scholarly journals Wheal Diameter Interpretation

2020 ◽  
Author(s):  
Keyword(s):  
Wheal Diameter

scholarly journals Developing and testing of a screening tool to predict people without IgE-mediated allergy: a quantitative analysis of the predictive value of a screening tool

2017 ◽  
Vol 67 (657) ◽  
pp. e293-e299 ◽  
Author(s):  
Victoria S Hammersley ◽  
Jessica Harris ◽  
Aziz Sheikh ◽  
Emma Davidson ◽  
Samantha Walker
Keyword(s):  
Screening Tool ◽  
Skin Prick Testing ◽  
Negative Control ◽  
Negative Answer ◽  
Predictive Values ◽  
Wheal Diameter ◽  
Ige Mediated ◽  
Skin Prick Tests ◽  
The Individual ◽  
Sensitivity Specificity

BackgroundConsultations in primary care for allergies are common. It can be difficult to differentiate between IgE-mediated (atopic) symptoms — which respond to allergen-specific interventions — and those that are non-atopic, without performing objective tests that are largely unavailable in UK general practice.Aim To develop and test a screening tool that can accurately discriminate between atopic and non-atopic individuals.Design and setting A validation study that took place in 2012 in adult volunteers aged >16 years in Scotland.MethodA questionnaire screening tool was developed using questions from a large cohort study and through consultation with experts. Participants answered the questions and had skin prick tests for four aeroallergens (house dust mite, cat, dog, and mixed grasses). Participants were classified as atopic if any average wheal diameter was ≥3 mm bigger than the negative control. Sensitivity, specificity, and positive and negative predictive values of individual and combinations of questions were calculated.ResultsIn all, 143 participants completed the questionnaire and underwent skin prick testing. Of these, 81 (56.6%) were atopic. Negative predictive values for the individual questions ranged from 48.2% (55 not atopic out of 114 negative answers) to 72.0% (18/25). An optimum combination of four questions was identified, in which a negative answer to all four questions was reported by 24 participants, 21 (87.5%) of whom were not atopic.ConclusionThe authors have identified a set of questions that correctly predict negative skin prick tests to common aeroallergens 88% of the time. These may be useful to exclude patients who do not warrant further investigation and who can reliably be advised that allergen avoidance is neither necessary nor helpful.

scholarly journals Comparative Cutaneous Histamine Release by Neuromuscular Blocking Agents

1986 ◽  
Vol 14 (4) ◽  
pp. 365-369 ◽  
Author(s):  
D. C. Galletly
Keyword(s):  
Histamine Release ◽  
Dose Response ◽  
Normal Values ◽  
Intradermal Injection ◽  
Neuromuscular Blocking ◽  
Neuromuscular Blocking Agents ◽  
Neuromuscular Blocking Drugs ◽  
Blocking Agents ◽  
Wheal Diameter ◽  
Calculated Dose

Normal values of cutaneous wheal diameter following intradermal injection of six neuromuscular blocking drugs were determined. The relative cutaneous histamine-releasing ability of each drug was derived from calculated dose-response relationships. Equipotent neuromuscular blocking doses were found to have a cutaneous histamine releasing ability relative to pancuronium (=1) of vecuronium 1.1; suxamethonium 1.7; alcuronium 5; atracurium 52; d-tubocurarine 172. A significant (P<.001) variation was found between the dose-response slopes perhaps suggesting a variation in the mechanism of histamine release.

The most common allergens according to skin prick test: The role of wheal diameter in clinical relevancy

2020 ◽  
Author(s):  
Raheleh Shokouhi Shoormasti ◽  
Maryam Mahloujirad ◽  
Nastaran Sabetkish ◽  
Anoushirvan Kazemnejad ◽  
Vahid Ghobadi Dana ◽  
...  
Keyword(s):  
Skin Prick Test ◽  
Prick Test ◽  
Wheal Diameter

scholarly journals The Lancet Weight Determines Wheal Diameter in Response to Skin Prick Testing with Histamine

PLoS ONE ◽  
2016 ◽  
Vol 11 (5) ◽  
pp. e0156211 ◽  
Author(s):  
Hjalte H. Andersen ◽  
Anna Charlotte Lundgaard ◽  
Anne S. Petersen ◽  
Lise E. Hauberg ◽  
Neha Sharma ◽  
...  
Keyword(s):  
Skin Prick Testing ◽  
Wheal Diameter

scholarly journals The Relationship between Mold Exposure and Allergic Response in Post-Katrina New Orleans

2010 ◽  
Vol 2010 ◽  
pp. 1-7 ◽  
Author(s):  
Felicia A. Rabito ◽  
Sara Perry ◽  
W. Edward Davis ◽  
C. Lillian Yau ◽  
Estelle Levetin
Keyword(s):  
Hurricane Katrina ◽  
New Orleans ◽  
Medical Facility ◽  
Allergy Clinic ◽  
Indoor Allergen ◽  
Respiratory Effects ◽  
Prick Test ◽  
Wheal Diameter ◽  
Mold Exposure ◽  
The Relationship

