Darsow U, Abeck D, Ring J
Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Technische Universität München.
Hautarzt. 1997 Aug;48(8):528-35. doi: 10.1007/s001050050623.
The role of allergic reactions in eliciting and maintaining atopic eczema (AE) is still controversial. In a subgroup of patients with atopic eczema, exacerbations of itching and eczematous skin lesions have been described after contract with aeroallergens. To investigate this observation, an epicutaneous patch test with IgE-inducing allergens (atopy patch test, APT) has been proposed, which results in eczematous skin reactions in 30-70% of AE patients. Usage of allergen concentrations exceeding 5000 PNU/g in petrolatum allows testing on clinically uninvolved skin without potentially irritating epidermal tape stripping. The clinical relevance of positive APT reactions is suggested by comparison of APT with skin prick test, specific IgE, patient's history and eczema pattern. Patients with an eczema pattern with preferred localization of skin lesions in air-exposed areas, a predictive history and raised specific IgE (depending on allergen) were shown to have the highest rate of positive APT. Future controlled studies with allergen avoidance and reexposition may focus on this patient group.
过敏反应在引发和维持特应性皮炎（AE）中的作用仍存在争议。在一部分特应性皮炎患者中，接触气传变应原后会出现瘙痒加剧和湿疹性皮肤损害加重的情况。为研究这一现象，有人提出了用诱导IgE的变应原进行表皮斑贴试验（特应性斑贴试验，APT），该试验在30% - 70%的AE患者中会引发湿疹性皮肤反应。在凡士林制剂中使用超过5000 PNU/g的变应原浓度，可在临床上未受累的皮肤进行测试，而无需进行可能具有刺激性的表皮胶带剥离。通过将APT与皮肤点刺试验、特异性IgE、患者病史和湿疹类型进行比较，提示APT阳性反应具有临床相关性。皮肤损害好发于暴露部位、有预测性病史且特异性IgE升高（取决于变应原）的湿疹类型患者，其APT阳性率最高。未来关于避免变应原和再次接触变应原的对照研究可能会聚焦于这一患者群体。
