Darsow U, Ring J
Klinische Kooperationsgruppe, Umweltdermatologie und Allerologie GSF/TUM, Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, TU München, Munich.
Hautarzt. 2003 Oct;54(10):930-6. doi: 10.1007/s00105-003-0601-7.
The role of IgE-mediated allergic reactions in atopic eczema remains controversial. Using the atopy patch test, aeroallergens such as house dust mites, animal dander or pollen can be identified as relevant trigger factors in a subgroup of patients with atopic eczema. The atopy patch test is an epicutaneous patch test employing allergens known to elicit IgE-mediated reactions and used to evaluate eczematous skin reactions. In a series of single- and multicenter studies, a method was developed, standardized and compared to other diagnostic techniques (specific serum-IgE, skin prick test) in atopic eczema patients. With regard to clinical history, the most specific results were obtained with the atopy patch test (allergen-dependent 69-92%), while sensitivity was higher for skin prick test (69-82%) and specific IgE (65-94%). The characterization of a patient subgroup with relevant IgE-mediated allergy may lead to more efficient avoidance and perhaps even specific immunotherapy strategies in the management of atopic eczema.
IgE介导的过敏反应在特应性皮炎中的作用仍存在争议。通过特应性斑贴试验,可确定屋尘螨、动物皮屑或花粉等气传变应原是特应性皮炎患者亚组中的相关触发因素。特应性斑贴试验是一种表皮斑贴试验,采用已知能引发IgE介导反应的变应原,用于评估湿疹性皮肤反应。在一系列单中心和多中心研究中,开发了一种方法,在特应性皮炎患者中进行标准化并与其他诊断技术(特异性血清IgE、皮肤点刺试验)进行比较。就临床病史而言,特应性斑贴试验获得的结果最具特异性(变应原依赖性为69-92%),而皮肤点刺试验(69-82%)和特异性IgE(65-94%)的敏感性更高。对具有相关IgE介导过敏的患者亚组进行特征描述,可能会在特应性皮炎的管理中带来更有效的避免措施,甚至可能采取特异性免疫治疗策略。