Epikutánne atopické patch testy (APT) sa zaradili v posledných rokoch medzi cenné diagnostické prostriedky potravinovej alergie. Medzi najčastejšie príznaky potravinovej alergie patrí postihnutie kože. Približne 40 % detí s atopickou dermatitídou trpí klinickou relevantnou potravinovou alergiou. Makro- i mikroskopické podobnosti medzi reakčnými miestami pri APT a kožnými zmenami pri atopickej dermatitíde naznačuje, že APT sú vhodným diagnostickým prostriedkom pre odhaľovanie kauzálneho alergénu pri tomto ochorení, pričom v detskom veku dominujú potravinové a v dospelom aerogénne (inhalačné) alergény.

Atopy patch test (APT) has developed into valuable diagnostic tool in the management of food allergy. To the most common clinical symptoms of food allergy belongs also the involvement of skin. About 40 % children with atopic dermatitis has clinically relevant food allergy. Macro- and microscopic similarities between APT reaction sites and skin changes in atopic dermatitis show that APT is suitable diagnostic tool for diagnosis of causal allergen in this disease. While in children the most common are food allergens, in adults dominate inhalant allergens (aeroallergens).

• MeSH
• Dermatitis, Atopic diagnosis   immunology   MeSH
• Humans MeSH
• Patch Tests methods   utilization   MeSH
• Food Hypersensitivity diagnosis   immunology   classification   MeSH
• Respiratory Hypersensitivity diagnosis   immunology   classification   MeSH
• Check Tag
• Humans MeSH

Epikutánní testy (ET) jsou standardní vyšetřovací metodou ke zjištění kontaktní senzibilizace. V přehledu jsou uvedeny současné poznatky o aplikaci ET, jejich indikace, výběr alergenů (standardizované, nestandardizované), typy testů, odečítání, komplikace a hodnocení klinické relevance. Autorka se podrobněji věnuje problematice častých kontaktních alergenů, mezi které patří soli kovů (nikl, kobalt, chrom) a složky kosmetických přípravků (vonné látky, konzervační látky). Z aktuálních kontaktních alergenů jsou zmíněné parafenylendiamin a textilní barvy.

Patch tests represent a standard method to diagnose a contact senzitization. Article reviews current knowledge on patch test application, indication, choice of alergens (standardized, non-standardized), test types, evaluation, complications and assesment of clinical relevance. The author presents in detail the issues of common allergens including metal salts (nickel, cobalt, chromium) and cosmetics components (fragrances, preservatives). Allergens as paraphenylendiamine and textile dyes are mentioned as well.

• Keywords
• fragrance, isothiazolinony,
• MeSH
• Allergens classification   MeSH
• Dermatitis, Allergic Contact etiology   MeSH
• Chromium adverse effects   MeSH
• Phenylenediamines adverse effects   MeSH
• Formaldehyde adverse effects   MeSH
• Cobalt adverse effects   MeSH
• Dermatitis, Contact * etiology   MeSH
• Skin Tests * classification   contraindications   methods   MeSH
• Humans MeSH
• Patch Tests methods   MeSH
• Nickel adverse effects   MeSH
• Nitriles adverse effects   MeSH
• Check Tag
• Humans MeSH

• MeSH
• Epidermis * MeSH
• Skin Absorption MeSH
• Skin * MeSH
• Humans MeSH
• Patch Tests * methods   standards   MeSH
• Permeability MeSH
• Check Tag
• Humans MeSH

