• Title/Summary/Keyword: Intradermal skin test

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Allergic skin test (알레르기 피부시험)

  • Son, Byong Kwan;Lim, Dae Hyun
    • Clinical and Experimental Pediatrics
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    • v.50 no.5
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    • pp.409-415
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    • 2007
  • Allergy skin prick test and intradermal test represent one of the major tools in the diagnosis of IgE-mediated diseases like as atopic asthma, allergic rhinitis, atopic dermatitis, food and drug allergy, and insect bite when properly performed. Skin tests are of particular importance in fields such as allergen standardization, pharmacology, and epidemiology. Even if skin tests seem easy to perform, adequate and proper interpretation requires well-trained physicians who can recognize the numerous factors that may modify the results of skin tests.

A Study on the Intradermal Skin Test of Antibiotics (항생물질 주사제의 피내반응검사에 대한 조사연구)

  • Yoo Jae-Hee;Shon Young-Hee;Kim Won-Ock
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.4 no.2
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    • pp.319-336
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    • 1997
  • This study was done to identify the reality in doing the intradermal skin test of injectional antibiotics and to serve a basis to the clinical and educational situations. For the study, the survey was done to the staff nurses who are working at one of the selected 39 hospitals in the capital area, from January 6 to Feburary 8 in 1997. The data analysis was done by mean, standard deviation, Fisher's exact test, t-test, ANOVA through running SAS computer program. The results of the study were as follows : 1. The dilution ratio of the antibiotics was mostly 1 : 10 regardless of what kind of antibitics. Making the contrast was done only for the suspended to the antibiotics. Mostly the reaction was detected after 15 to 20 minutes from its diameter of redness and wheals. Most of the respondents answered they do the intradermal skin test only once for the same antibiotics. 2. In the education on the skin test the 66.7% from the respondents had exposed to the education mostly through the new nurses orientation. The 85,4% from them answered the need of the continuous education which had a significant difference in the number of beds(p=.046). The had experiences of detecting positive reactions(98.3%), and of anaphylaxis(49.5%) which had a significant difference in experience(p=.002) and in their age groups(p=.000). 3. The averge score of the confidence on the intradermal skin test was 3.32 form 4-point scale. Also it had a significant difference from the number of beds(p=.010), the year of experiences(p=.016), and their age groups(p=.046). 4. From the general characteristics of respondents, the injection methods had a significant difference in the amounts of injection, whether adopting the contrast pairing, and the repeatable skin tests for the same antibiotics. 5. Only 15 from 39 hospitals had their protocol about the intradermal skin test provided by nursing department which differs in its contents from that provided by the medical information center. From the results of the study, it is suggested that the continuous education on the intradermal skin test and its unified protocol should be provided. Also it is recomended that the drug manufacturer should notice about its anaphylactic cautions and pack its extra skin test use.

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Effects of EMLA Cream in Intradermal Skin Test of Ampicillin Sodium Antibiotics (EMLA 크림이 ampicillin sodium 항생제 피내반응검사에 미치는 효과)

  • Kim, Jin;Kang, Hee-Young
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.18 no.1
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    • pp.46-53
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    • 2011
  • Purpose: The purpose of this study was to identify the effects of EMLA cream (eutectic mixture of local anesthetics, lidocaine and prilocaine) on pain during ampicillin sodium intradermal (ID) skin test, and also to assess skin reaction after the skin test. Methods: Forty-three nurse-volunteers had skin tests with 0.01ml-0.05ml ampicillin sodium antibiotics. Skin tests were done on each forearm to compare the pain level of the skin test site after application of EMLA cream with the pain level when no EMLA cream was applied. EMLA cream was applied at the ID skin test site with an occlusive dressing for one hour. Pain was evaluated using a visual analogue scale and pain sensation using the short form McGill Pain Questionnaire. The transverse diameter of the wheal and redness was read right after and at 15 minutes after the skin test. The results were compared using independent t-tests. Results: Pain score and sensation with EMLA cream treatment were significantly lower than when EMLA cream was not applied. There was no difference in skin reactions; reading of the skin test was not affected by EMLA cream. Conclusions: EMLA cream was found to be an effective local anesthetic to relieve the pain of clients having ampicillin sodium antibiotics ID skin tests.

Hypersensitivity Reaction to Perioperative Drug Mistaken for Local Anesthetic Systemic Toxicity in a Patient under Brachial Plexus Block

  • Jun, Jee Young;Kim, Youn Jin;Kim, Jong Hak;Han, Jong In
    • Kosin Medical Journal
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    • v.33 no.3
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    • pp.468-476
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    • 2018
  • Perioperative anaphylaxis, although rare, is a severe, life-threatening unexpected systemic hypersensitivity reaction. Simultaneous administration of various drugs during anesthesia, the difficulty of communicate with patients in sedation and anesthesia, and coverage of the patient with surgical drapes are considered to be factors that impede early recognition of anaphylactic reactions. It is very important to perform an intradermal skin test because antibiotics are the most common cause of perioperative anaphylaxis. We report a case of negative-intradermal skin test antibiotic anaphylaxis mistaken for local aesthetic systemic toxicity without increase of serum tryptase for confirmative diagnostic biomaker during surgery under brachial plexus block. It is not possible to exclude the danger of anaphylaxis completely, even if it is negative-intradermal skin test and normal tryptase level. Therefore, anesthesiologists should be closely monitored and treated early for antibiotics related hypersensitive reaction, like other medicines during anesthesia.

