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Prevalence of positive atopy patch test in an unselected pediatric population
Nicola Fuiano1, Giuliana Diddi1, Maurizio Delvecchio2
1Pediatric Allergy Service, ASL FG Torremaggiore, I, Rome, Italy.
Insights
Epidemiological studies often overlook cell-mediated allergies in children. The atopy patch test, essential for diagnosing T-cell-mediated allergies, should be included in future allergy research.
Area of Science:
- Pediatric Allergy and Immunology
- Epidemiology of Allergic Diseases
- Cell-Mediated Hypersensitivity
Background:
- Allergic disorders like atopic dermatitis, rhinitis, and asthma are increasing in children.
- Current epidemiological studies often neglect cell-mediated allergies due to underutilization of the atopy patch test.
- The atopy patch test is crucial for identifying T-cell-mediated allergic mechanisms.
Purpose of the Study:
- To assess the prevalence of positive atopy patch test results in an unselected pediatric population.
- To compare the prevalence of atopy patch test positivity with skin prick test results.
- To highlight the importance of including the atopy patch test in future allergy epidemiological studies.
Main Methods:
- A cross-sectional survey was conducted in a rural Italian town involving primary and junior secondary school students.
- Data were collected using a specific questionnaire, skin prick tests, and atopy patch tests.
- The study included an unselected population of 456 children.
Main Results:
- Out of 456 children, 17.1% had a positive skin prick test and 12.5% had a positive atopy patch test.
- 8.8% of subjects tested positive exclusively to the atopy patch test, indicating T-cell-mediated allergy.
- House dust mite was the most frequent allergen for both tests, but particularly for the atopy patch test.
Conclusions:
- The prevalence of positive atopy patch test results in children is comparable to skin prick test results.
- A significant proportion of children (8.8%) showed positive results only to the atopy patch test.
- The atopy patch test should be incorporated into future epidemiological studies to capture T-cell-mediated allergies.
Background:
In the latest decades, epidemiological studies on allergic disorders in children, including atopic dermatitis, rhinitis and asthma, demonstrated a continuous increase in prevalence. However, such studies are usually performed by questionnaires and, sometimes, by skin prick test or in vitro IgE tests, while the portion of allergy sustained by the cell-mediated mechanism is neglected, because the essential test, i.e. the atopy patch test is not performed.
Methods:
This cross-sectional survey studied by a specific questionnaire, skin prick test and atopy patch test, an unselected population, represented by the entire scholastic population attending a Primary school and a Junior Secondary school in the rural town of San Marco in Lamis, 12.000 inhabitants (Puglia, Italy).
Results:
Among the 456 subjects included, 78 (17.1 %) had a positive skin prick test and 57 (12.5 %) had a positive atopy patch test. In particular, 13.4 % of subjects were positive only to skin prick test and 8.8 % were positive only to atopy patch test. The allergen most frequently positive was the house dust mite, with 41 positive results to skin prick test and 55 to atopy patch test, while for pollen positive results concerned almost exclusively the skin prick test.
Conclusions:
This survey on an unselected population of children detected a prevalence of positive results to atopy patch test not so distant from the positive results to skin prick test, and in 8.8 % of subjects the atopy patch test was the only positive test. This would suggest to add the atopy patch test in future epidemiological studies on allergy, in order to avoid to overlook the not negligible portion of patients with T-cell-mediated allergy.
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