BACKGROUND: Efforts to replace the rabbit skin irritation test have been underway for many years, encouraged by the EU Cosmetics Directive and REACH. Recently various in vitro tests have been developed, evaluated and validated. OBJECTIVE: A key difficulty in confirming the validity of in vitro methods is that animal data are scarce and of limited utility for prediction of human effects, which adversely impacts their acceptance. This study examines whether in vivo or in vitro data most accurately predicted human effects. METHODS: Using the 4-hr human patch test (HPT) we examined a number of chemicals whose EU classification of skin irritancy is known to be borderline, or where in vitro methods provided conflicting results. RESULTS: Of the 16 chemicals classified as irritants in the rabbit, only five substances were found to be significantly irritating to human skin. Concordance of the rabbit test with the 4-hr HPT was only 56%, whereas concordance of human epidermis models with human data was 76% (EpiDerm) and 70% (EPISKIN). CONCLUSIONS: The results confirm observations that rabbits overpredict skin effects in humans. Therefore, when validating in vitro methods, all available information, including human data, should be taken into account before making conclusions about their predictive capacity.

• MeSH
• Animal Testing Alternatives standards   MeSH
• Biological Assay standards   MeSH
• Irritants adverse effects   diagnostic use   MeSH
• False Positive Reactions MeSH
• Cosmetics adverse effects   diagnostic use   MeSH
• Rabbits MeSH
• Skin drug effects   MeSH
• Humans MeSH
• Patch Tests standards   MeSH
• Predictive Value of Tests MeSH
• Skin Irritancy Tests standards   MeSH
• Animals MeSH
• Check Tag
• Rabbits MeSH
• Humans MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Comparative Study MeSH
• Validation Study MeSH

Předkládáme první výsledky malého souboru 15 dětí s atopickou dermatitidou ve věku od 6 do l8 let, u kterých byly provedeny epikutánní testy s evropskou standardní sadou alergenů a dalšími alergeny speciální sady (thimerosal, propolis, imidazolidinylurea, propylenglykol a další). Pozitivní reakce byla zaznamenána u 11 dětí, u 6 z nich se jednalo o oligovalentní alergii. Nejčastějšími alergeny byly soli niklu, dále fragrance mix, thimerosal a peruánský balzám.

The results of patch testing (standard and special test battery TROLAB) in 15 children aged 6 - 18 years with atopic dermatitis (according Hanifin and Rajka) are reported. 11 of children had 1 or more positive reactions. The most common allergens yielding positive results were nickel sulfate, fragrance mix, balsam of Peru, thimerosal and neomycin sulfate.

• MeSH
• Allergens diagnostic use   MeSH
• Dermatitis, Atopic diagnosis   immunology   MeSH
• Child MeSH
• Skin Tests standards   statistics & numerical data   MeSH
• Humans MeSH
• Adolescent MeSH
• Reference Standards MeSH
• Age Factors MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Adolescent MeSH
• Male MeSH
• Female MeSH

Few studies concerning the importance of food allergy in adolescents and adult patients with atopic eczema exist. The atopy patch tests with food have mostly been studied in infants and children since food allergy plays a role especially in this age group. Aim: The evaluation of the contribution of atopy patch tests in the diagnostic work-up of food allergy (to wheat, cow milk, peanuts, soya and eggs) in the patients with atopic eczema older than 14 years of age. Method: 120 patients were examined in the study in the diagnostic work-up of food allergy – 86 women and 34 men, the mean age 26.5 (s.d. 9.8) and the median SCORAD at the beginning of the study 32.9 (s.d. 14.0). Complete dermatological and allergological examinations in the diagnostic work-up of food allergy were performed (assessment of personal history, assessment of serum specific IgE, skin prick tests, atopy patch tests, diagnostic hypoallergenic diet, food challenge tests with egg, soy, wheat, cow milk and double – blind, placebo – controlled food challenge test with cow milk and wheat. The results of atopy patch tests were compared with the results of other diagnostic methods in the diagnosis of food allergy. Results: The food allergy to cow milk and wheat was confirmed in double – blind, placebo controlled food challenge test in few patients in our study (4 %). The suspicion of food allergy to egg is in 8 %, to peanuts in 13 % and to soya in 4 % of patients in our study. The assessment of atopy patch tests response seems to be of great importance. The reaction in atopy patch tests with more papules has the greatest diagnostic accuracy for predicting the result of challenge tests. At the beginning and at the end of diagnostic hypoallergenic diet the severity of atopic eczema/dermatitis syndrome was recorded in all patients enrolled in the study by evaluating SCORAD. The decrease of SCORAD was statistically important. Conclusion: Atopy patch tests alone cannot be used as a single test for the determination of food allergy in patients with atopic eczema/dermatitis syndrome but such a test, together with other diagnostic methods, can help to trace the food allergy.

