Lakshmi Chembolli, Srinivas C R
Department of Dermatology, PSG Hospitals, Peelamedu, Coimbatore, India.
Indian J Dermatol Venereol Leprol. 2007 Mar-Apr;73(2):103-5. doi: 10.4103/0378-6323.31895.
Parthenium dermatitis is a major problem in urban and rural India. Patients with severe allergic rhinitis due to exposure to pollens of parthenium are reported to have parthenium specific IgE and IgG antibodies. Parthenium induces contact dermatitis by Type IV hypersensitivity and allergic rhinitis by Type-I hypersensitivity.
The study was undertaken to detect Type-I and Type-IV hypersensitivity amongst patients with parthenium dermatitis.
Fourteen patients with clinical features of parthenium dermatitis who patch tested positive to parthenium were included in the study. Patch testing was done by standard method and results interpreted as recommended by the ICDRG. Serum IgE was determined by chemiluminescence immuno assay system (CLIA). Prick testing was performed and interpreted by standard method.
Twelve out of the 14 patients included, showed a positive prick test. Serum IgE was elevated in all patients to varying degrees (mean IgE-1279.9 IU/ml; N--up to 100 IU/ml).
The positive patch test, prick test and elevated serum IgE suggest that both Type-I and Type-IV hypersensitivity may play a role in the induction and perpetuation of parthenium dermatitis in most patients. To date, delayed hypersensitivity was thought to be solely responsible for parthenium dermatitis. This study suggests that a combined type-I and type IV hypersensitivity mechanisms may be operational.
银胶菊皮炎是印度城乡地区的一个主要问题。据报道，因接触银胶菊花粉而患有严重过敏性鼻炎的患者体内存在银胶菊特异性IgE和IgG抗体。银胶菊通过IV型超敏反应诱发接触性皮炎，通过I型超敏反应诱发过敏性鼻炎。
本研究旨在检测银胶菊皮炎患者中的I型和IV型超敏反应。
本研究纳入了14例具有银胶菊皮炎临床特征且斑贴试验对银胶菊呈阳性的患者。斑贴试验采用标准方法进行，结果按照国际接触性皮炎研究组（ICDRG）的建议进行解读。血清IgE通过化学发光免疫分析系统（CLIA）测定。点刺试验采用标准方法进行并解读。
纳入的14例患者中有12例点刺试验呈阳性。所有患者的血清IgE均有不同程度升高（平均IgE-1279.9 IU/ml；正常上限-100 IU/ml）。
阳性的斑贴试验、点刺试验以及升高的血清IgE表明，I型和IV型超敏反应在大多数银胶菊皮炎患者的诱发和持续过程中可能都起作用。迄今为止，人们认为迟发型超敏反应是银胶菊皮炎的唯一原因。本研究表明，I型和IV型超敏反应的联合机制可能在起作用。
