absence of mast cell degranulation was tested by electron microscopic investigation of skin biopsies obtained from positive and negative skin reactions. None of the volunteers had a positive skin prick test. More than 90% of the volunteers had a positive intradermal test with both rocuronium and cisatracurium. The highest molar drug concentration that was not associated with a positive intradermal test was 10(-6) M (rocuronium) and 10(-7) M (cisatracurium), equivalent to vial dilution 1 : 1000 for both drugs. In none of the volunteers was mast cell degranulation detected. Non-mast-cell-mediated positive intradermal skin reactions are frequently occurring with rocuronium and cisatracurium, even at vial dilution 1 : 1000. A clinically applicable test technique is needed that is able to separate positive skin tests associated with mast cell degranulation from non-mast-cell-mediated reactions.

  16. [Skin tuberculin test (STT) for screening tuberculosis in contacts of tuberculosis patients].

    PubMed

    Toure, N O; Dia, Y; Diatta, A; Ndiaye, E H M; Thiam, K; Niang, A; Fall, N; Kane, M; Mbae, F; Cisse, A; Hane, A A

    2006-01-01

    Many studies have underlined the theorical and practical role of Skin Tuberculin Test (STT) as an important tool for the diagnosis and for the screening of tuberculosis in the population. This prospective study evaluated STT in 51 smear positive tuberculosis patients and 108 contacts tuberculosis patients apparently in a good health condition. Twenty seven patients have disappeared before the end of the study and 7 patients were excluded for non suitable results. So we analysed only 73 cases. The mean age was 34 years, with extreme of 1 and 77 years. There were 33 male and 40 female patients for a sex-ratio of 0,8. BCG vaccination scar was found in 64% of patients. We calculated the Body-Mass-Index and we found a proteinocaloric malnutrition (BMI<18,5) in 30%. The mean diameter of STT induration was 12,3mm with extremes of 7 and 20mm. Considering a STT < 7 mm as negative, 4 patients (5%) had a negative STT and 69 (95%) a positive STT. 13 of these 69 patients had a STT > 15mm. The age group of the 10 to 50 years had more positive STT. Meanwhile, according to the sexe and to the nutritional status, there was no statistical difference. All patients with a negative STT received BCG vaccination after 2 months of follow-up. Those with STT>15mm were examinated and had a chest X-ray the day of their enrolment, at the second month and at the sixth month and we didn't find any evolutive tuberculosis. According to these results, we can conclude that STT is not an important test for the screening of pulmonary tuberculosis in contact patients. Clinical examination, chest X-ray and sputum smear remain very important for the diagnosis. Despite these results, STT remain the only validated technic between the different tuberculin tests. Its interest was twofold: the research of an acquired immunity against tuberculosis after BCG immunisation and it is clinical test for the diagnosis of tuberculosis in children.

  17. Follow-up to the ECVAM prevalidation study on in vitro tests for acute skin irritation. The European Centre for the Validation of Alternative Methods Skin Irritation Task Force report 2.

    PubMed

    Zuang, Valérie; Balls, Michael; Botham, Philip A; Coquette, Alain; Corsini, Emanuela; Curren, Rodger D; Elliott, Graham R; Fentem, Julia H; Heylings, Jon R; Liebsch, Manfred; Medina, Jesús; Roguet, Roland; van de Sandt, Johannes J M; Wiemann, Christianne; Worth, Andrew P

    2002-01-01

    The European Centre for the Validation of Alternative Methods (ECVAM) Skin Irritation Task Force was established in 1996, to review the status of the development and validation of alternative tests for skin irritation and corrosion, and to identify appropriate non-animal tests for predicting human skin irritation that were sufficiently well-developed to be prevalidated and validated by ECVAM. The EpiDerm method, based on a reconstituted human skin model, was proposed as being sufficiently well advanced to enter a prevalidation (PV) study. Based on a review of test protocols, prediction models (PMs), and data submitted by test developers on ten specified chemicals, with 20% sodium lauryl sulphate as a reference standard, the task force recommended the inclusion of four other tests: EPISKIN and PREDISKIN, based on reconstituted human epidermis or on human skin; the non-perfused pig-ear test, based on pig skin; and the skin integrity function test (SIFT), with ex vivo mouse skin. The prevalidation study on these methods was funded by ECVAM, and took place during 1999-2000. The outcome of the PV study was that none of the methods was ready to enter a formal validation study, and that the protocols and PMs of the methods had to be improved in order to increase their predictive abilities. Improved protocols and PMs for the EpiDerm and EPISKIN methods, the pig ear test, and the SIFT were presented at an extended Task Force meeting held in May 2001. It was agreed that, in the short term, the performance of the revised and harmonised EpiDerm and EPISKIN methods, as well as the modified SIFT, should be evaluated in a further study with a new set of 20 test chemicals. In addition, it was decided that the SIFT and the pig ear test would be compared to see if common endpoints (transepidermal water loss, methyl green-pyronine stain) could be identified.

  18. Recent tests at Langley with a University of Tennessee Space Institute (UTSI) skin friction balance

    NASA Technical Reports Server (NTRS)

    Lawing, Pierce L.; Vakili, A. D.; Wu, J. M.

    1987-01-01

    The experience at LaRC with the University of Tennessee Space Institute skin friction balances is summarized. The Karman-Schoenherr flat plate skin friction formulation is included for comparison. It is concluded that the balance is capable of operation in environments as diverse as cryogenic, transonic, high-shear rate of the 0.3 meter Transonic Cryogenic Tunnel, and high-temperature supersonic environment of the Unitary Plan Wind Tunnel. Proposed new research is outlined.

  19. Allergy to betalactam antibiotics in children: results of a 20-year study based on clinical history, skin and challenge tests.

    PubMed

    Ponvert, C; Perrin, Y; Bados-Albiero, A; Le Bourgeois, M; Karila, C; Delacourt, C; Scheinmann, P; De Blic, J

    2011-06-01

    Studies based on skin and challenge tests have shown that 12-60% of children with suspected betalactam hypersensitivity were allergic to betalactams. Responses in skin and challenge tests were studied in 1865 children with suspected betalactam allergy (i) to confirm or rule out the suspected diagnosis; (ii) to evaluate diagnostic value of immediate and non-immediate responses in skin and challenge tests; (iii) to determine frequency of betalactam allergy in those children, and (iv) to determine potential risk factors for betalactam allergy. The work-up was completed in 1431 children, of whom 227 (15.9%) were diagnosed allergic to betalactams. Betalactam hypersensitivity was diagnosed in 50 of the 162 (30.9%) children reporting immediate reactions and in 177 of the 1087 (16.7%) children reporting non-immediate reactions (p<0.001). The likelihood of betalactam hypersensitivity was also significantly higher in children reporting anaphylaxis, serum sickness-like reactions, and (potentially) severe skin reactions such as acute generalized exanthematic pustulosis, Stevens-Johnson syndrome, and drug reaction with systemic symptoms than in other children (p<0.001). Skin tests diagnosed 86% of immediate and 31.6% of non-immediate sensitizations. Cross-reactivity and/or cosensitization among betalactams was diagnosed in 76% and 14.7% of the children with immediate and non-immediate hypersensitivity, respectively. The number of children diagnosed allergic to betalactams decreased with time between the reaction and the work-up, probably because the majority of children with severe and worrying reactions were referred for allergological work-up more promptly than the other children. Sex, age, and atopy were not risk factors for betalactam hypersensitivity. In conclusion, we confirm in numerous children that (i) only a few children with suspected betalactam hypersensitivity are allergic to betalactams; (ii) the likelihood of betalactam allergy increases with earliness and

  20. Skin Pigment

    MedlinePlus

    ... the Professional Version Also of Interest Test your knowledge Impetigo is a bacterial skin infection. The infection ... Learn more about our commitment to Global Medical Knowledge . Merck Manuals About Disclaimer Permissions Privacy Contributors Terms ...

  1. Antimicrobial activity of the investigational pleuromutilin compound BC-3781 tested against Gram-positive organisms commonly associated with acute bacterial skin and skin structure infections.

    PubMed

    Sader, Helio S; Biedenbach, Douglas J; Paukner, Susanne; Ivezic-Schoenfeld, Zrinka; Jones, Ronald N

    2012-03-01

    BC-3781 is a novel semisynthetic pleuromutilin antimicrobial agent developed as an intravenous and oral therapy for acute bacterial skin and skin structure infections (ABSSSI) and respiratory tract infections (RTI). BC-3781 and comparator agents were tested by the broth microdilution method against 1,893 clinical Gram-positive organisms predominantly causing ABSSSI. BC-3781 exhibited potent activity against methicillin-resistant Staphylococcus aureus (MIC(50/90), 0.12/0.25 μg/ml), coagulase-negative staphylococci (MIC(50/90), 0.06/0.12 μg/ml), β-hemolytic streptococci (MIC(50/90), 0.03/0.06 μg/ml), viridans group streptococci (MIC(50/90), 0.12/0.5 μg/ml), and Enterococcus faecium (including vancomycin-nonsusceptible strains) (MIC(50/90), 0.12/2 μg/ml). Compared with other antibiotics in use for the treatment of ABSSSI, BC-3781 displayed the lowest MICs and only a minimal potential for cross-resistance with other antimicrobial classes.

  2. Antimicrobial Activity of the Investigational Pleuromutilin Compound BC-3781 Tested against Gram-Positive Organisms Commonly Associated with Acute Bacterial Skin and Skin Structure Infections

    PubMed Central

    Biedenbach, Douglas J.; Paukner, Susanne; Ivezic-Schoenfeld, Zrinka; Jones, Ronald N.

    2012-01-01

    BC-3781 is a novel semisynthetic pleuromutilin antimicrobial agent developed as an intravenous and oral therapy for acute bacterial skin and skin structure infections (ABSSSI) and respiratory tract infections (RTI). BC-3781 and comparator agents were tested by the broth microdilution method against 1,893 clinical Gram-positive organisms predominantly causing ABSSSI. BC-3781 exhibited potent activity against methicillin-resistant Staphylococcus aureus (MIC50/90, 0.12/0.25 μg/ml), coagulase-negative staphylococci (MIC50/90, 0.06/0.12 μg/ml), β-hemolytic streptococci (MIC50/90, 0.03/0.06 μg/ml), viridans group streptococci (MIC50/90, 0.12/0.5 μg/ml), and Enterococcus faecium (including vancomycin-nonsusceptible strains) (MIC50/90, 0.12/2 μg/ml). Compared with other antibiotics in use for the treatment of ABSSSI, BC-3781 displayed the lowest MICs and only a minimal potential for cross-resistance with other antimicrobial classes. PMID:22232289

  3. [Sensitivity and specificity of prick skin test with two concentrations of standardized extract of Culex quinquefasciatus in allergic children].

    PubMed

    Castro-Almarales, Raúl Lázaro; Álvarez-Castelló, Mirta; Ronquillo-Díaz, Mercedes; Rodríguez-Canosa, José S; González-León, Mayda; Navarro-Viltre, Bárbara I; Betancourt-Mesia, Daniel; Enríquez-Domínguez, Irene; Reyes-Zamora, Mary Carmen; Oliva-Díaz, Yunia; Mateo-Morejón, Maytee; Labrada-Rosado, Alexis

    2016-01-01

    Diagnostic options for immune reactions to mosquito bites are limited. In Cuba, IgE-mediated reactions are frequently related to Culex quinquefasciatus bite. To determine the sensitivity and specificity of skin prick test with two doses of standardized extract in nitrogen protein units (PNU of Culex quinquefasciatus (BIOCEN, Cuba). An analytical study was conducted on 100 children between 2 and 15 years old. Fifty atopic patients with a history of allergy to mosquito bite and positive specific serum IgE Culex quinquefasciatus and fifty atopic patients without a history of allergy to mosquito bite and negative specific serum IgE to Culex quinquefasciatus. Skin prick tests (SPT) were performed by duplicates on the forearms of the patients. Investigated doses were 100 PNU/mL and 10 PNU/mL. SPT with the highest concentration obtained a mean wheal size of 22.09 mm2 and for lower doses of 8.09 mm2, a statistically significant difference (p=0.001, Student's t test). Positive skin test correlated in 100% of patients with the presence of specific IgE. Testing with both doses showed a 94% of specificity and 88% of sensitivity. The diagnostic accuracy of SPT using both doses of standardized extract was similar, which justifies its use for diagnosis of sensitization to Culex quinquefasciatus in patients with symptoms of allergy to mosquito bite.

  4. Interferon-gamma release assays and tuberculin skin testing for diagnosing latent Mycobacterium tuberculosis infection in at-risk groups in Poland.

