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The use of patch testing in the diagnosis of food allergy

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Abstract

Diagnosing food allergies can be challenging to the practitioner. Our armamentarium includes standardized skin prick testing, radioallergoimmunosorbent (RAST) testing, and food challenges. These methods have certainly been helpful in the IgE-mediated disorders, including urticaria and anaphylaxis. However, diagnosing patients who have the non-IgE (cellmediated) or mixed (IgE and cell-mediated) disorders remains challenging with our current diagnostic methods. Recent studies have examined the use of patch testing for these foodallergic patients, specifically those with atopic dermatitis and eosinophilic esophagitis. In this article, we review literature regarding patch testing: its methods, its statistical usefulness, and its potential future role.

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References and Recommended Reading

  1. Sampson HA: Update on food allergy. J Allergy Clin Immunol 2004, 113:805–819.Excellent general review on food allergy.

    Article  PubMed  CAS  Google Scholar 

  2. Leung DY, Bieber T: Atopic dermatitis. Lancet 2003, 361:151–160.Outstanding review on the pathogenesis of atopic dermatitis.

    Article  PubMed  Google Scholar 

  3. Spergel JM, Beausoleil JL, Mascarenhas M, Liacouras CA: The use of skin prick tests and patch tests to identify causative foods in eosinophilic esophagitis. J Allergy Clin Immunol 2002, 109:363–368.First article discussing patch testing in food allergies other than atopic dermatitis.

    Article  PubMed  Google Scholar 

  4. Rostenberg A, Sulzberger M: Some results of patch tests. Arch Dermatol 1937, 35:433–454.

    CAS  Google Scholar 

  5. Mitchell EB, Crow J, Chapman MD, et al.: Basophils in allergen-induced patch test sites in atopic dermatitis. Lancet 1982, 1:127–130.

    Article  PubMed  CAS  Google Scholar 

  6. Darsow U, Ring J: Airborne and dietary allergens in atopic eczema: a comprehensive review of diagnostic tests. Clin Exp Dermatol 2000, 25:544–551.

    Article  PubMed  CAS  Google Scholar 

  7. Niggemann B, Ziegert M, Reibel S: Importance of chamber size for the outcome of atopy patch testing in children with atopic dermatitis and food allergy. J Allergy Clin Immunol 2002, 110:515–516.

    Article  PubMed  Google Scholar 

  8. Niggemann B, Reibel S, Roehr CC, et al.: Predictors of positive food challenge outcome in non-IgE-mediated reactions to food in children with atopic dermatitis. J Allergy Clin Immunol 2001, 108:1053–1058.

    Article  PubMed  CAS  Google Scholar 

  9. Rance F: What is the optimal occlusion time for the atopy patch test in the diagnosis of food allergies in children with atopic dermatitis? Pediatr Allergy Immunol 2004, 15:93–96.

    Article  PubMed  Google Scholar 

  10. Perackis K, Celik-Bilgili S, Staden U, et al.: Influence of age on the outcome of the atopy patch test with food in children with atopic dermatitis. J Allergy Clin Immunol 2003, 112:625–627.

    Article  PubMed  Google Scholar 

  11. Kerschenlohr K, Darsow U, Burgdorf WH, et al.: Lessons from atopy patch testing in atopic dermatitis. Curr Allergy Asthma Rep 2004, 4:285–289.ellent review on atopy patch testing.

    Article  PubMed  Google Scholar 

  12. Turjanmaa K: "Atopy patch tests" in the diagnosis of delayed food hypersensitivity. Allergie et Immunologie 2002, 34:95–97.

    PubMed  CAS  Google Scholar 

  13. Roehr CC, Reibel S, Ziegert M, et al.: Atopy patch tests, together with determination of specific IgE levels, reduce the need for oral food challenges in children with atopic dermatitis. J Allergy Clin Immunol 2001, 107:548–553.

    Article  PubMed  CAS  Google Scholar 

  14. Ring J, Darsow U, Gfesser M, Vieluf D: The ‘atopy patch test’ in evaluating the role of aeroallergens in atopic eczema. Inter Arch Allergy Immunol 1997, 113:379–383.

    CAS  Google Scholar 

  15. Niggemann B: Evolving role of the atopy patch test in the diagnosis of food allergy. Curr Opin Allergy Clin Immunol 2002, 2:253–256.

