Cutaneous Lymphoid Hyperplasia Which Developed after Allergy Skin Test of Antibiotics / 대한피부과학회지

Cutaneous lymphoid hyperplasia (CLH, pseudolymphoma) refers to a heterogeneous group of benign reactive T- and/or B-cell lymphoproliferative diseases of the skin, that resemble cutaneous lymphoma both clinically and histologically. Despite the unknown causes of CLH development, various stimuli can induce CLH, such as medications, infections, insect bites, photosensitivity and foreign agents. To date, there has been no reported case of CLH development after an allergy skin test of antibiotics. Thus, we report a patient who developed CLH following an allergy skin test of antibiotics. He was a 21-year-old man who presented with 1.5x1.5 cm sized erythematous plaque with yellowish crusts on his right forearm that showed features of a CLH, based on histopathologic assessment.

Prevalence of Sensitization to Tyrophagus putrescentiae in Children with Allegic Diseases / 소아알레르기및호흡기학회지

PURPOSE: Tyrophagus putrescentiae (Tyr p) is known as the third most common mite following Dermatophagoides pteronyssinus (Der p) and Dermatophagoides farina (Der f) in Korea. And it is an important allergen in allergic diseases, but there have been no reports on its sensitization rate in Korean children. The aim of this study was to evaluate its sensitization rate and the relationship between Tyr p and other parameters related to allergy. METHODS: This study included 662 allergic patients who visited the allergy clinic of Severance Children's Hospital between 2005 and 2008. Patients consisted of 472 asthmatic children, 102 patients with allergic rhinitis, 59 patients with atopic dermatitis, 7 patients with chronic urticaria and 22 patients with other diseases. Skin prick tests with 32 common allergens and measurements of peripheral blood eosinophil counts, serum total IgE level and eosinophil cationic protein were performed in subjects. RESULTS: Of the 662 patients, 592 (89.4%) showed positive responses to more than one allergen. The number of patients sensitized to Tyr p was 129 (19.5%). The wheal size induced by Tyr p was positively related to age (r=0.102 P=0.009) as well as the wheal size induced by house dust (r=0.298 P<0.001), Der p (r=0.272, P<0.001) and Der f (r=0.272, P<0.001). The wheal size induced by Tyr p was also positively related to serum total eosinophil counts (r=0.101,P=0.015) and IgE (r=0.153, P<0.001) and number of positive skin prick test (r=0.272, P<0.001). CONCLUSION: Sensitization to Tyr p is prevalent in children with allergic disease. Therefore, this result should be considered when evaluating allergic children. Further studies are needed to elucidate the clinical significance of sensitization to Tyr p.

The usefulness of Phadiatop R test for screening atopy in asthmatic subjects / 천식및알레르기

BACKGROUND: Phadiatop test has been introduced as a single test for screening the atopics who were sensitized to common inhalant allergens. MATERIAL AND METHOD: We compared the clinical efficiency of Phadiatop test and total IgE level for defining presence of atopy in 136 asthmatic subjects. The presence of atopy was defined by skin prick test done with 10 common inhalant allergens. More than 2+ skin reactivity was defined as having atopy. Phadiatop test and total IgE level in serum were measured using Pharmacia CAP systems. RESULT: 109 out of 136 subjects had more than 2+ skin reactivity to at least one allergen and another 27 subjects had 1+ or negative skin reactivity to allergens. The performance characteristics of Phadiatop test for screening atopy was superior than total IgE level, with sensitivity(91.7% vs. 82.6%), positive predictive value(94.3% vs. 86.5%) and concordance rate(89.0 % vs. 75.7% ). Specificity and negative predictive value of the Phadistop test were acceptable and higher than that of total IgE level. CONCLUSION: These results suggested that Ph adiatop may be simple and useful for screening atopic status in Korean asthmatic subjects.

A Study of Clinical Correlations between Skin Test, Radioallergosorbent Test and Bronchial Provocation Test in House Dust Asthmatics

We evaluated the correlations between the allergy skin test for house dust radioallergosorbent test (RAST) and the bronchial provocation test for revealing the sensitivity of the skin test and RAST, and for aiding in the search for the causative allergen in house dust asthmatics. There was an overall 72.5% agreement between the prick test and RAST, a 73.8% agreement between the prick test and house dust bronchoprovocation test (HD-BPT), and a 71.3% agreement between HD-BPT and RAST. A positive RAST was found with a positive HD-BPT in 71.2% of cases, and if RAST was negative, HD-BPT was negative in 46.9% of cases. 69.6% of the positive cases on prick test (more than 21 mm of erythema) were positive with RAST. All of the cases with a negative skin reaction to the prick test were negative to RAST. A positive skin test was found with a positive HD-BPT in 77.1% of cases, and if the prick test was negative, the HD-BPT was negative in 50.0% of cases. 87.5% of cases with a RAST positive exhibited a positive result with HD-BPT. A significant correlation was found between the results of prick tests and those of RASTs in the early response group of HD-BPT, but not in the late and dual response groups. There were significant correlations between total serum IgE and the results of HD-BPT, and total serum IgE value and the results of RAST. The greater the size of the prick test, the greater the likelihood of a positive HD-BPT. All 5 cases with an end point of intradermal skin test of a 5 degrees -5(-l) X 10(-2) dilution of house dust noted a negative HD-BPT. There was no significant correlation between total serum IgE and total eosinophil count. There was no significant correlation between wheal and erythema size of prick test and PC20 of methacholine.