    PubMed

    Kruczak, Katarzyna; Mastalerz, Lucyna; Sładek, Krzysztof

    2016-03-01

    The diagnostics of latent tuberculosis infection in Poland using the tuberculin skin test is challenging due to the obligatory Bacillus Calmette-Guérin vaccinations. Interferon-gamma release assays are still very rarely used for diagnostics. We compared the tuberculin skin test and the QuantiFERON-TB Gold In-Tube test to evaluate the degree of latent tuberculosis infection in at-risk groups for tuberculosis (homeless, close contacts, periodic contacts, nursing-home attendees) and in healthy individuals. QuantiFERON-TB Gold In-Tube tests were carried out on 785 individuals from the homeless (n=150), close contacts (n=171), periodic contacts (n=163), nursing-home attendees (n=152), and healthy individuals (n=149). The tuberculin skin test was performed on 129, 156, 147, 148, and 121 participants, respectively. We evaluated the (a) correlation between serum concentrations of interferon gamma and the tuberculin-skin-test induration diameter; (b) between the number of QuantiFERON-TB Gold In-Tube-positive results and the tuberculin-skin-test diameter in the studied groups; and (c) agreement between both tests and the kappa coefficient using the tuberculin-skin-test diameters of 5, 10, and 15mm. Larger tuberculin-skin-test induration diameters were associated with elevated serum concentrations of interferon gamma. We found a positive correlation between the number of positive QuantiFERON-TB Gold In-Tube screening results and the tuberculin-skin-test induration diameter. The agreement between QuantiFERON-TB Gold In-Tube and tuberculin-skin-test screening results improved with increasing tuberculin-skin-test induration diameter. Based on measures of tuberculin-skin-test induration diameter alone, it is difficult to diagnose latent tuberculosis infection with certainty. The agreement of the QuantiFERON-TB Gold In-Tube test increases with the tuberculin-skin-test diameter. Tuberculin-skin-test diameters larger than 15mm are more likely to be associated with active infection

  5. [Tuberculin skin test screening in a military school in Istanbul city center].

    PubMed

    Bozkanat, Erkan; Ciftçi, Faruk; Apaydin, Murat; Kartaloğlu, Zafer; Tozkoparan, Ergun; Deniz, Omer; Sezer, Ogün; Ilvan, Ahmet; Bilgiç, Hayati

    2005-01-01

    To investigate the reason of high incidence of annual patients with tuberculosis (TB) in a military school previously known by screening tuberculin skin test (TST) and finding out the proportion of annual infection risk (PAIR), the prevalance of TB infection and the distribution for each grades. Our study is a cross-sectional epidemiologic study made about TB infection. TST were screened for all students in the school. 5 TU PPD was injected to every student and after 72 hours, the results were evaluated by measuring the diameter of enduration. Test was repeated after 10 days for negative reactions. Age, sex, the number of BCG wound, smoking and dwelling for last 5 years were asked from the students and their answers were recorded. More than 10 mm enduration for cases who had no BCG and 15 mm enduration for cases who had BCG were accepted positive. Chest roentgenogram was taken for each student enrolled into the study. Infection prevalance and PAIR were calculated after tests and measurements. The total number of students was 948. Of 917 (96.7%) were male and 31 (3.3%) were female. The mean age was 19.72 +/- 1.25. The mean of TST was 12.79 +/- 5.96 mm for all students. According to the number of BCG scar, the numbers of students, percentage and the mean of TST were like that 70 (7.3%) cases no BCG scar 8.41 +/- 7.87 mm, 393 (41.4%) students one BCG scar, 11.94 +/- 6.26 mm, 343 (36.1%) cases two BCG scars, 13.74 +/- 5.12 mm, 142 (14.9%) students three or more then three scars, 14.97 +/- 4.11 mm. In the students who had no BCG, TST positivity was 50%. TB infection prevalance of entire school and PAIR were 46% and 3.44% (respectively). In this study, we found that increased number of BCG wound associated with the increased diameter of TST enduration. The proportion of unvaccinated students was similar to the same age population in our country but it showed differences in the distribution of regions. The students who started first grade had serious TB infection risk in

  6. Impact of Allergic Reactions on Food-Specific IgE Concentrations and Skin Test Results.

    PubMed

    Sicherer, Scott H; Wood, Robert A; Vickery, Brian P; Perry, Tamara T; Jones, Stacie M; Leung, Donald Y M; Blackwell, Beth; Dawson, Peter; Burks, A Wesley; Lindblad, Robert; Sampson, Hugh A

    2016-01-01

    Although there is concern that food allergy reactions may negatively affect the natural history of food allergy, the impact of reactions on food-specific IgE (sIgE) levels or skin prick test (SPT) wheal size is unknown. To measure the effects of allergic reactions on SPT wheal size and sIgE concentrations to milk, egg, and peanut. Participants included 512 infants with likely milk or egg allergy enrolled in a multicenter observational study. Changes in sIgE level and SPT wheal size to milk, egg, and peanut were measured before and after oral food challenge (OFC) or accidental exposure for 377 participants. The median age of the cohort at the time of analysis was 8.5 years (67% males). There were no statistically significant changes in sIgE level or SPT wheal size after positive OFC to milk, egg, or peanut (n = 20-27 for each food). Change in sIgE level and SPT wheal size was measured after 446 and 453 accidental exposure reactions, respectively. The median change in sIgE level was a decrease of 0.33 kU(A)/L (P < .01) after milk and 0.34 kU(A)/L (P < .01) after egg reactions, but no other statistically significant changes in sIgE level or SPT wheal size were observed for milk, egg, or peanut. When we limited the analysis to only those participants who had diagnostic testing done within 6 months of an accidental exposure reaction, we found that peanut SPT wheal size increased by 1.75 mm (P < .01), but a significant increase was not noted when all participants with testing done within 12 months were considered. The results suggest that reactions from OFCs and accidental exposure are not associated with increases in sensitization among children allergic to milk, egg, or peanut. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  7. Diagnostic tools for hypersensitivity to platinum drugs and taxanes: skin testing, specific IgE, and mast cell/basophil mediators.

    PubMed

    Caiado, Joana; Picard, Matthieu

    2014-08-01

    Hypersensitivity reactions (HSRs) to platinum drugs and taxanes are increasing in cancer patients, and rapid drug desensitization has emerged as a safe and effective method to reintroduce these drugs in reactive patients. Optimal management of patients presenting HSRs to chemotherapy depends on the use of various diagnostic tools, which include measurement of mast cell/basophil mediator release following a HSR and skin testing. Serum tryptase should be measured in patients presenting chemotherapy HSRs, and its elevation would support mast cell/basophil activation. Skin testing to platinum drugs has a high sensitivity and specificity and is critical to guide the management of platinum-reactive patients. Taxane skin testing is also emerging as a useful diagnostic and risk stratification tool in the evaluation of patients with HSRs to taxanes. Platinum sIgE assays have been recently developed and can be helpful in combination with skin testing or as an alternative when skin testing is not available.

  8. [Medical students at risk: prevalence and incidence of tuberculin skin test conversion].

    PubMed

    Chung-Delgado, Kocfa; Guillén-Bravo, Sonia; Navarro-Huamán, Laura; Quiroz-Portella, Rafael; Revilla-Montag, Alejandro; Ruíz-Alejos, Andrea; Zapata-Pachas, Mariana; Bernabé-Ortiz, Antonio

    2012-08-01

    One third of the world population is affected by latent tuberculosis, with 9.4 million new cases; medical students have 2 to 50 times the probability of acquiring the infection. Establish the baseline prevalence of positive tuberculin skin test (TST) at the beginning of medical studies and determine the incidence and variables associated with TST conversion in medical students. Secondary analysis of a historical cohort (2007-2010) of medical students in a private Peruvian university. The TST conversion was evaluated. A binomial regression analysis was applied for each associated variable. 707 medical students were included, of whom 219 (31%) were male. The basal prevalence of reactive TST was 14.4%. Significant associations were found with the year of university entry of 2007-08 (p = 0.007) and a history of tuberculosis (p = 0.02). With a total of 822 person-years, the incidence of conversion was 2.92 cases per 100 person-years (CI95%: 1.96-4.36). The TST conversion was associated with the year of university entry (RR = 2,55; IC95%: 1,06-6,30) and a body mass index > 25 kg/m² (RR = 0,16; IC95%: 0,01-0,97). No association was detected with gender, tobacco or alcohol use. There is evidence of a high basal prevalence of latent tuberculosis infection in medical students. The incidence rate is within expected values and high in comparison with the general population. People with BMI > 25 kg/m² have protection against a latent infection. In medical students, more attention should be paid to biosecurity.

  9. Risk of redocumenting penicillin allergy in a cohort of patients with negative penicillin skin tests.

    PubMed

    Rimawi, Ramzy H; Shah, Kaushal B; Cook, Paul P

    2013-11-01

    Even though electronic documentation of allergies is critical to patient safety, inaccuracies in documentation can potentiate serious problems. Prior studies have not evaluated factors associated with redocumenting penicillin allergy in the medical record despite a proven tolerance with a penicillin skin test (PST). Assess the prevalence of reinstating inaccurate allergy information and associated factors thereof. We conducted a retrospective observational study from August 1, 2012 to July 31, 2013 of patients who previously had a negative PST. We reviewed records from the hospital, long-term care facilities (LTCF), and primary doctors' offices. Vidant Health, a system of 10 hospitals in North Carolina. Patients with proven penicillin tolerance rehospitalized within a year period from the PST. We gauged hospital reappearances, penicillin allergy redocumentation, residence, antimicrobial use, and presence of dementia or altered mentation. Of the 150 patients with negative PST, 55 (37%) revisited a Vidant system hospital within a 1-year period, of whom 21 were LTCF residents. Twenty (36%) of the 55 patients had penicillin allergy redocumented without apparent reason. Factors associated with penicillin allergy redocumentation included age >65 years (P = 0.011), LTCF residence (P = 0.0001), acutely altered mentation (P < 0.0001), and dementia (P < 0.0001). Penicillin allergy was still listed in all 21 (100%) of the LTCF records. At our hospital system, penicillin allergies are often redocumented into the medical record despite proven tolerance. The benefits of PST may be limited by inadequately removing the allergy from different electronic/paper hospital, LTCF, primary physician, and community pharmacy records. © 2013 Society of Hospital Medicine.

  10. Use of Specific IgE and Skin Prick Test to Determine Clinical Reaction Severity.

    PubMed

    Ta, Von; Weldon, Brittany; Yu, Grace; Humblet, Olivier; Neale-May, Susan; Nadeau, Kari

    2011-01-01

    AIMS: To determine whether specific IgE and skin prick test correlate better in predicting reaction severity during a double-blinded placebo controlled food challenge (DBPCFC) for egg, milk, and multiple tree nut allergens. STUDY DESIGN: Prospective study. PLACE AND DURATION OF STUDY: Department of Pediatrics, Stanford University School of Medicine, August 2009 and ongoing. METHODOLOGY: We examined the reaction severity of twenty-four subjects to nine possible food allergens: milk, egg, almond, cashew, hazelnut, peanut, sesame, pecan and walnut. Specific IgE and SPT were performed before each DBPCFC. DBPCFC results were classified into mild (1), moderate (2), or severe (3) reactions using a modified Bock's criteria. RESULTS: Twenty four subjects underwent a total of 80 DBPCFC. Eighty percent of all DBPCFCs resulted in a positive reaction. A majority, 71%, were classified as mild. No reactions occurred with a SPT of zero mm while three reactions occurred with a negative specific IgE. All reactions were reversible with medication. CONCLUSION: These data suggest that SPT and specific IgE levels are not associated with reaction severity (p<0.64 and 0.27, respectively). We also found that combining specific IgE and SPT improved specificity but did not help to achieve clinically useful sensitivity. For instance, an SPT > 5mm had a sensitivity of 91% and specificity of 50%. Combining SPT > 5mm and IgE > 7 resulted in a reduced sensitivity of 64%. Unexpectedly, a history of anaphylaxis 70% (n=17) was not predictive of anaphylaxis on challenge 4% (n=2).

  11. Cigarette Smoking and Skin Prick Test in Patients With Allergic Rhinitis

    PubMed Central

    Khazaei, Hossein Ali; Khazaei, Bahman; Dashtizadeh, Gholam Ali; Mohammadi, Mahdi

    2015-01-01

    Background: Allergic Rhinitis (AR) is the most common allergic disease, affecting 30% of population around the world. The disease is predominantly associated with exposure to some aeroallergens like cigarette smoking. Skin Prick Test (SPT) is a method of detecting immediate allergic reactions and is applied for controlling disease and therapeutic modality. Objectives: This study was designed to investigate the effect of cigarette smoking on SPT results among male and female individuals with AR disease. Patients and Methods: A total of 478 patients with AR admitted to the 2 main hospitals of Zahedan City from 2005 to 2012, were recruited in this analytic-descriptive study. Categories of smokers and never smokers were used based on patient’s statements and their history of smoking. SPT was performed with panel of some allergens and results were recorded and analyzed statistically. Odds ratio and confidence interval method were calculated using univariate logistic regression. Results: The results of this study indicated that 41.4% of patients with allergic rhinitis was smoker with ages ranged from 15 to 70 years. The result of this study also showed that smoking has no effect on SPT results of pollen and weeds aeroallergens conducted on male and female AR patients. However, male were significantly more sensitive than female in terms of sensitivity to the aspergillus, cladosporium, house dust mite, grasses, wheat, cockroach, and feather allergens. Conclusions: Our findings did not support the effect of cigarette smoking on SPT reactivity to pollen and weeds aeroallergens. However, male were significantly more sensitive than female in terms of sensitivity to some allergens. PMID:26495257

  12. Measurement of morphological and physiological skin properties in aged care residents: a test-retest reliability pilot study.

