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Where To Prick The Apple For Skin Testing?

2009; Elsevier BV; Volume: 123; Issue: 2 Linguagem: Inglês

10.1016/j.jaci.2008.12.125

1097-6825

S.A. van der Werff, A. E. J. Dubois, S. van der Heide, Eric van de Weg, Paul Arens, Berber Vlieg‐Boerstra,

Contact Dermatitis and Allergies

RATIONALE: Prick-to-prick skin tests (SPTs) with fresh apple are used to assess sensitisation in subjects with oral allergy symptoms (OAS) to apple. We hypothesized that the location of pricking in the apple influences the outcome of SPT results. Aim: To study differences in SPT results taken from different locations of the apple surface in several apple cultivars.METHODS: In the fall of 2007, 20 adult apple allergic subjects were tested by SPTs with apple material obtained from both the stalk and the middle region of four different apple cultivars: Crisps Pink, Golden Delicious, Elize and Santana. These tests were repeated in the spring of 2008 in 31 subjects before the birch pollen season. Sixteen subjects participated in both test series. In the spring 2008, Santana was replaced by Modi due to the limited availability of Santana. For each apple cultivar, differences between SPTs from both regions were calculated by Wilcoxon Signed Rank test within each test series. Besides, the percentage of negative SPTs (wheal diameter ≤ 3 mm) were assessed.RESULTS: SPTs from the stalk region gave significantly greater responses than SPTs from the middle region (p values varying from 0.001 to 0.04), except for Santana (p = 0.067) and Elize 2008 (p = 0.228). 5% of SPTs from the middle region were negative, while only 1% of the SPTs from the stalk region were negative.CONCLUSIONS: SPT response is correlated to the location of pricking. Therefore, standardization of the location of pricking is needed. We propose the stalk region as location of choice. RATIONALE: Prick-to-prick skin tests (SPTs) with fresh apple are used to assess sensitisation in subjects with oral allergy symptoms (OAS) to apple. We hypothesized that the location of pricking in the apple influences the outcome of SPT results. Aim: To study differences in SPT results taken from different locations of the apple surface in several apple cultivars. METHODS: In the fall of 2007, 20 adult apple allergic subjects were tested by SPTs with apple material obtained from both the stalk and the middle region of four different apple cultivars: Crisps Pink, Golden Delicious, Elize and Santana. These tests were repeated in the spring of 2008 in 31 subjects before the birch pollen season. Sixteen subjects participated in both test series. In the spring 2008, Santana was replaced by Modi due to the limited availability of Santana. For each apple cultivar, differences between SPTs from both regions were calculated by Wilcoxon Signed Rank test within each test series. Besides, the percentage of negative SPTs (wheal diameter ≤ 3 mm) were assessed. RESULTS: SPTs from the stalk region gave significantly greater responses than SPTs from the middle region (p values varying from 0.001 to 0.04), except for Santana (p = 0.067) and Elize 2008 (p = 0.228). 5% of SPTs from the middle region were negative, while only 1% of the SPTs from the stalk region were negative. CONCLUSIONS: SPT response is correlated to the location of pricking. Therefore, standardization of the location of pricking is needed. We propose the stalk region as location of choice.