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Diagnostic accuracy of atopy patch tests for food allergy in children with atopic dermatitis aged less than two years.
Allergol Immunopathol (Madr) 2014 Jan-Feb; 42(1):22-8AI

Abstract

BACKGROUND

Atopy patch tests (APT) have been introduced as a valuable tool for the diagnosis of food allergy. However, interpretation of the readout of APT requires further clarification.

OBJECTIVE

To investigate the accuracy of APT in identifying atopic sensitisation to hen's eggs (HE), cow's milk (CM), soybean and wheat in Chinese children with atopic dermatitis (AD) aged less than two years and to evaluate skin signs of APT for accurate diagnosis of food allergy.

METHODS

APT was performed and food allergy confirmed by open oral food challenges with HE, CM, soybean and wheat in 150 Chinese AD children aged less than two years. The sensitivity, specificity, positive (PPV) and negative (NPV) predictive values, positive (LR+) and negative likelihood ratio (LR-) of APT were calculated.

RESULTS

Erythema and infiltration were not sufficiently indicative of a positive APT. The PPV increased with the appearance of indurations and the number of papules. The true positive APT rate increased from scores of + to +++. The PPV and specificity were 100% while APT scores of +++ were obtained with HE, CM and wheat. The sensitivity of APT with HE, CM, soybean and wheat allergy ranged from 59.6% to 90.5%, while the specificity ranged from 82.1% to 92.4%.

CONCLUSION

The APT is a suitable method for the diagnosis of AD in Chinese children aged less than two years with food allergies. Erythema and infiltration are not sufficient indicators of APT positivity. The PPV increases with indurations and the number of papules.

Authors+Show Affiliations

Department of Dermatology, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.Department of Dermatology, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.Department of Dermatology, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.Department of Dermatology, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.Department of Dermatology, Children's Hospital of Chongqing Medical University, Chongqing 400014, China. Electronic address: huawpfk@163.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23253686

Citation

Yang, H, et al. "Diagnostic Accuracy of Atopy Patch Tests for Food Allergy in Children With Atopic Dermatitis Aged Less Than Two Years." Allergologia Et Immunopathologia, vol. 42, no. 1, 2014, pp. 22-8.
Yang H, Xiao YZ, Luo XY, et al. Diagnostic accuracy of atopy patch tests for food allergy in children with atopic dermatitis aged less than two years. Allergol Immunopathol (Madr). 2014;42(1):22-8.
Yang, H., Xiao, Y. Z., Luo, X. Y., Tan, Q., & Wang, H. (2014). Diagnostic accuracy of atopy patch tests for food allergy in children with atopic dermatitis aged less than two years. Allergologia Et Immunopathologia, 42(1), pp. 22-8. doi:10.1016/j.aller.2012.10.007.
Yang H, et al. Diagnostic Accuracy of Atopy Patch Tests for Food Allergy in Children With Atopic Dermatitis Aged Less Than Two Years. Allergol Immunopathol (Madr). 2014;42(1):22-8. PubMed PMID: 23253686.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diagnostic accuracy of atopy patch tests for food allergy in children with atopic dermatitis aged less than two years. AU - Yang,H, AU - Xiao,Y Z, AU - Luo,X Y, AU - Tan,Q, AU - Wang,H, Y1 - 2012/12/17/ PY - 2012/08/21/received PY - 2012/09/28/revised PY - 2012/10/09/accepted PY - 2012/12/21/entrez PY - 2012/12/21/pubmed PY - 2014/10/11/medline KW - Atopic dermatitis KW - Atopy patch test KW - Chinese children KW - Diagnostic accuracy KW - Food allergy SP - 22 EP - 8 JF - Allergologia et immunopathologia JO - Allergol Immunopathol (Madr) VL - 42 IS - 1 N2 - BACKGROUND: Atopy patch tests (APT) have been introduced as a valuable tool for the diagnosis of food allergy. However, interpretation of the readout of APT requires further clarification. OBJECTIVE: To investigate the accuracy of APT in identifying atopic sensitisation to hen's eggs (HE), cow's milk (CM), soybean and wheat in Chinese children with atopic dermatitis (AD) aged less than two years and to evaluate skin signs of APT for accurate diagnosis of food allergy. METHODS: APT was performed and food allergy confirmed by open oral food challenges with HE, CM, soybean and wheat in 150 Chinese AD children aged less than two years. The sensitivity, specificity, positive (PPV) and negative (NPV) predictive values, positive (LR+) and negative likelihood ratio (LR-) of APT were calculated. RESULTS: Erythema and infiltration were not sufficiently indicative of a positive APT. The PPV increased with the appearance of indurations and the number of papules. The true positive APT rate increased from scores of + to +++. The PPV and specificity were 100% while APT scores of +++ were obtained with HE, CM and wheat. The sensitivity of APT with HE, CM, soybean and wheat allergy ranged from 59.6% to 90.5%, while the specificity ranged from 82.1% to 92.4%. CONCLUSION: The APT is a suitable method for the diagnosis of AD in Chinese children aged less than two years with food allergies. Erythema and infiltration are not sufficient indicators of APT positivity. The PPV increases with indurations and the number of papules. SN - 1578-1267 UR - https://www.unboundmedicine.com/medline/citation/23253686/Diagnostic_accuracy_of_atopy_patch_tests_for_food_allergy_in_children_with_atopic_dermatitis_aged_less_than_two_years_ L2 - http://www.elsevier.es/en/linksolver/ft/pii/S0301-0546(12)00272-8 DB - PRIME DP - Unbound Medicine ER -