    PubMed

    Rayner, Robyn; Carville, Keryln; Leslie, Gavin; Dhaliwal, Satvinder S

    2017-04-01

    This test-retest pilot study investigated the intra-rater reliability and reproducibility of non-invasive technologies to objectively quantify morphological (colour, thickness and elasticity) and physiological (transepidermal water loss (TEWL), hydration, sebum and pH) skin properties in an aged care population. Three consecutive measurements were taken from five anatomical skin sites, with the mean of each measurement calculated. The intra-class correlation coefficient (ICC) and the standard error of measurement (SEM) were used to examine the intra-rater reliability and reproducibility of measurements. Non-invasive technologies in this study showed almost perfect reliability for ultrasound measurements of the subepidermal low echogenicity band (SLEB) (ρ = 0·95-0·99) and skin thickness (ρ = 0·95-0·99) across all sites. The ICC was substantial to almost perfect for pH (ρ = 0·76-0·88) and viscoelasticity (ρ = 0·67-0·91) across all sites. Hydration (ρ = 0·53-0·85) and skin retraction (ρ = 0·57-0·99) measurements ranged from moderate to almost perfect across all sites. TEWL and elasticity were substantial to almost perfect across four sites. Casual sebum levels and most colour parameters showed poor ICC. The use of non-invasive technologies in this study provided an objective and reliable means for quantifying ageing skin and may offer future studies a valuable option for assessing skin tear risk. © 2016 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  13. Skin prick tests and specific IgE in 10-year-old children: Agreement and association with allergic diseases.

    PubMed

    Chauveau, A; Dalphin, M-L; Mauny, F; Kaulek, V; Schmausser-Hechfellner, E; Renz, H; Riedler, J; Pekkanen, J; Karvonen, A M; Lauener, R; Roduit, C; Vuitton, D A; von Mutius, E; Dalphin, J-C

    2017-09-01

    Accurate assessment of atopic sensitization is pivotal to clinical practice and research. Skin prick test (SPT) and specific IgE (sIgE) are often used interchangeably. Some studies have suggested a disagreement between these two methods, and little is known about their association with allergic diseases. The aims of our study were to evaluate agreement between SPT and sIgE, and to compare their association with allergic diseases in 10-year-old children. Skin prick test, sIgE measurements, and assessment of allergic diseases were performed in children aged 10 years in the Protection against Allergy: STUdy in Rural Environments (PASTURE) cohort. The agreement between SPT and sIgE was assessed by Cohen's kappa coefficient with different cutoff values. Skin prick tests and sIgE were performed in 529 children. The highest agreement (κ=.44) was found with a cutoff value of 3 and 5 mm for SPT, and 3.5 IU/mL for sIgE. The area under the curve (AUC) obtained with SPT was not significantly different from that obtained with sIgE. For asthma and hay fever, SPT (cutoff value at 3 mm) had a significantly higher specificity (P<.0001) than sIgE (cutoff value at 0.35 IU/mL) and the specificity was not different between both tests (P=.1088). Skin prick test and sIgE display moderate agreement, but have a similar AUC for allergic diseases. At the cutoff value of 3 mm for SPT and 0.35 IU/mL for sIgE, SPT has a higher specificity for asthma and hay fever than sIgE without difference for sensitivity. © 2017 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

  14. Mathematical model to predict skin concentration of drugs: toward utilization of silicone membrane to predict skin concentration of drugs as an animal testing alternative.

    PubMed

    Sugibayashi, Kenji; Todo, Hiroaki; Oshizaka, Takeshi; Owada, Yoko

    2010-01-01

    To calculate the skin concentration of active ingredients in cosmetics and topical pharmaceuticals using silicone membrane permeation. A series of parabens were used as model ingredients. Skin concentration of parabens was calculated using silicone membrane permeability. Their partition coefficient from formulations to the silicone membrane was determined by the membrane permeation profiles, and used to calculate their silicone membrane concentration, under an assumption that the membrane is one homogenous diffusion layer. The same procedure was applied for hairless rat skin. The calculated concentration of parabens in silicone membrane was very close to their observed values. However, the skin concentration calculated by skin permeability was not similar to the observed concentration. Re-calculation was performed under the assumption that the skin consists of two diffusion layers. This modification using permeation data through full-thickness and stripped skin enabled precise prediction of the skin concentration of parabens. In addition, the partition coefficient to the silicone membrane was useful to estimate their skin concentration. Ingredient concentration in skin can be precisely predicted using diffusion equations and partition coefficients through permeation experiments using a silicone membrane. The calculated in-skin concentration is useful for formulation studies of cosmetics and topical pharmaceuticals.

  15. Diagnosis of penicillin allergy revisited: the value of case history, skin testing, specific IgE and prolonged challenge.

    PubMed

    Hjortlund, J; Mortz, C G; Skov, P S; Bindslev-Jensen, C

    2013-08-01

    Skin testing in duplicate, correlation between case history of immediate and nonimmediate reactions and challenge outcome and prolonged oral treatment with penicillin in the diagnostic evaluation of allergic reactions to β-lactam antibiotics, mimicking real-life situations, have only been addressed in few studies. A total of 342 patients suspected of having β-lactam allergy were investigated according to the European Network for Drug Allergy (ENDA) guidelines and patients found to be negative in the ENDA program were supplemented with a 7-day oral treatment with penicillin. Skin testing with penicillins was performed in duplicate. Patients with case histories of reactions to other β-lactams were also subsequently challenged with the culprit drug. Nineteen patients were IgE-sensitized to penicillin. Then, intracutaneous tests (ICTs) were performed, in which 35 patients tested positive for allergy, 21 with delayed and 14 with immediate reactions. Only three patients tested positive for the major (PPL) and/or minor (MDM) penicillin determinants, all being positive for penicillin G in ICT. The remaining 291 patients were challenged with penicillin: 10 tested positive in single-dose challenge and 23 tested positive in the 7-day challenge. A total of 17 of 78 patients with a negative penicillin challenge tested positive during challenges with other β-lactams. We found no correlation between case histories of immediate and nonimmediate reactions and reaction time during challenge. The data suggest that case history is often insufficient to discriminate between immediate reactors and nonimmediate reactors. A 7-day challenge with the culprit β-lactam may yield more positive reactions than the accepted one- or 2-day challenge. Interpretation of skin testing should be made with caution. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Assessing the Prevalence of Latent Tuberculosis among Health Care Providers in Zagazig City, Egypt Using Tuberculin Skin Test and QuantiFERON-TB Gold In-Tube Test.

    PubMed

    El-Sokkary, Rehab H; Abu-Taleb, Ashwak M; El-Seifi, Omnia S; Zidan, Haidy E; Mortada, Eman M; El-Hossary, Dalia; Farag, Salama E

    2015-12-01

    Early detection of latent tuberculosis infection (LTBI) will prevent development of active TB among health care providers. The aim of the study was to assess the prevalence of LTBI among health care providers and compare the QuantiFERON-TB Gold In-Tube Test (QFT-GIT) and Tuberculin skin test in efforts to detect LTBI and to investigate possible associated risk factors of infection. A cross sectional study was carried out during the period of 6 months in the Chest Hospital in Zagazig city and the Nephrology Unit at Zagazig University Hospitals in 132 randomly selected health care providers who were examined for LTBI by QFT-GIT and Tuberculin skin test and for the associated risk factors as well. The prevalence of LTBI identified by QFT-GIT and by Tuberculin skin test was 28.8% and 59.1%, respectively. Poor agreement was observed between the two tests (kappa=0.10). Working more than 10 years, being nurse, diabetic and smoker were risk factors significantly associated with LTBI (p<0.05). QFT-GIT is considered a useful tool in detecting LTBI cases, especially in a country where BCG vaccination is a national policy (as in Egypt). Duration of work, profession, diabetes and smoking are the risk factors for LTBI. Active surveillance and infection control measures are recommended to reduce the risk of LTBI. Copyright© by the National Institute of Public Health, Prague 2015.

  17. In vivo testing of silver treated fibers for the evaluation of skin irritation effect and hypoallergenicity.

    PubMed

    Paladini, F; Sannino, A; Pollini, M

    2014-07-01

    Textiles are a fertile breeding ground for a multitude of micro-organisms under appropriate conditions of moisture and temperature. The broad-spectrum biocide properties of silver are well known and many technologies have been developed so far to treat textiles with silver. The efficacy of the silver deposition technology presented in this article has been already demonstrated in previous works, where the strong adhesion of silver nanoparticles to the substrate and their antibacterial capability have been assessed. This work focuses on the evaluation of any possible interaction of silver treated cotton with human skin, in terms of skin irritation and hypoallergenicity. Moreover, the presence of silver and the antibacterial capability against Gram positive and Gram negative bacteria, namely Staphylococcus aureus and Escherichia coli, were verified even after several washing cycles in order to develop a product with long-term antibacterial capability and no adverse effects in terms of skin irritation and hypoallergenicity. © 2013 Wiley Periodicals, Inc.

  18. Use of in vitro testing to identify an unexpected skin sensitizing impurity in a commercial product: a case study.

    PubMed

    Natsch, Andreas; Gfeller, Hans; Emter, Roger; Ellis, Graham

    2010-03-01

    Due to regulatory constraints and ethical considerations, the quest for alternatives to animal testing has gained a new momentum. In general, animal welfare considerations and compliance with regulations are the key drivers for this research. Mechanistically based in vitro tests addressing specific toxicological questions can yield new information, for example on reactive components, and thus in certain cases the in vitro tests are not only second choice replacements of a 'gold standard' animal test but can also be used to develop safer products. Here we report a case study from the in vitro investigation on the commercial fragrance chemical Azurone. This compound was found to be a moderate skin sensitizer in the LLNA, whereas the structurally closely similar compound Calone is a non-sensitizer. A peptide reactivity assay indicated, that indeed Azurone yields peptide depletion, thus the in vitro assays confirmed the animal test result. LC-MS analysis of the peptide reactivity sample showed the presence of peptide adducts of unexpected molecular weight. They were consistent with the reaction of the peptide with a catechol related to Azurone. Detailed analytics indicated that indeed this catechol is present in the original batches as an impurity, but it has escaped quality control analysis, as it is not detectable in routine GC-analysis. A new purified batch was prepared, re-tested in the in vitro assays and predicted by the tests to be a non-sensitizer. A confirmatory LLNA test indeed yielded a significantly (10-fold) higher EC3 value of the new batch, but the LLNA was still positive. A dose-response study in the EpiSkin assay indicated that this molecule still has a significant skin irritation potential, which may generate the weak positive signal in the LLNA. This case study illustrates how the mechanistically based in vitro LC-MS peptide reactivity assay can be used to contribute to the understanding of the sensitization mechanism of a commercial product and help

  19. Allergic contact dermatitis to plants: an analysis of 68 patients tested at the Skin and Cancer Foundation.

    PubMed

    Cook, D K; Freeman, S

    1997-08-01

    Allergic contact dermatitis to plant allergens is a common problem in Australia. We present the cumulative experience of the Contact Dermatitis Clinic of the Skin and Cancer Foundation (Darlinghurst, NSW, Australia) a tertiary referral clinic. Results from a series of 68 patients with positive patch tests to 88 plant allergens are reported. We found that Grevillea species, Compositae, Rhus, Alstroemeria and various timber sawdusts were the most common plant allergens.

  20. Carboplatin hypersensitivity: does introduction of skin test and desensitization reliably predict and avoid the problem? A prospective single-center study.

    PubMed

    Gomez, Ruth; Harter, Philipp; Lück, Hans-Joachim; Traut, Alexander; Kommoss, Stefan; Kandel, Michaela; du Bois, Andreas

    2009-10-01

    Carboplatinum-based retreatment can be regarded as a standard option in the so-called platinum-sensitive ovarian cancer, but its use can be limited by the occurrence of sometimes severe hypersensitivity reactions (HSRs). This study analyzes the value of carboplatin skin testing and desensitization. Between 2004 and 2006, all patients with carboplatin reinduction chemotherapy received an intradermal injection of 0.2 microL of carboplatin and saline as negative control before chemotherapy. Carboplatin was administered in the standard way if the test was negative. If positive, carboplatin was administered after an already published desensitization protocol. Fifty-four patients received retreatment with carboplatinum and were submitted to skin test. Seven patients (13%) had positive skin test, whereas 4 patients developed HSRs although they had negative skin test (8.5% false-negative rate). Skin test predicted HSRs in only 64% of the afflicted patients. Desensitization was performed in all patients with positive skin test, and 5 (71%) of 7 could receive 3 to 11 further carboplatinum courses. Repeated HSRs occurred in 2 of 7 patients despite desensitization; however, none of the HSRs after desensitization were severe. Skin test did not reliably predict carboplatinum-induced HSR, but desensitization was demonstrated to be a rather successful strategy. Taking the low predictive value into account, we started another prospective series of administering antiallergic medication to all patients with carboplatinum retreatment and offer desensitization if any HSR occurs.

  1. Development of an in vitro modified skin absorption test for the investigation of the follicular penetration pathway of caffeine.

    PubMed

    Trauer, S; Lademann, J; Knorr, F; Richter, H; Liebsch, M; Rozycki, C; Balizs, G; Büttemeyer, R; Linscheid, M; Patzelt, A

    2010-01-01

    The Organization for Economic Cooperation and Development (OECD) recommends caffeine as a reference substance for in vitro skin absorption tests using Franz diffusion cells (FDC). However, it has not been possible to investigate the follicular penetration pathway using this method until now. The aim of this study was to develop a technique to allow the examination of the follicular penetration pathway of a substance penetrating into the skin. The OECD standard method was therefore combined with the follicle closing technique (FCT), an established in vivo method. By using test skin of varying follicular densities, different penetration values were obtained for the test substance caffeine. The follicular penetration rate was determined by an indirect calculation after modifying the in vivo FCT for use in the in vitro FDC. This method is the first to allow the differentiation of penetration pathways by combining the OECD standard method (using the FDC) and the FCT. Caffeine showed a surprisingly high rate of penetration through the follicular shunts in vitro.

