Ingordo V, D'Andria G, D'Andria C, Tortora A
Department of Dermatology, Italian Navy Main Hospital M.O. Giulio Venticinque Taranto.
J Eur Acad Dermatol Venereol. 2002 Sep;16(5):450-4. doi: 10.1046/j.1468-3083.2002.00525.x.
The most frequently employed diagnostic criteria of atopic dermatitis (AD) can be fulfilled in the absence of elevated total circulating IgE or specific IgE to food allergens or environmental aeroallergens and/or in the absence of personal or familial history of atopy as well. Therefore a distinction between 'extrinsic' or 'allergic' and 'intrinsic' or 'non-allergic' AD has been suggested. Recently, a patch test with environmental aeroallergens, named atopy patch test (APT), has been proposed for use in the study of AD. OBJECTIVE The aim of this study was to investigate the reactivity to APT in patients with 'extrinsic' and 'intrinsic' AD.
PATIENTS, MATERIALS AND METHODS: Two groups of adult male subjects with AD were examined consecutively in our department (Department of Dermatology, Italian Navy Main Hospital, Taranto, Italy) andpatch tested with whole bodies of house dust mites (HDM) at a concentration of 20% in petrolatum (Dermatophagoides pteronyssinus 50%, D. farinae 50%). The groups included: (i) 95 patients affected by the adult clinical form of 'extrinsic' AD; (ii) 12 patients affected by the adult clinical form of 'intrinsic' AD; and (iii) a control group of 49 adult healthy male subjects with a negative anamnesis for eczema and atopy and negative skin prick test to aeroallergens/food allergens and/or normal level of total circulating IgE, also patch tested with the same allergen. The statistical differences were calculated by chi2 test and 95% confidence intervals (CI) were provided.
The APT was positive in 47.4% (CI: 37-57%) of'extrinsic'AD, in 66.6% (CI: 41-93%) of'intrinsic' AD and in 12.2% (CI: 3-21%) of healthy subjects. The differences between the two AD subgroups and the control group were statistically significant (P < 0.001).
APT positivity is more frequent in both 'extrinsic' and 'intrinsic' AD than in unaffected subjects. Other studies are needed to confirm our data and to explain why the APT is positive in the 'intrinsic' form.
特应性皮炎（AD）最常用的诊断标准在循环总IgE未升高、对食物过敏原或环境气传过敏原的特异性IgE未升高和/或无个人或家族特应性病史的情况下也可满足。因此，有人提出区分“外源性”或“过敏性”AD和“内源性”或“非过敏性”AD。最近，一种用于环境气传过敏原的斑贴试验，即特应性斑贴试验（APT），已被提议用于AD的研究。目的本研究旨在调查“外源性”和“内源性”AD患者对APT的反应性。
患者、材料和方法：两组成年男性AD患者在我们科室（意大利塔兰托意大利海军总医院皮肤科）接受连续检查，并用浓度为20%的凡士林包裹的屋尘螨（HDM）全虫进行斑贴试验（粉尘螨50%，户尘螨50%）。这些组包括：（i）95例患有“外源性”AD成人临床形式的患者；（ii）12例患有“内源性”AD成人临床形式的患者；以及（iii）一个由49名成年健康男性受试者组成的对照组，他们对湿疹和特应性的既往史为阴性，对气传过敏原/食物过敏原的皮肤点刺试验为阴性和/或循环总IgE水平正常，也用相同的过敏原进行斑贴试验。通过卡方检验计算统计学差异，并提供95%置信区间（CI）。
“外源性”AD患者中47.4%（CI：37-57%）的APT呈阳性，“内源性”AD患者中66.6%（CI：41-93%）的APT呈阳性，健康受试者中12.2%（CI：3-21%）的APT呈阳性。两个AD亚组与对照组之间的差异具有统计学意义（P<0.001）。
“外源性”和“内源性”AD患者的APT阳性率均高于未受影响的受试者。需要其他研究来证实我们的数据，并解释为什么“内源性”形式的APT呈阳性。
