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Delayed hypersensitivity responses in children after local cutaneous anesthesia
B Björkstén1, B Jung, E B Tågsjö
1Department of Pediatrics, University Hospital, Linköping, Sweden.
Acta Paediatrica Scandinavica
|November 1, 1987
Summary
Cutaneous analgesia effectively reduced pain during delayed-type hypersensitivity (DTH) skin tests in children but did not affect DTH reactions. This suggests DTH testing can be simplified in immunized populations.
Area of Science:
- Immunology
- Dermatology
- Pediatrics
Background:
- Delayed-type hypersensitivity (DTH) is a crucial immune response.
- Assessing DTH reactions in children can be challenging due to pain.
- Cutaneous analgesia aims to mitigate procedural discomfort.
Purpose of the Study:
- To evaluate the impact of cutaneous analgesia on DTH reactions.
- To determine the efficacy of lidocaine/prilocaine in reducing pain during DTH testing.
- To assess the utility of specific antigens for DTH testing in school children.
Main Methods:
- A lidocaine/prilocaine mixture was compared to a placebo for cutaneous analgesia.
- DTH reactions were induced by skin injections and assessed after 48 hours.
- Antigen testing included tetanus, mumps, tuberculin, and candida in 116 school children.
Main Results:
- Cutaneous analgesia significantly reduced pain (p < 0.001) without altering DTH reactions.
- High positivity rates were observed for tetanus (98%) and mumps (82%) antigens.
- Lower positivity rates were found for tuberculin (11%) and candida (62%) antigens.
Conclusions:
- Cutaneous analgesia is a safe and effective method for pain reduction in pediatric DTH testing.
- DTH testing in adequately immunized children can be streamlined by using fewer, highly positive antigens like tetanus and mumps.
- Routine use of cutaneous analgesia is recommended for DTH testing in young children to improve compliance and reduce distress.