  2. Full-field bulge test for planar anisotropic tissues: part I--experimental methods applied to human skin tissue.

    PubMed

    Tonge, Theresa K; Atlan, Lorre S; Voo, Liming M; Nguyen, Thao D

    2013-04-01

    The nonlinear anisotropic properties of human skin tissue were investigated using bulge testing. Full-field displacement data were obtained during testing of human skin tissues procured from the lower back of post-mortem human subjects using 3-D digital image correlation. To measure anisotropy, the dominant fiber direction of the tissue was determined from the deformed geometry of the specimen. Local strains and stress resultants were calculated along both the dominant fiber direction and the perpendicular direction. Variation in anisotropy and stiffness was observed between specimens. The use of stress resultants rather than the membrane stress approximation accounted for bending effects, which are significant for a thick nonlinear tissue. Of the six specimens tested, it was observed that specimens from older donors exhibited a stiffer and more isotropic response than those from younger donors. It was seen that the mechanical response of the tissue was negligibly impacted by preconditioning or the ambient humidity. The methods presented in this work for skin tissue are sufficiently general to be applied to other planar tissues, such as pericardium, gastrointestinal tissue, and fetal membranes. The stress resultant-stretch relations will be used in a companion paper to obtain material parameters for a nonlinear anisotropic hyperelastic model.

  3. Performance of skin tests with allergens from B. melitensis B115 and rough B. abortus mutants for diagnosing swine brucellosis.

    PubMed

    Dieste-Pérez, L; Blasco, J M; De Miguel, M J; Marín, C M; Barberán, M; Conde-Álvarez, R; Moriyón, I; Muñoz, P M

    2014-01-10

    Swine brucellosis by Brucella suis biovar 2 is an emerging disease whose control is based on serological testing and culling. However, current serological tests detect antibodies to the O-polysaccharide (O/PS) moiety of Brucella smooth lipopolysaccharide (S-LPS), and thus lack specificity when infections by Yersinia enterocolitica O:9 and other gram-negative bacteria carrying cross-reacting O/PS occur. The skin test with the protein-rich brucellin extract obtained from rough B. melitensis B115 is assumed to be specific for discriminating these false positive serological reactions (FPSR). However, B115 strain, although unable to synthesize S-LPS, accumulates O/PS internally, which could cause diagnostic problems. Since the brucellin skin test has been seldom used in pigs and FPSR are common in these animals, we assessed its performance using cytosoluble protein extracts obtained from B. abortus rough mutants in manBcore or per genes (critical for O/PS biosynthesis) and B. melitensis B115. The diagnostic sensitivity and specificity were determined in B. suis biovar 2 culture positive and brucellosis free sows, and apparent prevalence in sows of unknown individual bacteriological and serological status belonging to B. suis biovar 2 naturally infected herds. Moreover, the specificity in discriminating brucellosis from FPSR was assessed in brucellosis free boars showing FPSR. The skin test with B. abortus ΔmanBcore and B. melitensis B115 allergens performed similarly, and the former one resulted in 100% specificity when testing animals showing FPSR in indirect ELISA, Rose Bengal and complement fixation serological tests. We conclude that O/PS-free genetically defined mutants represent an appropriate alternative to obtain Brucella protein extracts for diagnosing swine brucellosis.

  4. Moisture Effects and Peel Testing of Polymethacrylimide and Honeycomb Core in Sandwich/Skin Structures

    DTIC Science & Technology

    1987-11-01

    suitahle. REFERENCES 1. Hollman, Martin, •which Sandwich?", Homebuilt Aircraft , Werner and Werner Publishing Co. Encino, CA. February 1984. 2...sandwich/skin laminates typical of candidate composite aircraft structures, provirtetl a more realistic guide for understanding how the moisture

  5. Proposal of abolition of the skin sensitivity test before equine rabies immune globulin application.

    PubMed

    Cupo, P; de Azevedo-Marques, M M; Sarti, W; Hering, S E

    2001-01-01

    An epizootic outbreak of rabies occurred in 1995 in Ribeirão Preto, SP, with 58 cases of animal rabies (54 dogs, 3 cats and 1 bat) confirmed by the Pasteur Institute of São Paulo, and one human death. The need to provide care to a large number of people for the application of equine rabies immune globulin (ERIG) prevented the execution of the skin sensitivity test (SST) and often also the execution of desensitization, procedures routinely used up to that time at the Emergency Unit of the University Hospital of the Faculty of Medicine of Ribeirão Preto, University of São Paulo (EU-UHFMRP-USP), a reference hospital for the application of heterologous sera. In view of our positive experience of several years with the abolition of SST and of the use of premedication before the application of antivenom sera, we used a similar schedule for ERIG application. Of the 1489 victims of animal bites, 1054 (71%) received ERIG; no patient was submitted to SST and all received intravenously anti-histamines (anti-H1 + anti-H2) and corticosteroids before the procedure. The patients were kept under observation for 60 to 180 minutes and no adverse reaction was observed. On the basis of these results, since December 1995 ERIG application has been decentralized in Ribeirão Preto and has become the responsibility of the Emergency Unit of the University Hospital and the Central Basic Health Unit, where the same routine is used. Since then, 4216 patients have received ERIG (1818 at the Basic Health Unit and 2398 at the EU-UHFMRP), with no problems. The ideal would be the routine use of human rabies immune globulin (HRIG) in public health programs, but this is problematic, because of their high cost. However, while this does not occur, the use of SST is no longer justified at the time of application of ERIG, in view of the clinical evidence of low predictive value and low sensitivity of SST involving the application of heterologous sera. It is very important to point out that a

  6. Low frequency of positive skin tests in asthmatic patients infected with Schistosoma mansoni exposed to high levels of mite allergens.

    PubMed

    Medeiros, Manoel; Almeida, Maria C; Figueiredo, Joanemile P; Atta, Ajax M; Mendes, Carlos M C; Araújo, Maria I; Taketomi, Ernesto A; Terra, Silvia A; Silva, Deise A O; Carvalho, Edgar M

    2004-04-01

    Helminthic infections and allergic diseases are highly prevalent in many parts of the world. Although skin reactivity to indoor allergens is decreased in subjects from helminthic endemic areas, the degree of exposure to mite allergens has not yet been investigated in these areas. This study evaluated the association between exposure to dust mites and skin reactivity to mite allergens in subjects with a history of wheezing in the last 12 months selected from a rural endemic area for schistosomiasis (group I, n = 21), and two non-Schistosoma mansoni endemic locale, a rural area (group II, n = 21) and a urban slum area (group III, n = 21). All subjects were evaluated by skin prick tests with mite allergens, and for total and specific immunoglobulin E (IgE) against dust mites, antibodies for S. mansoni, and for intestinal parasites. Dust samples from each subjects' home were quantified for mite allergen and species of the mite identification. Except for S. mansoni infection which was more prevalent in group I than in groups II and III (p < 0.0001), the prevalence of intestinal parasites, and total and specific IgE levels were similar for all groups. Despite the levels of mite allergens and specifically to Der p 1 detected in dust samples of subjects home from all three areas, the frequency of positive skin reactivity to mite antigens was significantly lower (19.0%) in subjects from group I relative to group II (76.2%) and group III (57.1%; p < 0.001). This result suggests that S. mansoni infection could modulate the immediate hypersensitivity skin response to mite allergens in highly exposed subjects.

  7. Dissociation between skin test reactivity and anti-aeroallergen IgE: Determinants among urban Brazilian children.

    PubMed

    Alcantara-Neves, Neuza M; Veiga, Rafael V; Ponte, João C M; da Cunha, Sérgio S; Simões, Silvia M; Cruz, Álvaro A; Yazdanbakhsh, Maria; Matos, Sheila M; Silva, Thiago Magalhães; Figueiredo, Camila A; Pontes-de-Carvalho, Lain C; Rodrigues, Laura C; Fiaccone, Rosemeire L; Cooper, Philip J; Barreto, Maurício L

    2017-01-01

    The dissociation between specific IgE and skin prick test reactivity to aeroallergens, a common finding in populations living in low and middle-income countries, has important implications for the diagnosis and treatment of allergic diseases. Few studies have investigated the determinants of this dissociation. In the present study, we explored potential factors explaining this dissociation in children living in an urban area of Northeast Brazil, focusing in particular on factors associated with poor hygiene. Of 1445 children from low income communities, investigated for risk factors of allergies, we studied 481 with specific IgE antibodies to any of Blomia tropicalis, Dermatophagoides pteronyssinus, Periplaneta americana and Blatella germanica allergens. Data on demographic, environmental and social exposures were collected by questionnaire; serum IgG and stool examinations were done to detect current or past infections with viral, bacterial, protozoan and intestinal helminth pathogens. We measured atopy by skin prick testing (SPT) and specific IgE (sIgE) to aerollergens in serum (by ImmunoCAP). SIgE reactivity to B. tropicalis extract depleted of carbohydrates was measured by an in-house ELISA. Total IgE was measured by in house capture ELISA. SNPs were typed using Illumina Omni 2.5. Negative skin prick tests in the presence of specific IgE antibodies were frequent. Factors independently associated with a reduced frequency of positive skin prick tests were large number of siblings, the presence of IgG to herpes simplex virus, Ascaris lumbricoides and Trichuris trichiura infections, living in neighborhoods with infrequent garbage collection, presence of rodents and cats in the household and sIgE reactivity to glycosylated B. tropicalis allergens. Also, SNP on IGHE (rs61737468) was negatively associated with SPT reactivity. A variety of factors were found to be associated with decreased frequency of SPT such as unhygienic living conditions, infections, total IgE, Ig

  8. Dissociation between skin test reactivity and anti-aeroallergen IgE: Determinants among urban Brazilian children

    PubMed Central

    Veiga, Rafael V.; Ponte, João C. M.; da Cunha, Sérgio S.; Simões, Silvia M.; Cruz, Álvaro A.; Yazdanbakhsh, Maria; Matos, Sheila M.; Silva, Thiago Magalhães; Figueiredo, Camila A.; Rodrigues, Laura C.; Fiaccone, Rosemeire L.; Cooper, Philip J.; Barreto, Maurício L.

    2017-01-01

    Background The dissociation between specific IgE and skin prick test reactivity to aeroallergens, a common finding in populations living in low and middle-income countries, has important implications for the diagnosis and treatment of allergic diseases. Few studies have investigated the determinants of this dissociation. In the present study, we explored potential factors explaining this dissociation in children living in an urban area of Northeast Brazil, focusing in particular on factors associated with poor hygiene. Methods Of 1445 children from low income communities, investigated for risk factors of allergies, we studied 481 with specific IgE antibodies to any of Blomia tropicalis, Dermatophagoides pteronyssinus, Periplaneta americana and Blatella germanica allergens. Data on demographic, environmental and social exposures were collected by questionnaire; serum IgG and stool examinations were done to detect current or past infections with viral, bacterial, protozoan and intestinal helminth pathogens. We measured atopy by skin prick testing (SPT) and specific IgE (sIgE) to aerollergens in serum (by ImmunoCAP). SIgE reactivity to B. tropicalis extract depleted of carbohydrates was measured by an in-house ELISA. Total IgE was measured by in house capture ELISA. SNPs were typed using Illumina Omni 2.5. Results Negative skin prick tests in the presence of specific IgE antibodies were frequent. Factors independently associated with a reduced frequency of positive skin prick tests were large number of siblings, the presence of IgG to herpes simplex virus, Ascaris lumbricoides and Trichuris trichiura infections, living in neighborhoods with infrequent garbage collection, presence of rodents and cats in the household and sIgE reactivity to glycosylated B. tropicalis allergens. Also, SNP on IGHE (rs61737468) was negatively associated with SPT reactivity. Conclusions A variety of factors were found to be associated with decreased frequency of SPT such as unhygienic

  9. Case of the month: The skin wrinkle test: a simple nerve injury test for paediatric and uncooperative patients.

    PubMed

    Tindall, A; Dawood, R; Povlsen, B

    2006-11-01

    Assessment of the distal neurological status after injuries to the hand and fingers is one of the most frequent parts of standard trauma practice. Two-point discrimination as clinical examination is often sufficient to identify such lesions, but difficulties occur in the comatose, young or otherwise uncooperative patient. This article describes a simple pain-free alternative method of assessing digital nerve integrity by submerging the finger tip in water and observing if wrinkles develop on the skin.

  10. FROZEN RAW FOODS AS SKIN-TESTING MATERIALS—Further Studies of Use in Cases of Allergic Disorders

    PubMed Central

    Ancona, Giacomo R.; Schumacher, Irwin C.

    1954-01-01

    In further studies on the use of frozen raw food as skin-testing material in patients with allergic disorders, the results of previous work were confirmed in a greater number of subjects using a larger number of foods: Tests with frozen raw foods by the scratch method induce true positive reactions of a larger size and in greater frequency than the corresponding commercial extracts by either the scratch or the intracutaneous method. Storage in the frozen state for several years does not affect the antigenic potency of the materials. The frozen preparations have caused no harmful effects in the subjects, are free from irritant properties, and are not urticariogenic. PMID:13126823

  11. Skin irritation to glass wool or continuous glass filaments as observed by a patch test among human Japanese volunteers.

