Brasch Jochen, Uter Wolfgang, Dibo Maher, Stockfleth Eggert, Swensson Ole, Christophers Enno
Department of Dermatology, University of Kiel, Germany.
Contact Dermatitis. 2002 May;46(5):253-7. doi: 10.1034/j.1600-0536.2002.460501.x.
The diagnostic meaningfulness of patch tests with house dust mite allergens is still questionable. Our own impression has been that positive results with a dermatophagoides mix may occur preferentially in patients with a generally enhanced responsiveness to contact allergens. To check this, all of our patients allocated to patch testing with the standard series were additionally patch tested with a dermatophagoides mix by the same technique that was used for standard contact allergens. Out of 571 patients tested, 188 showed delayed responses to this mix that were indistinguishable from typical allergic patch test reactions but of no apparent clinical relevance. No relationship was found between positive dermatophagoides patch tests and an atopic disposition of the patients or characteristics of their eczema. However, 64.4% of the patients with a positive dermatophagoides patch test showed a response to at least 1 contact allergen of the standard series, compared to only 56.4% of the patients without a positive dermatophagoides reaction (p < 0.05). The reactivity to the mite mix was not related to the responsiveness towards any particular contact allergens. We suppose that some unidentified factors may contribute to positive reactions to the dermatophagoides mix that may also favour an enhanced general responsiveness to contact allergens.
使用屋尘螨过敏原进行斑贴试验的诊断意义仍存在疑问。我们自己的印象是,对粉尘螨混合物的阳性结果可能优先出现在对接触性过敏原反应普遍增强的患者中。为了验证这一点,我们所有分配接受标准系列斑贴试验的患者,都额外使用与标准接触性过敏原相同的技术进行了粉尘螨混合物的斑贴试验。在571名接受测试的患者中,188名对该混合物出现了延迟反应,这些反应与典型的过敏性斑贴试验反应难以区分,但没有明显的临床相关性。在粉尘螨斑贴试验阳性与患者的特应性体质或湿疹特征之间未发现关联。然而,粉尘螨斑贴试验阳性的患者中,64.4%对标准系列中至少1种接触性过敏原出现反应,而粉尘螨反应阴性的患者中这一比例仅为56.4%(p<0.05)。对螨虫混合物的反应性与对任何特定接触性过敏原的反应性无关。我们推测,一些未确定的因素可能导致对粉尘螨混合物出现阳性反应,这些因素也可能有利于增强对接触性过敏原的总体反应性。