• Keywords
• Atopic eczema/dermatitis syndrome, Food allergy, Atopy patch tests, Open exposure test, Double – blind placebo – controlled food challenge tests,
• MeSH
• Dermatitis, Atopic etiology   MeSH
• Adult MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Patch Tests MeSH
• Food Hypersensitivity diagnosis   complications   MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Female MeSH

V poslední době je do klinické praxe zaváděna nová diagnostická metoda zvaná atopické epikutánní testy. Toto sdělení reviduje dosavadní výsledky a zkušenosti s atopickými testy s aerogenními alergeny (aeroalergeny). Pokud se vyřeší problémy se standardizací a sjednocením metodiky atopických testů (zejména co se týče koncentrace alergenů) vyšetření atopickými epikutánními testy by se mohlo stát součástí rutinního diagnostického postupu u pacientů s atopickým ekzémem.

Recently atopy patch tests as a new diagnostic method is introduced in the clinical practice. This article reviews actual results and experience regarding atopy patch tests with airborn allergens (aeroallergens). There are still certain problems with the stardandization (especially the concentration) of the allergens. As soon as these problems are solved, this metod could become a component of the routine diagnostic procedure in patiens with atopic dermatitis.

• MeSH
• Allergens analysis   immunology   classification   MeSH
• Dermatitis, Atopic diagnosis   etiology   immunology   MeSH
• Eczema diagnosis   etiology   immunology   MeSH
• Skin Tests methods   trends   utilization   MeSH
• Humans MeSH
• Check Tag
• Humans MeSH

• MeSH
• Dermatitis, Atopic diagnosis   etiology   immunology   MeSH
• Child MeSH
• European Union MeSH
• Humans MeSH
• Patch Tests methods   utilization   MeSH
• Food Hypersensitivity diagnosis   etiology   immunology   MeSH
• Sensitivity and Specificity MeSH
• Check Tag
• Child MeSH
• Humans MeSH

Several irritants were used in the in vitro irritation medical device round robin. The objective of this study was to verify their irritation potential using the human patch test (HPT), an in vitro assay, and in vivo data. The irritants were lactic acid (LA), heptanoic acid (HA), sodium dodecyl sulfate (SDS), Genapol® X-80 (GP), and Y-4 polymer. Dilute saline and sesame seed oil (SSO) solutions of each were evaluated using a 4 and 18 h HPT and the EpiDerm™ SIT-MD RhE assay; results were then compared to existing rabbit skin irritation test data. Results from the 4 h HPT were negative in most cases except for GP and SDS, while the 18 h HPT also identified some LA, HA, and GP samples as irritants. EpiDerm™ SIT-MD correctly identified all irritants except GP in SSO due to limited solubility. Data from cutaneous rabbit irritation tests were negative, while all intracutaneous results were strongly or weakly positive except for the most dilute GP solutions. These findings indicate that EpiDerm™ SIT-MD results correlate with those from the rabbit intracutaneous test and confirm that RhE assays are suitable replacements for animals in evaluating the tissue irritation potential of medical devices.