    PubMed

    Tsunoda, Masashi; Kido, Takamasa; Mogi, Sachiyo; Sugiura, Yumiko; Miyajima, Eriko; Kudo, Yuichiro; Kumazawa, Tatenao; Aizawa, Yoshiharu

    2014-01-01

    Glass wool and continuous glass filaments have been used in industry. We examined the irritability of those among Japanese. A patch test was performed on 43 volunteers for the followings: glass wool for non-residential use with and without a urea-modified phenolic resin binder, that for residential use with and without the binder, and continuous glass filaments with diameters of 4, 7, 9, and 13 µm. Materials were applied to an upper arm of each volunteer for 24 h. The skin was observed at 1 and 24 h after the removal. At 1 h after removal, slight erythema was observed on the skin of a woman after the exposure to glass wool for residential use without the binder. Erythema was observed on the skin of another woman at 1 h after a 24-h exposure to glass wool for non-residential use without the binder. There were no reactions at 24 h after the removal. The low reactions in the patch test suggested that the irritability caused by glass wool, irrespective of a resin component, could be induced mechanically, and that the irritability caused by continuous glass filaments with resin could be slight and either mechanical or chemical.

  12. Skin Irritation to Glass Wool or Continuous Glass Filaments as Observed by a Patch Test among Human Japanese Volunteers

    PubMed Central

    TSUNODA, Masashi; KIDO, Takamasa; MOGI, Sachiyo; SUGIURA, Yumiko; MIYAJIMA, Eriko; KUDO, Yuichiro; KUMAZAWA, Tatenao; AIZAWA, Yoshiharu

    2014-01-01

    Glass wool and continuous glass filaments have been used in industry. We examined the irritability of those among Japanese. A patch test was performed on 43 volunteers for the followings: glass wool for non-residential use with and without a urea-modified phenolic resin binder, that for residential use with and without the binder, and continuous glass filaments with diameters of 4, 7, 9, and 13 µm. Materials were applied to an upper arm of each volunteer for 24 h. The skin was observed at 1 and 24 h after the removal. At 1 h after removal, slight erythema was observed on the skin of a woman after the exposure to glass wool for residential use without the binder. Erythema was observed on the skin of another woman at 1 h after a 24-h exposure to glass wool for non-residential use without the binder. There were no reactions at 24 h after the removal. The low reactions in the patch test suggested that the irritability caused by glass wool, irrespective of a resin component, could be induced mechanically, and that the irritability caused by continuous glass filaments with resin could be slight and either mechanical or chemical. PMID:25070402

  13. A new method to test the effectiveness of sunscreen ingredients in a novel nano-surface skin cell mimic.

    PubMed

    Krishnan, Rajagopal; Elmets, Craig A; Nordlund, Thomas M

    2006-01-01

    Photophysical properties of sunscreens are commonly studied in solvent media, which do not mimic the skin, or in complex artificial skin systems, which are difficult to handle. In an earlier study, we showed that polystyrene nanosphere suspensions mimic the mixed polarity environment of skin cell systems. This paper presents a new method to quantify the effectiveness of sunscreens in the polystyrene nanosphere environment. This method utilizes the intrinsic UV-B fluorescence of polystyrene nanospheres. We studied three UV-B sunscreens by this new method and compared their extinction coefficients with observed values in solvent. The values follow the trend observed in solvents, but the ratio of their extinction coefficient in solvent to the value obtained by this new method is 1.3-1.8 instead of 1. This difference might be caused by the mixed polarity or the microgeometry of the nanosphere system. Regardless of the difference in the extinction coefficients, this new system can be used to test hundreds of chemicals for their sunscreening potential in a cost-effective way. One marked advantage of this new method is its ability to test both hydrophobic and hydrophilic sunscreening chemicals in the same environment. This is virtually impossible for current solvent-based models, which require different solvents for hydrophobic and hydrophilic chemicals. The new method also allows the simultaneous evaluation of a host of photophysical properties of sunscreening chemicals.

  14. Multi-laboratory validation of SkinEthic HCE test method for testing serious eye damage/eye irritation using liquid chemicals.

    PubMed

    Alépée, N; Leblanc, V; Adriaens, E; Grandidier, M H; Lelièvre, D; Meloni, M; Nardelli, L; Roper, C S; Santirocco, E; Toner, F; Van Rompay, A; Vinall, J; Cotovio, J

    2016-03-01

    A prospective multicentric study of the reconstructed human corneal epithelial tissue-based in vitro test method (SkinEthic™ HCE) was conducted to evaluate its usefulness to identify chemicals as either not classified for serious eye damage/eye irritation (No Cat.) or as classified (Cat. 1/Cat. 2) within UN GHS. The aim of this study was to demonstrate the transferability and reproducibility of the SkinEthic™ HCE EITL protocol for liquids and define its predictive capacity. Briefly, 60 chemicals were three times tested (double blinded) in 3 laboratories and 45 additional chemicals were tested three times in one laboratory. Good within laboratory reproducibility was achieved of at least 88.3% (53/60) and 92.4% (97/105) for the extended data set. Furthermore, the overall concordance between the laboratories was 93.3% (56/60). The accuracy of the SkinEthic™ HCE EITL for the extended dataset, based on bootstrap resampling, was 84.4% (95% CI: 81.9% to 87.6%) with a sensitivity of 99.0% (95% CI: 96.4% to 100%) and specificity of 68.5% (95% CI: 64.0% to 74.0%), thereby meeting all acceptance criteria for predictive capacity. This efficient transferable and reproducible assay is a promising tool to be integrated within a battery of assays to perform an eye irritation risk assessment. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Multi-laboratory evaluation of SkinEthic HCE test method for testing serious eye damage/eye irritation using solid chemicals and overall performance of the test method with regard to solid and liquid chemicals testing.

    PubMed

    Alépée, N; Adriaens, E; Grandidier, M H; Meloni, M; Nardelli, L; Vinall, C J; Toner, F; Roper, C S; Van Rompay, A R; Leblanc, V; Cotovio, J

    2016-08-01

    A prospective multicentre study of the reconstructed human corneal epithelial tissue-based in vitro test method (SkinEthic™ HCE) was conducted to evaluate its usefulness to identify chemicals as either not classified for serious eye damage/eye irritation (No Cat.) or as classified (Cat. 1/Cat. 2) within UN GHS. The aim of this study was to demonstrate the transferability and reproducibility of the SkinEthic™ HCE EITS protocol for solids and define its predictive capacity. Briefly, 60 chemicals were three times tested (double blinded) in 3 laboratories and 35 additional chemicals were tested three times in one laboratory. Good within laboratory reproducibility was achieved of at least 95% (57/60) and 96.8% (92/95) for the extended data set. Furthermore, the overall concordance between the laboratories was 96.7% (58/60). The accuracy of the SkinEthic™ HCE EITS for the extended dataset, based on bootstrap resampling, was 81.0% (95% CI: 78.9% to 83.2%) with a sensitivity of 90.5% (95% CI: 88.1% to 92.9%) and specificity of 73.6% (95% CI: 71.7% to 75.5%). Overall, 200 chemicals were tested (105 liquids (EITL protocol) and 95 solids (EITS protocol)) resulting in a sensitivity of 95.2%, specificity of 72.1% and accuracy of 83.7%, thereby meeting all acceptance criteria for predictive capacity. Copyright © 2016 Elsevier B.V. All rights reserved.

  16. Integration, Testing, and Analysis of Multispectral Imager on Small Unmanned Aerial System for Skin Detection

    DTIC Science & Technology

    2014-03-01

    1.8 Preview Chapter II explores the background literature for skin detection , SUAS, methods for vision processing, and metrics for imagery ...subpixel domain (Morales, 2012). Proper spatial pixel density is essential for a sensor and target detection methods . When targeting spectral...sensor for automated target detection , thus the equation has been modified to work with aberrated imagery (Thurman & Fienup, 2010). /GSD pR f

  17. Field Method for Testing Repellency of an Icaridin-Containing Skin Lotion against Vespid Wasps

    PubMed Central

    Boevé, Jean-Luc; Eertmans, Frank; Adriaens, Els; Rossel, Bart

    2016-01-01

    Vespid wasps are ecologically beneficial predators of insects but their stings also pose a human health risk. Current control methods based on killing vespids are suboptimal. Here, the repellent effect against Vespula vulgaris of a 20% icaridin skin lotion was evaluated under field conditions. An experimental setup was designed in which six artificial skin pieces (10 × 10 cm) were video-recorded for 1 h, to count each min the numbers of flying and feeding vespids. Prior to monitoring, five pieces were successively smeared with 2 mg of cream per cm2, in 30 min intervals, from t = −120 min to 0. The sixth sheet remained untreated to serve as a control. One milliliter of an attractant, fruit jam, was deposited on each of the six surfaces at t = 0. The control surface was free of any flying or feeding vespid during an average period of 25 min, whereas the other five surfaces (treated at t = −120, −90, −60, −30, and 0 min) remained vespid-free for 39, 40, 45, 49, and 51 min, respectively. The skin lotion remained significantly active for at least 2 h. The experimental methodology is adjustable and allows the study of repellents against vespids in semi-natural conditions. PMID:27271672

  18. Alum-precipitated autoclaved Leishmania major plus bacille Calmette-Guérrin, a candidate vaccine for visceral leishmaniasis: safety, skin-delayed type hypersensitivity response and dose finding in healthy volunteers.

    PubMed

    Kamil, A A; Khalil, E A G; Musa, A M; Modabber, F; Mukhtar, M M; Ibrahim, M E; Zijlstra, E E; Sacks, D; Smith, P G; Zicker, F; El-Hassan, A M

    2003-01-01

    In a previous efficacy study, autoclaved Leishmania major (ALM) + bacille Calmette-Guérrin (BCG) vaccine was shown to be safe, but not superior to BCG alone, in protecting against visceral leishmaniasis. From June 1999 to June 2000, we studied the safety and immunogenicity of different doses of alum-precipitated ALM + BCG vaccine mixture administered intradermally to evaluate whether the addition of alum improved the immunogenicity of ALM. Twenty-four healthy adult volunteers were recruited and sequentially allocated to receive either 10 microg, 100 microg, 200 microg, or 400 microg of leishmanial protein in the alum-precipitated ALM + BCG vaccine mixture. Side effects were minimal for all doses and confined to the site of injection. All volunteers in the 10 microg, 100 microg, and 400 microg groups had a leishmanin skin test (LST) reaction of > or = 5 mm by day 42 and this response was maintained when tested after 90 d. Only 1 volunteer out of 5 in the 200 microg group had a LST reaction of > or = 5 mm by day 42 and the reasons for the different LST responses in this group are unclear. This is the first time that an alum adjuvant with ALM has been in used in humans and the vaccine mixture was safe and induced a strong delayed type hypersensitivity (DTH) reaction in the study volunteers. On the basis of this study we suggest that 100 1 microg of leishmanial protein in the vaccine mixture is a suitable dose for future efficacy studies, as it induced the strongest DTH reaction following vaccination.

  19. Safety and efficacy of the C-Tb skin test to diagnose Mycobacterium tuberculosis infection, compared with an interferon γ release assay and the tuberculin skin test: a phase 3, double-blind, randomised, controlled trial.

    PubMed

    Ruhwald, Morten; Aggerbeck, Henrik; Gallardo, Rafael Vázquez; Hoff, Søren T; Villate, José I; Borregaard, Bettine; Martinez, José A; Kromann, Ingrid; Penas, Antón; Anibarro, Luis L; de Souza-Galvão, Maria Luiza; Sánchez, Francisca; Rodrigo-Pendás, Jose Ángel; Noguera-Julian, Antoni; Martínez-Lacasa, Xavier; Tuñez, Maria Victoria; Fernández, Virginia Leiro; Millet, Joan P; Moreno, Antonio; Cobos, Nazaret; Miró, José M; Roldan, Llanos; Orcau, Angels; Andersen, Peter; Caylá, Joan A

    2017-04-01

    Targeted screening and treatment of Mycobacterium tuberculosis infection substantially reduces the risk of developing active tuberculosis. C-Tb (Statens Serum Institute, Copenhagen, Denmark) is a novel specific skin test based on ESAT-6 and CFP10 antigens. We investigated the safety and diagnostic potential of C-Tb compared with established tests in the contact-tracing setting. Negative controls, close contacts, occasional contacts, and patients with active pulmonary tuberculosis were enrolled at 13 centres in Spain. We compared C-Tb with the QuantiFERON-TB Gold In-Tube ([QFT] Qiagen, Hilden, Germany) interferon γ release assay (IGRA) and the purified protein derivative (PPD) RT 23 tuberculin skin test ([TST] Statens Serum Institute). All participants older than 5 years were tested with QFT. Some participants in the negative control group received C-Tb without the TST to test for potential interactions between C-Tb and PPD RT 23. The rest were randomly assigned in blocks of ten and tested with both C-Tb and TST, with five in each block receiving injection of C-Tb in the right arm and the TST in the left arm and five vice versa. The primary and safety analyses were done in all participants randomly assigned to a group who received any test. This trial is registered with ClinicalTrials.gov, number NCT01631266, and with EudraCT, number 2011-005617-36. From July 24, 2012, to Oct 2, 2014, 979 participants were enrolled, of whom 263 were negative controls, 299 were occasional contacts, 316 were close contacts, and 101 were patients with tuberculosis. 970 (99%) participants completed the trial. Induration sizes were similar for C-Tb and TST, but TST positivity was affected by BCG vaccination status. We found a strong positive trend towards C-Tb test positivity with increasing risk of infection, from 3% in negative controls to 16% in occasional contacts, to 43% in close contacts. C-Tb and QFT results were concordant in 785 (94%) of 834 participants aged 5 years and older

  20. Bayesian integrated testing strategy (ITS) for skin sensitization potency assessment: a decision support system for quantitative weight of evidence and adaptive testing strategy.