Anaphylaxis occurred immediately after prophylactic antibiotics injection with negative intradermal skin test during laparoscopic cholecystectomy

  • Jeong, Hyung Joo;Kung, Hsi Chiang;Park, Tae Woo;Kang, Dong Hee;Shin, Yu Som;Kim, Ju Deok
    • Kosin Medical Journal
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    • v.33 no.2
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    • pp.245-251
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    • 2018
  • Prophylactic antibiotics that are used to prevent post-operative infection can commonly cause anaphylactic reactions during anesthesia. It is therefore necessary to perform a skin test before antibiotics are administered in order to diagnose and prevent anaphylactic reactions. However, the results of the antibiotic skin test can differ according to the drug, dose, and reagent concentration. We report a case of anaphylactic shock with bronchospasm and cardiovascular collapse immediately following administration of the prophylactic cefazedone after induction of general anesthesia for laparoscopic cholecystectomy.

A Survey on Paragonimus Infection Among School Population in Kyodong and Samsan Island, Gangwha-Gun (강화군(江華郡) 교동도(喬桐島) 및 삼산도내(三山島內) 학교입구(學校入口)의 폐흡충감염(肺吸虫感染) 조사(調査))

  • Han, Kyung-Min;Ahn, Yung-Kyum;Lee, Keun-Tae
    • Journal of agricultural medicine and community health
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    • v.7 no.1
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    • pp.66-73
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    • 1982
  • Paragonimus westermani is one of the most popular endemic parasitic diseases in Korea. The nation-wide prevalence survey were carried out by Gobayashi (1921) with sputum examination and by Walton and Chyu (1959) with the intradermal skin test respectively. Recent studies showed the decline of positive rate in intradermal skin test of the local inhabitants and also showed the less distribution of intermediate host. The fact seemed that caused by economic improvement of village people, decrease of intermediate host by increasing use of pesticides, becoming lower water level at streams and rivers and better irrigation and finally by better community health education etc. Gangwha area of Gyeonggi-Do was found out as an endemic area of Paragonimus westermani through some studies in the past, however, in the vicinity area of Gangwha, the study in Kyodong island (myon) was carried out in 1965 by Yun et al. Therefore author carried out the intradermal skin test for 2,380 students of primary, middle and high school in Kyodong island and Samsan island. The results showed as follows : 1) The positive rate of intradermal test for paragonimus westermani infection showed positive in 152 among 1,845 students (8.2%) in Kyodong island, and 21 among 637 students (3.3%) in Samsan island respectively. 2) According to grade levels, 49 among 973 students (5.0%) in primary school, 62 among 962 students (6.4%) in middle school and 53 among 445 students (11.9%) in high school showed positive rate. This showed the higher grade the higher positive rate. 3) Among these total 164 positive cases in the intradermal skin test, only in 3 cases eggs were found in sputum. 4) Finding out the intermediate host, only 28 crayfishes from Kyodong island and 12 from Samsan island were collected and examined for metacercaria infection, however, none of metacercaria was found. 5) As a control group, 2 primary schools from the main island were selected. In these schools from the sixth grade students showed positive rate of 4.8% in Naega primary school and 0% in Hajeom Primary school respectively. Those results showed much decrease than studies carried out in the past. 6) The survey for food habit showed that 15 among 1,274 students (1.2%) had experiences of eating raw intermediate host(crayfish) and 266 among 988 students (27.0%) ate cooked.

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Comparison of Intradermal Skin Test and Multiple Allergen Simultaneous Test Results in Canine Atopic Dermatitis