• MeSH
• Animal Testing Alternatives MeSH
• Benchmarking MeSH
• Sodium Dodecyl Sulfate toxicity   MeSH
• Irritants toxicity   MeSH
• Rabbits MeSH
• Skin drug effects   MeSH
• Lactic Acid toxicity   MeSH
• Heptanoic Acids toxicity   MeSH
• Humans MeSH
• Patch Tests methods   MeSH
• Polyethylene Glycols toxicity   MeSH
• Polyvinyl Chloride toxicity   MeSH
• Reproducibility of Results MeSH
• Skin Irritancy Tests methods   MeSH
• Equipment and Supplies * MeSH
• Animals MeSH
• Check Tag
• Rabbits MeSH
• Humans MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH

Současný výskyt kontaktní fotoalergie u naší populace není znám. Základním cílem naší prácebylo vyzkoušení diagnostických postupů ozářených epikutánních testů při vyšetřování kožní fotosenzitivity.Testovali jsme látkami ze sady TROLAB (výrobce Hermal). Tyto látky mohou způsobovatfotoalergii, fototoxicitu a/nebo kontaktní přecitlivělost. V začátku studie jsme vyšetřovali MED a jejíindividuální sezonní variace, abychom určili dobu vhodnou pro vyšetřování pomocí ozářenýchepikutánních testů. Jako průměrnou suberytémovou dávku jsme používali 5 J/cm2 UV-A.Probandy jsme rozdělili do dvou skupin podle přítomnosti či nepřítomnosti fotosenzitivníchobtíží. Fotosenzitivní obtíže byly přítomny u 17 osob, 10 osob (kontroly) nemělo žádné příznakyfotosenzitivity. Ačkoli 5 kontrolních osob (50 %) mělo kontaktní přecitlivělost, i u 8 případů (47 %)z fotosenzitivní skupiny byla přítomná kontaktní alergie. Fotoalergická reakce se objevila u 2 zdravýchkontrol. Výskyt pozitivních odpovědí u fotosenzitivní skupiny se projevil u 5 osob (29,4 %).Výsledky práce se sunscreeny vykazují, že propandion, cinamáty a oxybenzon byly nejčastějšímifotoalergenními látkami. Tyto údaje svědčí o tom, že některé fotosenzitivní obtíže mohou býtzpůsobeny odpovědí na světlem aktivované součásti sunscreenů. Proto jsou fyzikální (nefotoalergizující)formy sunscreenů doporučovány u citlivých lidí, zejména jsou-li užívány od dětství.

The epidemiology of contact photoallergy in our population is not well known at present.Therefore the basic aim of our project was to establish the scale of diagnostic methods in theassessment of skin photosensitivity state by use of photo-patch tests. We tested some substances(TROLAB® set provided by Hermal comp.). These substances could cause photoallergy, phototoxicity,and/or contact sensitivity. In the beginning of the studywe have assessed the minimal erythema doseand its individual seasonal variations to determine the time required for photo-patch testing. Themean suberythematous UV-A dose of 5 J/cm2 was used.The group of 27 patients was studied: 17 patients with known photosensitivity in personal historyand 10 persons without photosensitivity as controls. Although in 5 controls (50 %) contact hypersensitivitywas detected, contact allergy was found out also in 8 cases (47 %) of photosensitive group.Photoallergic reaction appeared on the skin of 2 healthy controls. The incidence of positive photoallergicresponders within the photosensitive group was 5 persons (29.4 %). The results of studyconducted with sunscreens showed that propandione, cinnamates and oxybenzone were the mostfrequent photoallergenic substances. These data suggest that some photosensitive troubles could becaused by a skin response against photoactivated sunscreen components. Thus the physical (nonphotoallergenic)forms of sunscreens are recommended in essentially sensitive people, especiallywhen used from childhood.

• MeSH
• Adult MeSH
• Photosensitizing Agents administration & dosage   diagnostic use   chemistry   MeSH
• Dermatitis, Contact MeSH
• Cosmetics administration & dosage   chemistry   MeSH
• Skin Tests methods   MeSH
• Middle Aged MeSH
• Humans MeSH
• Photosensitivity Disorders diagnosis   etiology   MeSH
• Sunscreening Agents administration & dosage   chemistry   MeSH
• Aged MeSH
• Radiation MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Review MeSH
• Comparative Study MeSH