    PubMed

    Jaworska, Joanna S; Natsch, Andreas; Ryan, Cindy; Strickland, Judy; Ashikaga, Takao; Miyazawa, Masaaki

    2015-12-01

    The presented Bayesian network Integrated Testing Strategy (ITS-3) for skin sensitization potency assessment is a decision support system for a risk assessor that provides quantitative weight of evidence, leading to a mechanistically interpretable potency hypothesis, and formulates adaptive testing strategy for a chemical. The system was constructed with an aim to improve precision and accuracy for predicting LLNA potency beyond ITS-2 (Jaworska et al., J Appl Toxicol 33(11):1353-1364, 2013) by improving representation of chemistry and biology. Among novel elements are corrections for bioavailability both in vivo and in vitro as well as consideration of the individual assays' applicability domains in the prediction process. In ITS-3 structure, three validated alternative assays, DPRA, KeratinoSens and h-CLAT, represent first three key events of the adverse outcome pathway for skin sensitization. The skin sensitization potency prediction is provided as a probability distribution over four potency classes. The probability distribution is converted to Bayes factors to: 1) remove prediction bias introduced by the training set potency distribution and 2) express uncertainty in a quantitative manner, allowing transparent and consistent criteria to accept a prediction. The novel ITS-3 database includes 207 chemicals with a full set of in vivo and in vitro data. The accuracy for predicting LLNA outcomes on the external test set (n = 60) was as follows: hazard (two classes)-100 %, GHS potency classification (three classes)-96 %, potency (four classes)-89 %. This work demonstrates that skin sensitization potency prediction based on data from three key events, and often less, is possible, reliable over broad chemical classes and ready for practical applications.

  1. A prevalidation study on in vitro tests for acute skin irritation. results and evaluation by the Management Team.

    PubMed

    Fentem, J H; Briggs, D; Chesné, C; Elliott, G R; Harbell, J W; Heylings, J R; Portes, P; Roguet, R; van de Sandt, J J; Botham, P A

    2001-02-01

    A prevalidation study on in vitro tests for acute skin irritation was conducted during 1999 and 2000. The overall objective of validation in this area, of which this prevalidation study is an initial stage, is to identify tests capable of discriminating irritants (I) from non-irritants (NI), as defined according to European Union (EU) risk phrases ("R38"; no classification) and the harmonised OECD criteria ("Irritant"; no label). This prevalidation study specifically addressed aspects of: protocol refinement (phase I), protocol transfer (phase II), and protocol performance (phase III), in accordance with the prevalidation scheme defined by the European Centre for the Validation of Alternative Methods (ECVAM). The tests evaluated were: EpiDerm (phases I, II and III), EPISKIN (phases I, II and III), PREDISKIN (phases I and II, and additional protocol refinement), the non-perfused pig ear method (phases I and II, and additional protocol refinement), and the mouse skin integrity function test (SIFT; phases I and II). Modified, standardised test protocols and well-defined prediction models were available for each of the tests at the end of phase I. The results of phase I (intralaboratory reproducibility) were sufficiently promising for all of the tests to progress to phase II. Protocol transfer between the Lead Laboratory and Laboratory 2 was undertaken for all five tests during phase II, and additional refinements were made to the test protocols. For EpiDerm, EPISKIN and the SIFT, the intralaboratory and interlaboratory reproducibilities were acceptable; however, better standardisation of certain aspects of the test protocols was needed prior to commencing phase III. Neither PREDISKIN nor the pig ear test performed sufficiently well in phase II to progress to phase III. The PREDISKIN protocol was overly sensitive, resulting in the prediction of all the NI chemicals as I. The variability in the pig ear test results was too great, indicating that the test would show

  2. Sensitivity of C-Tb: a novel RD-1-specific skin test for the diagnosis of tuberculosis infection.

    PubMed

    Hoff, Soren T; Peter, Jonathan G; Theron, Grant; Pascoe, Mellissa; Tingskov, Pernille N; Aggerbeck, Henrik; Kolbus, Daniel; Ruhwald, Morten; Andersen, Peter; Dheda, Keertan

    2016-03-01

    C-Tb, a novel Mycobacterium tuberculosis and 6-kDa early secretory antigenic target/10-kDa culture filtrate protein (ESAT-6/CFP-10)-specific skin test, has high specificity in bacille Calmette-Guerin-vaccinated healthy controls. However, the sensitivity of C-Tb has hitherto not been determined. The objective was to determine the sensitivity of C-Tb in patients with active tuberculosis (TB) in comparison with the tuberculin skin test (TST) and QuantiFERON-TB Gold In-Tube (QFT-GIT).C-Tb and TST were randomly administered in a double-blinded fashion to one or the other forearm in 253 patients with active TB with or without HIV co-infection. QFT-GIT testing was performed prior to skin testing.Using a receiver operating characteristic curve-derived cut-point of 5 mm, C-Tb sensitivity was similar to QFT-GIT (73.9 (95% CI 67.8-79.3) versus 75.1 (95% CI 69.3-80.2)), and similar in HIV-infected and HIV-uninfected patients (76.7 (95% CI 69.0-83.3) versus 69.5 (95% CI 59.2-78.5)). However, sensitivity was significantly diminished in HIV-infected patients with CD4 counts <100 cells·mm(-3). C-Tb and QFT-GIT combined had significantly higher sensitivity than C-Tb alone (p<0.0001). C-Tb was safe with no significant adverse events. The 5 mm cut-point corresponded to that found in the previously published specificity study (TESEC-04).C-Tb has similar sensitivity compared with QFT-GIT for the diagnosis of M. tuberculosis infection. Sensitivity was reduced only in HIV-infected patients with severe immunosuppression. Further studies in different settings are required to validate the proposed 5 mm cut-point.

  3. Skin sensitisation--moving forward with non-animal testing strategies for regulatory purposes in the EU.

    PubMed

    Basketter, David; Alépée, Nathalie; Casati, Silvia; Crozier, Jonathan; Eigler, Dorothea; Griem, Peter; Hubesch, Bruno; de Knecht, Joop; Landsiedel, Robert; Louekari, Kimmo; Manou, Irene; Maxwell, Gavin; Mehling, Annette; Netzeva, Tatiana; Petry, Thomas; Rossi, Laura H

    2013-12-01

    In a previous EPAA-Cefic LRI workshop in 2011, issues surrounding the use and interpretation of results from the local lymph node assay were addressed. At the beginning of 2013 a second joint workshop focused greater attention on the opportunities to make use of non-animal test data, not least since a number of in vitro assays have progressed to an advanced position in terms of their formal validation. It is already recognised that information produced from non-animal assays can be used in regulatory decision-making, notably in terms of classifying a substance as a skin sensitiser. The evolution into a full replacement for hazard identification, where the decision is not to classify, requires the generation of confidence in the in vitro alternative, e.g. via formal validation, the existence of peer reviewed publications and the knowledge that the assay(s) are founded on key elements of the Adverse Outcome Pathway for skin sensitisation. It is foreseen that the validated in vitro assays and relevant QSAR models can be organised into formal testing strategies to be applied for regulatory purposes by the industry. To facilitate progress, the European Partnership for Alternative Approaches to animal testing (EPAA) provided the platform for cross-industry and regulatory dialogue, enabling an essential and open debate on the acceptability of an in vitro based integrated strategy. Based on these considerations, a follow up activity was agreed upon to explore an example of an Integrated Testing Strategy for skin sensitisation hazard identification purposes in the context of REACH submissions. Copyright © 2013 Elsevier Inc. All rights reserved.

  4. The Challenge of Producing Skin Test Antigens with Minimal Resources Suitable for Human Application against a Neglected Tropical Disease; Leprosy

    PubMed Central

    Rivoire, Becky L.; TerLouw, Stephen; Groathouse, Nathan A.; Brennan, Patrick J.

    2014-01-01

    True incidence of leprosy and its impact on transmission will not be understood until a tool is available to measure pre-symptomatic infection. Diagnosis of leprosy disease is currently based on clinical symptoms, which on average take 3–10 years to manifest. The fact that incidence, as defined by new case detection, equates with prevalence, i.e., registered cases, suggests that the cycle of transmission has not been fully intercepted by implementation of multiple drug therapy. This is supported by a high incidence of childhood leprosy. Epidemiological screening for pre-symptomatic leprosy in large endemic populations is required to facilitate targeted chemoprophylactic interventions. Such a test must be sensitive, specific, simple to administer, cost-effective, and easy to interpret. The intradermal skin test method that measures cell-mediated immunity was explored as the best option. Prior knowledge on skin testing of healthy subjects and leprosy patients with whole or partially fractionated Mycobacterium leprae bacilli, such as Lepromin or the Rees' or Convit' antigens, has established an acceptable safety and potency profile of these antigens. These data, along with immunoreactivity data, laid the foundation for two new leprosy skin test antigens, MLSA-LAM (M. leprae soluble antigen devoid of mycobacterial lipoglycans, primarily lipoarabinomannan) and MLCwA (M. leprae cell wall antigens). In the absence of commercial interest, the challenge was to develop these antigens under current good manufacturing practices in an acceptable local pilot facility and submit an Investigational New Drug to the Food and Drug Administration to allow a first-in-human phase I clinical trial. PMID:24874086

  5. [The diagnosis of latent tuberculosis infection in children in XXI century. Is tuberculin skin test still up to date?].

    PubMed

    Bielecka, Teresa; Komorowska-Piotrowska, Anna; Mazur, Agnieszka; Feleszko, Wojciech

    2015-10-13

    Tuberculosis morbidity rates in Poland have been gradually decreasing. Nevertheless, there are approximately 8 thousand cases being registered annually, which includes almost 3 thousand massively infectious patients. In the last 3 years, around 100 cases/year have been reported among children below 14 years of age. Infection with Mycobacterium tuberculosis should be considered in all patients who present symptoms suggesting tuberculosis, have had recent contact with a person suffering from lung tuberculosis or are planned to undergo an immunosuppressive treatment. HIV infected patients are also supposed to have screening tests for M. tuberculosis infection performed. For over a 100 years tuberculin skin test (TST) was the only test capable of confirming tuberculous infection. TST is based on the assessment of skin reaction to intracutaneous injection of tuberculin. Due to cross-reaction to the injected tuberculin in BCG vaccinated individuals, the correct interpretation of the test is difficult. Since 13 years new immunological assays have been available. They are based on detecting interferon gamma (Interferon Gamma Release Assay - IGRA) concentration in blood serum, which has previously been incubated with Mycobacterium tuberculosis antigens absent in the BCG strain. In infected individuals interferon gamma is intensively produced by memory cells in reaction to the contact with previously met Mycobacterium antigens. Many trials have proved IGRA's high sensitivity and, higher than TST, specificity. Recent guidelines promote the usage of IGRAs, even in children.

  6. Immediate-type hypersensitivity reactions to proton pump inhibitors: usefulness of skin tests in the diagnosis and assessment of cross-reactivity.

    PubMed

    Kepil Özdemir, S; Yılmaz, I; Aydin, Ö; Büyüköztürk, S; Gelincik, A; Demirtürk, M; Erdoğdu, D; Cömert, S; Erdoğan, T; Karakaya, G; Kalyoncu, A F; Oner Erkekol, F; Dursun, A B; Misirligil, Z; Bavbek, S

    2013-08-01

    Data are limited about the value of skin tests in the diagnosis of proton pump inhibitor (PPI)-induced hypersensitivity reactions and the cross-reactivity between PPIs. We aimed to assess the role of skin testing in the diagnosis of PPI-related immediate hypersensitivity reactions and the cross-reactivity patterns among PPIs. The study was designed in a prospective, national, multicentre nature. Sixty-five patients with a suggestive history of a PPI-induced immediate hypersensitivity reaction and 30 control subjects were included. Standardized skin prick and intradermal tests were carried out with a panel of PPIs. Single-blind, placebo-controlled oral provocation tests (OPTs) with the PPIs other than the culprit PPI that displayed negative results in skin tests (n = 61) and diagnostic OPTs with the suspected PPI (n = 12) were performed. The suspected PPIs were lansoprazole (n = 52), esomeprazole (n = 11), pantoprazole (n = 9), rabeprazole (n = 2), and omeprazole (n = 1). The sensitivity, specificity, and negative and positive predictive values of the skin tests with PPIs were 58.8%, 100%, 70.8%, and 100%, respectively. Fifteen of the 31 patients with a hypersensitivity reaction to lansoprazole had a positive OPT or skin test result with at least one of the alternative PPIs (8/52 pantoprazole, 6/52 omeprazole, 5/52 esomeprazole, 3/52 rabeprazole). Considering the high specificity, skin testing seems to be a useful method for the diagnosis of immediate-type hypersensitivity reactions to PPIs and for the evaluation of cross-reactivity among PPIs. However, OPT should be performed in case of negativity on skin tests. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Simulating plastic surgery: from human skin tensile tests, through hyperelastic finite element models to real-time haptics.