  • Nam, Hyeyeon;Yun, Taesik;Koo, Yunhoi;Lee, Dohee;Chae, Yeon;Park, Jooyoung;Choi, Dongjoon;Kim, Hakhyun;Yang, Mhan-Pyo;Kang, Byeong-Teck
    • Journal of Veterinary Clinics
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    • v.38 no.3
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    • pp.120-126
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    • 2021
  • Intradermal skin test (IDST) is generally considered a useful tool in identifying causal allergens in canine atopic dermatitis. Currently, multiple allergen simultaneous test (MAST), an in vitro testing method for allergen-specific immunoglobulin E, is being used as an alternative method. However, there are no reports comparing the IDST and MAST results in the same dogs. This study compared the results of both tests to evaluate the agreement and correlation between them. The sensitivity, specificity, and accuracy of the MAST were 76.2%, 64%, and 66.7%, respectively. Moderate positive predicted value (PPV, 50-75%) or high sensitivity (80-100%) were identified for indoor allergens, such as cat epithelia, house dust, and house dust mites. In contrast, high negative predicted value (NPV, 93.3-100%) and specificity (60-100%) were observed for environmental allergens and fungi. Although the agreement between IDST and MAST for all allergens was fair (κ = 0.301), that for each allergen was poor (κ < 0.01), except for birch (κ = 0.158). Spearman's rank correlation analysis revealed a low correlation between the MAST and IDST results (ρ = 0.308, p = 0.001). As compared to the IDST results, the MAST results did not identify the causative allergens sufficiently. IDST may not be performed for environmental allergens and fungi with high NPV and specificity if the MAST result is negative, but it may have to be performed for indoor allergens with moderate PPV and high sensitivity when the MAST result is positive.

Evaluation of the Agreement between Immunodot Assays and Intradermal Skin Testing or Favrot Diagnostic Criteria in Canine Atopic Dermatitis

  • Cho, Sun-Hyung;Kang, Ji-Houn;Yang, Mhan-Pyo;Kang, Byeong-Teck
    • Journal of Veterinary Clinics
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    • v.33 no.5
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    • pp.270-273
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    • 2016
  • This study was undertaken to identify differences between atopic and non-atopic dogs in three rapid screening immunodot assays as well as the ability of the assays to predict the results of intradermal skin testing (IDST) or Favrot diagnostic criteria (FDC). Twenty-nine dogs diagnosed with canine atopic dermatitis (CAD) were selected as the atopic group. Twenty-five dogs without CAD were included as the non-atopic group. Three types of immunodot assays were conducted on all serum samples from both groups: Allercept E-screen 2nd generation (ES2G), Canine Allergic Tendency Reference Test (ALERT), and Asan Easy Test Canine IgE (AETC). IDST, which included 39 allergens, and immunodot assays were performed concurrently in 13 dogs from the atopic group and compared. While there were no significant differences in positivity between the two groups in the evaluation of ALERT (P = 0.435) and AETC (P = 0.313), positivity in ES2G testing was significantly higher in the non-atopic group than the atopic group (P = 0.038). The ES2G, ALERT, and AETC results showed fair (${\kappa}=0.235$), slight (${\kappa}=0.133$), and slight (${\kappa}=0.014$) accordance with IDST, respectively. The outcomes of ES2G, ALERT, and AETC indicated poor (${\kappa}=-0.211$), slight (${\kappa}=0.106$), and slight (${\kappa}=0.087$) agreement with FDC. In conclusion, rapid screening immunodot assays were not useful for the diagnosis of CAD. These assays may provide a supplementary method for predicting the results of IDST in atopic dogs.

Eye Irritation, Skin Irritation and Skin Sensitization Tests for Aloewhite in Animals (Aloewhite의 안점막 및 피부에 대한 국소자극시험)

  • 김형식;곽승준;김규봉;이승기;박현선;홍채영;안미영;조태형;오선택
    • Toxicological Research
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    • v.12 no.1
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    • pp.53-58
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    • 1996
  • Eye irritation, primary skin irritation and skin sensitization tests for Aloewhite were tested in New Zealand White rabbits and Hartley guinea pig. In primary skin irritation test of male New Zealand White rabbits, body weights were not significantly changed and Primary Irritation Index (PII) was O.47, indicating Aloewhite as mildly irritating material. In ocular irritation test, any injury on iris, conjunctival membrane, and cornea in New Zealand White rabbits was not observed. No injuries of the ocular mucous membrane were also recorded. Skin sensitization was tested in guinea pig after intradermal and epicutaneous induction and graded 1 with zero % sensitization rate. These results indicate that Aloewhite was not considered to be irritant in test organs of animals.

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Drug eruption by antihistamine mistaken for chronic urticaria in a child

  • Lee, Gun Moo;Chu, Shou-Yu;Kang, Sung Yeon;Kim, Hyo-Bin;Park, Jin-Sung;Kim, Ja Kyoung
    • Clinical and Experimental Pediatrics
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    • v.62 no.2
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    • pp.75-78
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    • 2019
  • Although rare, antihistamines can cause adverse effects, including drug-induced eruptions or anaphylaxis. A 4-year-old child visited the pediatric department of a hospital for skin eruptions after administration of antihistamines, (e.g., ucerax [hydroxyzine] or leptizine [levocetirizine]), for cholinergic rashes; he did not have pruritus. Skin prick, intradermal, and drug provocation tests were performed to determine the relationship between the antihistamines and eruptions. Levocetirizine induced wheals in the skin prick test and a rash in the oral drug provocation test. In contrast, ketotifen induced no reaction in the skin prick test but showed a positive reaction in the oral provocation test. Our case report highlights that children can experience the same types of adverse reactions as seen in adults, and cross-reactivity between various antihistamines can occur.