    Article  PubMed  Google Scholar 

  16. Niggemann B, Reibel S, Wahn U: The atopy patch test (APT): a useful tool for the diagnosis of food allergy in children with atopic dermatitis. Allergy 2000, 55:281–285.Article describing the use of atopy patch testing in the diagnosis of food allergy in atopic dermatitis.

    Article  PubMed  CAS  Google Scholar 

  17. Majamaa H, Moisio P, Holm K, et al.: Cow’s milk allergy: diagnostic accuracy of skin prick and patch tests and specific IgE. Allergy 1999, 54:346–351.

    Article  PubMed  CAS  Google Scholar 

  18. Majamaa H, Moisio P, Holm K, Turjanmaa K: Wheat allergy: diagnostic accuracy of skin prick and patch tests and specific IgE. Allergy 1999, 54:851–856.

    Article  PubMed  CAS  Google Scholar 

  19. Isolauri E, Turjanmaa K: Combined skin prick and patch testing enhances identification of food allergy in infants with atopic dermatitis. J Allergy Clin Immunol 1996, 97:9–15.Early study examining patch testing in atopic dermatitis.

    Article  PubMed  CAS  Google Scholar 

  20. Breuer K, Heratizadeh A, Wulf A, et al.: Late eczematous reactions to food in children with atopic dermatitis. Clin Exp Allergy 2004, 34:817–824.

    Article  PubMed  CAS  Google Scholar 

  21. Vanto T, Juntunen-Backman K, Kalimo K, et al.: The patch test, skin prick test, and serum milk-specific IgE as diagnostic tools in cow’s milk allergy in infants. Allergy 1999, 54:837–842.

    Article  PubMed  CAS  Google Scholar 

  22. Niggemann B: The role of the atopy patch test (APT) in diagnosis of food allergy in infants and children with atopic dermatitis. Pediatr Allergy Immunol 2001, 12(Suppl14):37–40.Excellent review on atopy patch testing.

    Article  PubMed  Google Scholar 

  23. Seidenari S, Giusti F, Bertoni L, Mantovani L: Combined skin prick and patch testing enhances identification of peanutallergic patients with atopic dermatitis. Allergy 2003, 58:45–49.

    Google Scholar 

  24. Stromberg L: Diagnostic accuracy of the atopy patch test and the skin-prick test for the diagnosis of food allergy in young children with atopic eczema/dermatitis syndrome. Acta Paediatr 2002, 91:1044–1049.

    Article  PubMed  CAS  Google Scholar 

  25. Niggemann B, Sielaff B, Beyer K, et al.: Outcome of double-blind, placebo-controlled food challenge tests in 107 children with atopic dermatitis. Clin Exp Allergy 1999, 29:91–96.

    Article  PubMed  CAS  Google Scholar 

  26. Gawrieh S, Shaker R: Treatment options for eosinophilic esophagitis: elemental diet. Curr Gastroenterol Rep 2004, 6:189.

    Article  PubMed  Google Scholar 

  27. Liacouras CA, Markowitz JE: Eosinophilic esophagitis: a subset of eosinophilic gastroenteritis. Curr Gastroenterol Rep 1999, 1:253–258.

    Article  PubMed  CAS  Google Scholar 

  28. Kelly KJ, Lazenby AJ, Rowe PC, et al.: Eosinophilic esophagitis attributed to gastroesophageal reflux: improvement with an amino acid-based formula. Gastroenterology 1995, 109:1503–1512.

    Article  PubMed  CAS  Google Scholar 

  29. De Boissieu D, Waguet JC, Dupont C: The atopy patch tests for detection of cow’s milk allergy with digestive symptoms. J Pediatr 2003, 142:203–205.

    Article  PubMed  Google Scholar 

  30. Isolauri E, Sutas Y, Makinen-Kiljunen S, et al.: Efficacy and safety of hydrolyzed cow milk and amino acid-derived formulas in infants with cow milk allergy. J Pediatr 1995, 127:550–557.

    Article  PubMed  CAS  Google Scholar 

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Spergel, J.M., Brown-Whitehorn, T. The use of patch testing in the diagnosis of food allergy. Curr Allergy Asthma Rep 5, 86–90 (2005). https://doi.org/10.1007/s11882-005-0061-5

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  • DOI: https://doi.org/10.1007/s11882-005-0061-5

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