    PubMed

    Lapeer, R J; Gasson, P D; Karri, V

    2010-12-01

    In this paper, we provide a summary of a number of experiments we conducted to arrive at a prototype real-time simulator for plastic surgical interventions such as skin flap repair and inguinal herniotomy. We started our research with a series of in-vitro tensile stress tests on human skin, harvested from female patients undergoing plastic reconstructive surgery. We then used the acquired stress-strain data to fit hyperelastic models. Three models were considered: General Polynomial, Reduced Polynomial and Ogden. Only Reduced Polynomial models were found to be stable, hence they progressed to the next stage to be used in an explicit finite element model aimed at real-time performance in conjunction with a haptic feedback device. A total Lagrangian formulation with the half-step central difference method was employed to integrate the dynamic equation of motion of the mesh. The mesh was integrated into two versions of a real-time skin simulator: a single-threaded version running on a computer's main central processing unit and a multi-threaded version running on the computer's graphics card. The latter was achieved by exploiting recent advances in programmable graphics technology.

  8. Discordance between Aeroallergen Specific Serum IgE and Skin Testing in Children < 4 years of age

    PubMed Central

    de Vos, Gabriele; Nazari, Ramin; Ferastraoaru, Denisa; Parikh, Purvi; Geliebter, Rebecca; Pichardo, Yikania; Wiznia, Andrew; Rosenstreich, David

    2015-01-01

    Background Atopic sensitization to aeroallergens in early life has been shown to be a strong risk factor for developing persisting asthma in young children with recurrent wheeze. Objective The aim of this study was to assess the yield of skin prick test (SPT) compared to allergen specific serum IgE testing (sIgE) at identifying aeroallergen sensitization in atopic children < 4 years of age. Methods Concordance between SPT (Greer Laboratories, ComforTen™) and allergen specific sIgE (Immulite 2000™) for 7 common aeroallergens was analyzed in forty atopic inner-city children, 18–48 months of age (mean 36 +/− 9 months) with recurrent wheezing, family history of asthma and/or eczema. Results In 80% of children one or more allergen sensitizations would have been missed if only SPT had been performed, and in 38% of children one or more sensitizations would have been missed if only serum IgE testing had been performed. Agreement and between SPT and sIgE test was fair for most allergens (kappa between −0.04 and 0.50), as was correlation between sIgE levels and SPT grade (rho between 0.21 and 0.55). Children with high total sIgE (≥300 kU/l) were more likely to have sIgE positive tests with negative corresponding skin test (p=0.025). Conclusions Our study showed significant discordance between allergen specific SPT and sIgE testing results for common aeroallergens, suggesting that both SPT and sIgE testing should be done when diagnosing allergic sensitization in young children at high risk of asthma. PMID:23706713

  9. Effects of repeated administration of intradermal skin test by Mantoux method on delayed-type hypersensitivity responses in healthy young and elderly subjects

    USDA-ARS?s Scientific Manuscript database

    Multi-test CMI to test immune response is no longer commercially available. DTH response is a highly suitable marker of immune function. Because delayed-type hypersensitivity (DTH) skin test can predict morbidity and mortality, it may be clinically meaningful test to evaluate the effect of nutrition...

  10. Alkali-treated penicillin G solution is a better option than penicillin G as an alternative source of minor determinants for penicillin skin test.

    PubMed

    Wangrattanasopon, Pongsak; Ruxrungtham, Kiat; Chantaphakul, Hiroshi; Buranapraditkun, Supranee; Klaewsongkram, Jettanong

    2012-01-01

    Both benzylpenicilloyl-polylysine (PPL) and minor determinant mixture (MDM) are the recommended standard reagents for penicillin skin testing. However, penicillin G is commonly suggested as an alternative source of minor determinants. This study evaluated the accuracy of penicillin G and alkali-treated penicillin G compared with the standardized MDM for skin testing. Sixty-eight patients with histories of allergies to penicillin or semisynthetic penicillins were skin tested with commercial Kit penicillin allergenic determinants (DAP) (PPL and DAP-MDM; Diater Laboratorios, Madrid, Spain). The in-house MDM (IH-MDM), prepared by alkali-treated aged penicillin, and fresh penicillin G sodium (PGs) were tested alongside DAP-MDM. Positive penicillin skin test results were identified in 22 patients (32.4%) using commercial reagents (PPL+ DAP-MDM) and 19 of them reacted to DAP-MDM alone or together with PPL. The accuracy of IH-MDM and PGs compared with DAP-MDM was 89.7 and 76.5%, respectively. Our study shows that alkali-treated penicillin G is a better option than penicillin G as an alternative source of MDM for skin testing in case the commercialized MDM is not available. Minor determinants play a significant role for penicillin allergy in Thailand and should be included in the penicillin skin test panel to verify suspected cases of penicillin allergy. (ClinicalTrials.gov number: NCT00789217).

  11. Is trimellitic anhydride skin testing a sufficient screening tool for selectively identifying TMA-exposed workers with TMA-specific serum IgE antibodies?

    PubMed

    Bernstein, Jonathan A; Ghosh, Debajyoti; Sublett, Wesley J; Wells, Heather; Levin, Linda

    2011-10-01

    Trimellitic anhydride (TMA) can elicit specific IgE-mediated immune responses leading to asthma. This single-blinded study investigated the ability of TMA skin testing to identify workers with TMA-serum specific IgE antibodies. Forty TMA-exposed workers who were previously screened for the presence of TMA-IgG and/or IgE serum specific antibodies were skin tested to a TMA-human serum albumin reagent by nurses blinded to their antibody responses. Findings from skin-prick tests were positive in 8 of 11 workers with TMA-serum specific IgE antibodies. Intracutaneous testing, performed only on skin prick testing-negative workers, was positive in two additional workers with TMA-serum specific IgE antibodies. A significant correlation was found between serum and skin test dilutions eliciting positive responses (ρ = 0.87, P < 0.05; n = 11). TMA skin testing provides an alternative and potentially more practical method for monitoring TMA-exposed workers for developing IgE sensitization.

  12. Neonatal tetanus in Peru: risk assessment with modified enzyme-linked immunosorbent assay and toxoid skin test.

    PubMed Central

    Vernacchio, L; Madico, G; Verastegui, M; Diaz, F; Collins, T S; Gilman, R H

    1993-01-01

    We used a modified enzyme-linked immunosorbent assay (ELISA) to investigate tetanus immunity in 232 pregnant Peruvian women. One hundred forty-two (61.2%) had protective antitoxin titers (> or = 0.01 IU/mL). Protective titers correlated positively with the number of toxoid doses reported during the current pregnancy. A majority of women reporting no toxoid doses during the current pregnancy had at least one prenatal health care visit. We evaluated a toxoid skin test in 44 of the subjects, but it correlated poorly with the ELISA. The modified ELISA is a useful in vitro method for studying tetanus immunity in the developing world. PMID:8259811

  13. Skin test reactivity to whole body and fecal extracts of American (Periplaneta americana) and German (Blatella germanica) cockroaches in atopic asthmatics.

    PubMed

    Menon, P; Menon, V; Hilman, B; Stankus, R; Lehrer, S B

    1991-12-01

    Forty-six atopic asthmatic subjects aged 3 to 58 years attending the allergy clinic of a university hospital were evaluated for prick skin test reactivity with commercially available extracts of cockroach (CCE) and house dust (HD). Additionally, skin testing was performed with American cockroach whole body (AWBE) and fecal extracts (AFE) as well as German cockroach whole body (GWBE) and fecal extracts (GFE) prepared in our laboratory. Commercial cockroach extract was prepared from American, German, and Oriental cockroach whole bodies. Skin test reactivity to the different extracts were as follows: 83% to HD, 70% to CCE, 70% to AWBE and/or GWBE, 63% to AWBE, 57% to GWBE, 63% to AFE and/or GFE, 52% to AFE, 50% to GFE, 48% to both AWBE and GWBE, and 39% to both AFE and GFE. The subjects with positive skin tests to AWBE and/or GWBE (70%) were the same individuals who showed skin test reactivity to CCE (70%). Subjects from lower income families (less than $10,000) had a significantly higher skin test reactivity to cockroach allergens than those from families with an annual income of $11,000 to $24,000 (P = .04). These results demonstrate the significance of cockroach sensitization in atopic asthmatics, suggest the importance of fecal cockroach allergens, and support earlier observations of shared interspecies allergens between American and German cockroach whole bodies.

  14. Use of a smart phone based thermo camera for skin prick allergy testing: a feasibility study (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Barla, Lindi; Verdaasdonk, Rudolf M.; Rustemeyer, Thomas; Klaessens, John; van der Veen, Albert

    2016-02-01

    Allergy testing is usually performed by exposing the skin to small quantities of potential allergens on the inner forearm and scratching the protective epidermis to increase exposure. After 15 minutes the dermatologist performs a visual check for swelling and erythema which is subjective and difficult for e.g. dark skin types. A small smart phone based thermo camera (FLIR One) was used to obtain quantitative images in a feasibility study of 17 patients Directly after allergen exposure on the forearm, thermal images were captured at 30 seconds interval and processed to a time lapse movie over 15 minutes. Considering the 'subjective' reading of the dermatologist as golden standard, in 11/17 pts (65%) the evaluation of dermatologist was confirmed by the thermo camera including 5 of 6 patients without allergic response. In 7 patients thermo showed additional spots. Of the 342 sites tested, the dermatologist detected 47 allergies of which 28 (60%) were confirmed by thermo imaging while thermo imaging showed 12 additional spots. The method can be improved with user dedicated acquisition software and better registration between normal and thermal images. The lymphatic reaction seems to shift from the original puncture site. The interpretation of the thermal images is still subjective since collecting quantitative data is difficult due to motion patient during 15 minutes. Although not yet conclusive, thermal imaging shows to be promising to improve the sensitivity and selectivity of allergy testing using a smart phone based camera.

  15. Natural evolution of skin-test sensitivity in patients with IgE-mediated hypersensitivity to cephalosporins.

    PubMed

    Romano, A; Gaeta, F; Valluzzi, R L; Zaffiro, A; Caruso, C; Quaratino, D

    2014-06-01

    There are studies demonstrating that skin-test sensitivity to penicillins can decrease over time and that allergic patients may lose sensitivity if the responsible compounds are avoided. With regard to subjects with IgE-mediated hypersensitivity to cephalosporins, however, such studies are lacking. We evaluated prospectively in a 5-year follow-up 72 cephalosporin-allergic patients. After the first evaluation, patients were classified into two groups according to their patterns of allergologic-test positivity: to both penicillins and cephalosporins (group A), or only to cephalosporins (group B). Skin tests and serum-specific IgE assays were repeated 1 year later and, in case of persistent positivity, 3 and 5 years after the first allergologic examination. Seven (43.7%) of the 16 subjects of group A and 38 (67.8%) of the 56 patients of group B became negative; one was lost to follow-up. Patients of group B became negative sooner and more frequently than group A subjects.

  16. Autologous serum skin test vs autologous plasma skin test in patients with chronic urticaria: evaluation of reproducibility, sensitivity and specificity and relationship with disease activity, quality of life and anti-thyroid antibodies.

    PubMed

    Kocatürk, Emek; Kavala, Mukaddes; Kural, Esra; Sarıgul, Sukran; Zındancı, Ilkin

    2011-01-01

    Recent concerns have arisen about the specificity and interpretation of the autologous serum skin test (ASST), suggesting that ASST might produce false-positive results, and proposing the use of autologous plasma (APST) instead for intradermal testing in autoreactive urticaria. We investigated autoreactivity to autologous plasma and compared the results for reproducibility, sensitivity, specificity and accuracy and evaluated their association with quality of life and anti-TPO antibodies. 70 adults with chronic spontaneous urticaria (CU) and 62 controls underwent testing with ASST and APST and the tests were repeated two days after the first visit. Blood tests measured anti-TPO levels. Disease activity was assessed by urticaria activity score (UAS-7) and quality of life impairment was assessed by DLQI and CU-Q(2)oL. There were no statistically significant differences between ASST (+) and ASST (-) and also APST (+) and APST (-) patients with regard to disease duration, anti-TPO antibodies, urticaria activity scores, DLQI scores and CU-Q(2)oL scores. The results of first ASST and APST were well correlated with the results of second ASST and APST. The specificity of the two tests was similar, while ASST had a higher sensitivity and accuracy. Our results showed that there is no need to use autologous plasma instead of autologous serum for intradermal testing in CU.

  17. [The dermatoscopy in the skin pathergy testing: case series in patients with suspected Behçet's Disease].

    PubMed

    Scherrer, Maria Antonieta Rios; de Castro, Lúcia Porto Fonseca; Rocha, Vanessa Barreto; Pacheco, Leonardo

    2014-01-01

    Behçet's disease is a multisystemic disease consisting of a varying combination of ocular, mucocutaneous, neurologic, cardiovascular, gastrointestinal and other manifestations. Its diagnosis is based on clinical criteria, in which a positive pathergy test scores 1. A case series with 26 suspected patients is presented, and the skin pathergy test was performed in 23. The results were read in 48hours, and they were considered negative when without papule, and positive with a papule or pustule. Positive results were divided by papule size, and dermatoscopy was done to measure and observe its clinical aspects. After the readings, a biopsy was performed, with annotation of histopathological aspects. The test was negative in 2 (8.7%) and positive in 21 (91.3%) patients. The results and the literature review are presented. Copyright © 2014 Elsevier Editora Ltda. All rights reserved.

  18. Skin tests and histamine release with P1-depleted Dermatophagoides pteronyssinus body extracts and purified P1.

    PubMed

    van der Zee, J S; van Swieten, P; Jansen, H M; Aalberse, R C

    1988-05-01

    Monoclonal antibodies were raised against P1 and Dp X, two major allergens in Dermatophagoides pteronyssinus extracts. The concentrations of IgE antibodies to P1 and Dp X in sera of mite-sensitive patients were determined in RAST with immunosorbent-bound monoclonal antibodies used for insolubilization of the allergens. The major allergen-specific IgE titers were compared with the total IgE response against D. pteronyssinus. The results of these serologic assays confirmed studies in the literature that P1 and Dp X are major allergens. The contribution of IgE anti-P1 to the total antimite response frequently exceeded 50% and, in general, appeared to be higher than the contribution of IgE anti-Dp X. Twenty percent of the mite-sensitive patients had no detectable IgE to either P1 or Dp X. The contribution of P1 to the biologic activity of D. pteronyssinus body extracts was derived from the effect of P1 depletion on the reactivity in the histamine-release test and skin test. This technique was preferred to the study of purified allergen because biologic activity of the nonabsorbed components is not affected. Immunization of rabbits with affinity-purified P1 yielded monospecific polyclonal antisera. Mite extracts depleted with either monoclonal or polyclonal anti-P1 were applied in the histamine-release test. The skin test was performed with extracts depleted with polyclonal anti-P1. In addition, the activity of affinity-purified P1 was investigated in these tests. The results indicated that P1 depletion of D. pteronyssinus body extracts had no detectable effect on the activity in most patients, namely, at least 70% of the activity was retained in the depleted extract. There was a considerable variation between patients in the sensitivity for purified P1, as compared to the sensitivity for whole D. pteronyssinus extracts. In the histamine-release test, the activity of purified P1 was up to 35% of the activity of the D. pteronyssinus body extract but did not exceed 10% in

  19. Determination of N-acetylglucosamine in cosmetic formulations and skin test samples by hydrophilic interaction liquid chromatography and UV detection.

    PubMed

    Pedrali, Alice; Bleve, Mariella; Capra, Priscilla; Jonsson, Tobias; Massolini, Gabriella; Perugini, Paola; Marrubini, Giorgio

    2015-03-25

    N-Acetylglucosamine is an ingredient in pharmaceuticals, nutritional supplements and in cosmetics. N-Acetylglucosamine in cosmetics is expected to improve skin hydration, reparation, and to contribute as anti-wrinkle agent. This study reports on the validation and application of an HPLC method based on HILIC and UV detection for determining N-acetylglucosamine in cosmetics and in samples obtained after testing the skin exposed to cosmetics formulations. The chromatographic column used is a ZIC(®)-pHILIC (150 mm × 4.6 mm, 5 μm particle size) on which a mobile phase containing acetonitrile-aqueous KH2PO4 (70:30, v/v) 15 mM was applied in isocratic elution mode injecting 20 μl of sample at 0.5 ml/min constant flow-rate and 10±1°C column temperature. Under these conditions the total run time was 10 min and N-acetylglucosamine eluted baseline separated from all other compounds in the samples. Calibration in the range from 40 to 80 μg/ml allowed to assess the method linearity (R(2)>0.999) in a concentration range corresponding to about 50% to 120% of the expected levels of N-acetylglucosamine in the formulations. Precision expressed by RSD% was always better than 2% in intra-day and inter-day assays of authentic samples. Accuracy was in all cases within 95-105% of the expected concentration value in formulations containing N-acetylglucosamine. The sensitivity of the method was at the level of 10 μg/ml as limit of detection, and at 40 μg/ml as limit of quantitation. The application of the method to formulations containing solid lipid nanoparticles documents its usefulness in cosmetic quality control. The results witness that the method is also suitable for the determination of N-acetylglucosamine in samples obtained from skin test strips.

  20. Acoustic fatigue testing on different materials and skin-stringer elements

    NASA Astrophysics Data System (ADS)

    Koenig, Klaus

    1994-09-01

    Within a comparative study, 29 different coupons covering 8 different designs and 6 different materials were fatigued by an excitation of 30 g(exp 2)/Hz on a shaker. The selected designs and materials represent realistic alternatives of an aircraft surface structure. The investigation led to the following conclusion: (1) Besides classical aluminium, CFRP is the best material with regard to sonic fatigue. (2) Al/Li, ARALL and Al layer materials showed shorter life times than the classical Al. (3) The most striking improvement in design for the dimensions selected here was achieved with separate doublers between skin and stringer. (4) The modal damping found was most often smaller than the 1.7 percent of the critical as known from ESDU for Al. (5) Pure CFRP without rivets showed the smallest damping: 0.6 - 0.9 percent.

  1. Randomised clinical trial investigating the specificity of a novel skin test (C-Tb) for diagnosis of M. tuberculosis infection.

    PubMed

    Aggerbeck, Henrik; Giemza, Rafaela; Joshi, Paulatsya; Tingskov, Pernille N; Hoff, Søren T; Boyle, Julia; Andersen, Peter; Lewis, David J M

    2013-01-01

    Tuberculin skin testing is simple and relatively inexpensive, but the specificity of PPD is affected by BCG vaccination. Determine optimal dose and specificity of recombinant ESAT-6 and CFP-10 (C-Tb) produced in Lactococcus lactis for diagnosis of M. tuberculosis infection. In a dose finding phase I trial 0.01 or 0.1 µg preserved and unpreserved C-Tb was injected by Mantoux technique in 38 patients with active tuberculosis and induration responses measured. In a phase II specificity trial in 151 uninfected, BCG vaccinated participants 0.1 µg C-Tb was compared to 2 TU PPD. 0.1 µg C-Tb gave a median induration of 15 mm after 2 days. Phenol preservation did not affect the response. The specificity of C-Tb was 99.3% (95% CI 96-100%) regarding indurations ≥5 mm as a positive outcome. This was higher than the specificity of PPD (63% using a cut-off of 5 mm or 92% using a cut-off of 15 mm to adjust for non-specific BCG responses). Local adverse reactions following C-Tb injection included transient itching and discomfort as expected components of the immune response. C-Tb offers a simple and convenient skin test to diagnose M. tuberculosis infection using a single, universal cut-off unaffected by BCG vaccination. ClinicalTrials.gov NCT01033929 and NCT01241188.

  2. The genetics of skin, hair, and eye color variation and its relevance to forensic pigmentation predictive tests.

    PubMed

    Maroñas, O; Söchtig, J; Ruiz, Y; Phillips, C; Carracedo, Á; Lareu, M V

    2015-01-01

    This review examines the potential application of single nucleotide polymorphism (SNP)-based predictive tests for skin, hair, and eye color to forensic analysis in support of police investigations lacking DNA database matches or eyewitness testimony. Brief descriptions of the biology of melanogenesis and the main genes involved are presented in order to understand the basis of common pigmentation variation in humans. We outline the most recently developed forensically sensitive multiplex tests that can be applied to investigative analyses. The review also describes the biology of the SNPs with the closest associations to, and therefore the best predictors for, common variation in eye, hair, and skin pigmentation. Because pigmentation pathways are complex in their patterns, many of the better-studied human albinism traits provide insight into how pigmentation SNPs interact, control, or modify gene expression and show varying degrees of association with the key genes identified to date. These aspects of SNP action are discussed in an overview of each of the functional groups of pigmentation genes.

  3. Comparison between Siriraj mite allergen vaccine and standardized commercial mite vaccine by skin prick testing in normal Thai adults.

    PubMed

    Visitsunthorn, Nualanong; Pacharn, Punchama; Jirapongsananuruk, Orathai; Weeravejsukit, Sirirat; Sripramong, Chaweewan; Sookrung, Nitat; Bunnag, Chaweewan

    2010-03-01

    House dust mite is a major cause of allergic asthma and rhinitis in Thai population. Skin prick test (SPT) is a useful tool for the diagnosis of the IgE-mediated reactions. The imported commercial mite vaccine for SPT is available but it is relatively expensive. Aim of this study is to compare Siriraj Mite Allergen Vaccine (SMAV) with standardized commercial mite allergen vaccine by skin prick testing in normal Thai adults. A double blind, self-controlled study between the SMAV and standardized commercial mite allergen vaccine was performed by SPT in 17 normal Thai adult males and non-pregnant or non-lactating females aged 18-60 years. The study showed that 35.29 % of non atopic adults had positive SPT reaction to Dp and Df of both SMAV and standardized commercial mite allergen vaccine. Mean wheal and flare diameters from SPT of Dp and Df of SMAV showed strong correlation with standardized commercial mite allergen vaccine (r= 0.768 and 0.897 in Dp and Df respectively, p <0.001). The intraclass correlation was also excellent (0.893 and 0.775 in Dp and Df respectively). There was no significant difference in wheal and flare diameter between SMAV and standardized commercial mite allergen vaccine. No systemic or large local reaction was found in any of the study cases.

  4. A paired comparison of tuberculin skin test results in health care workers using 5 TU and 10 TU tuberculin

    PubMed Central

    Stuart, R.; Bennett, N.; Forbes, A.; Grayson, M

    2000-01-01

    BACKGROUND—Historically, 10 TU has been employed in Australia and the United Kingdom to perform the tuberculin skin test (TST). However, this makes it difficult to compare the rates of TST positivity with other countries such as the USA who use 5 TU. To assess the impact of the dose of tuberculin on the TST a comparison was made of TST responses in health care workers given a TST with both 5 and 10 TU.
METHODS—Two TSTs were performed simultaneously in each health care worker using 5 and 10 TU. Each dose was randomly assigned in a blinded manner to the right or left forearm and read at 48-72 hours by a single nurse who was blinded to the assignment of the 5 and 10 TU doses.
RESULTS—A total of 128 health care workers were enrolled, 119 (93%) of whom had a past history of BCG vaccination. The overall mean difference in paired reaction sizes for the two doses was 1.5 mm with 95% limits of agreement of -3.6 to 6.5 mm.
CONCLUSION—A slightly larger TST reading was seen with 10 TU than with 5 TU. The mean difference of 1.5 mm between the two doses should be considered when comparing rates of TST positivity between countries who use different doses of tuberculin to perform the tuberculin skin test.

 PMID:10899248

  5. Delayed-type hypersensitivity, contact sensitivity, and phytohemagglutinin skin-test responses of heat- and cold-stressed calves.

    PubMed

    Kelley, K W; Greenfield, R E; Evermann, J F; Parish, S M; Perryman, L E

    1982-05-01

    Three-week-old Holstein bull calves were used to investigate the effect of a 2-week chronic heat (35 C) or cold (-5 C) exposure on delayed-type hypersensitivity (DTH) reactions to purified protein derivative after sensitization with heat-killed Mycobacterium tuberculosis, contact sensitivity (CS) reactions to 1-fluoro-2,4-dinitrobenzene, and phytohemagglutinin (PHA) skin tests. Heat exposure reduced expression of DTH reactions by 42% and CS reactions by 38% at 24 hours after elicitation of the responses. The PHA-induced skin tests were not affected after 1 week of heat exposure, but this reaction was reduced by 20% after 2 weeks of heat exposure. The immune response of calves exposed to cold air temperatures was more complex. Cold exposure suppressed CS reactions by 39% at the end of both the 1st and 2nd weeks. The PHA response was reduced by 39% after 2 weeks of cold exposure. The DTH response depended on duration of cold exposure. The DTH reaction was increased by 42% after 1 week, but was reduced by 14% after 2 weeks. These data are consistent with the hypothesis that environmental stressors alter host resistance by affecting the immune system. Furthermore, these stress-induced changes in immune events depend on the type of immune response, the nature of the environmental stressor, and the length of time that calves are exposed to the stressor.

  6. The effects of serial skin testing with purified protein derivative on the level and quality of antibodies to complex and defined antigens in Mycobacterium bovis-infected cattle

    USDA-ARS?s Scientific Manuscript database

    Several serologic tests designed to detect antibodies to immunodominant Mycobacterium bovis antigens have recently emerged as ancillary tests for the detection of bovine tuberculosis in cattle, particularly when applied after injection of purified protein derivative (PPD) for skin test that signific...

  7. Comparison of interferon gamma release assay & tuberculin skin tests for diagnosis of latent tuberculosis in patients on maintenance haemodialysis.

    PubMed

    Agarwal, Sanjay K; Singh, Urvashi B; Zaidi, Sabahat H; Gupta, Sanjay; Pandey, Ravinder M

    2015-04-01

    Tuberculosis (TB) is a common infection in patients on haemodialysis. There is a definite role of treatment of latent TB (LTB) in these patients. However, diagnosis of LTB in these patients by tuberculin skin test (TST) is unreliable. There is suggestion that interferon gamma release assay (IGRA) will be more reliable test for diagnosis of LTB in this setting. Thus, we evaluated value of IGRA and TST for the diagnosis of LTB in patients on dialysis in an Indian setting. Patients with end stage kidney disease on dialysis were included. Patients with active TB were excluded. Each patient was subjected to TST (induration of ≥10 mm was taken as positive) and QuantiFERON TB Gold In-Tube test (QFT-GIT) for diagnosis of LTB. A total of 185 patients were included; 129 (69.7%) were males and mean age was 36.7 ± 12.3 yr. Past history of TB was present in 18 (9.7%) patients. One hundred and