Objectives. The study's objective was to examine the relation between mold/dampness exposure and mold sensitization among residents of Greater New Orleans following Hurricane Katrina. Methods. Patients were recruited from the Allergy Clinic of a major medical facility. Any patient receiving a skin prick test for one of 24 molds between December 1, 2005 and December 31, 2008 was eligible for the study. Exposure was assessed using standardized questionnaires. Positive mold reactivity was defined as a wheal diameter >3 mm to any mold genera. Results. Approximately 57% of participants tested positive to any indoor allergen, 10% to any mold. Over half of respondents had significant home damage, 34% reported dampness/mold in their home, half engaged in renovation, and one-third lived in a home undergoing renovation. Despite extensive exposure, and multiple measures of exposure, we found no relationship between mold/dampness exposure and sensitivity to mold allergens. Conclusions. These results along with results of earlier research indicate no excess risk of adverse respiratory effects for residents living in New Orleans after the devastation of Hurricane Katrina.

scholarly journals Design of an Optimally-Diagnostic Skin Test With Fewer Samples for Diagnosis of Sensitivity to Eight Allergens: a First-In-Human Study of Dose Escalation and Simultaneous Administration in Chinese Subjects

2020 ◽  
Author(s):  
Xiaoyi Ning ◽  
Yun Kuang ◽  
Shuwei Zhao ◽  
Guoping Yang ◽  
Wenjing Hou ◽  
...  
Keyword(s):  
Skin Test ◽  
Human Study ◽  
Allergic Diseases ◽  
Significance Test ◽  
Simultaneous Administration ◽  
Open Label ◽  
Prick Test ◽  
Wheal Diameter ◽  
The Difference ◽  
Allergen Extracts

Abstract Background: Skin prick test is usually the preferred test in the diagnostic workup for allergic diseases, while there are few types of standardized allergen extracts available. Besides, standardization and composition give no assurance that the allergen extracts are within the concentration range that give the best chance of a true diagnosis. We designed a first-in-human diagnostic skin test with fewer samples to identify the optimally diagnostic concentration for eight standardized extracts from frequent native allergens, and to assess the safety of the eight allergens extracts’ simultaneous administration for supporting clinical allergen screening.Methods: Patients aged 18-45 years who had a history of allergic diseases were enrolled in this two-part open-label, parallel study: Study 1, each patient was given three concentrations of one allergen extract in turn. Study 2, each patient was given two concentrations of eight allergens extracts. Negative and positive controls were given each time the allergen was given. Both safety and sensitivity were evaluated to determine the optimally diagnostic concentration. Related-Samples Friedman's Two-Way Analysis was used to evaluate the difference of wheal diameter between different concentrations of each allergen. SPSS Statistics 26 was used for statistical analysis, and the significance test level was 0.05.Results: The sensitivity of allergens increased with the increasing of concentration. The eight investigated allergens showed good safety and did not reach the dose limit toxicity whether used alone or in combination. The optimally diagnostic concentration for eight aeroallergens were respectively determined as 33333 DU/mL, 12000 DU/mL, 8667 DU/mL, 50000 DU/mL, 40000 DU/mL, 3333 DU/mL, 7000 DU/mL, and 5000 DU/mL.Conclusions: This study designed a solution to determine the optimally diagnostic concentration with fewer subjects for further clinical trials of the eight investigated allergens and the results of this phase I clinical trial support further clinical research of investigated allergens. Trial registration: The trial was registered on www.chictr.org.cn (ChiCTR1900023952, 06/19/2019, retrospectively registered).

Airway Nitric Oxide in Children with HDM-Induced Allergic Rhinitis

2021 ◽  
pp. 194589242110644
Author(s):  
Woralak Sutiratanachai ◽  
Watcharoot Kanchongkittiphon ◽  
Natchanun Klangkalya ◽  
Wanlapa Jotikasthira ◽  
Potjanee Kiewngam ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Allergic Rhinitis ◽  
Provocation Test ◽  
Specific Ige ◽  
Nasal Symptom ◽  
Roc Curve Analysis ◽  
Prick Test ◽  
Vas Score ◽  
Total Nasal Symptom Score ◽  
Wheal Diameter

Background Rhinitis is a common problem in children. Airway nitric oxide (NO) was proposed to represent eosinophilic inflammation. Objectives To evaluate airway NO level in children with house dust mite (HDM)-induced allergic rhinitis Methods Children aged 5 to 18 years old with moderate–severe persistent rhinitis and positive result for the HDM nasal provocation test (NPT) was enrolled. The nasal symptoms evaluated by total nasal symptom score (TNSS) and visual analog scale (VAS) were recorded. Skin prick test (SPT) to common aeroallergens, fractional exhaled nitric oxide (FeNO), nasal nitric oxide (nNO), and blood test for specific IgE (sIgE) to HDM was measured. Rhinitis severity was categorized as severe if the VAS score > 7. Results Forty-eight children with HDM-induced allergic rhinitis with the mean age of 9.3 ± 2.4 years were enrolled. nNO levels and VAS score were significantly correlated (R = 0.398, P = .005). Children with severe rhinitis had significantly higher nNO levels than moderate rhinitis (1652.05 vs 941.30 parts per billion [ppb], P = .002), while there was no difference in FeNO level. ROC curve analysis demonstrated the cut-off value of nNO at 1350 ppb (AUC 0.764, 95% CI: 0.616-0.911, P = .002) for detecting severe HDM-induced allergic rhinitis with the sensitivity of 78% and the specificity of 71%. The level of FeNO in children who had HDM mean wheal diameter (MWD) > 8 mm was significantly higher than those with HDM MWD of 3 to 8 mm and those with a negative test (39.7 vs 14.3 vs 14.4 ppb; P = .006, respectively). Children who had sIgE to HDM < 0.35 KUA/L had significantly lower FeNO than those with sIgE to HDM 0.35 to 50 KUA/L and >50 KUA/L (9.5 vs 19.7 vs 40.4 ppb; P = .029, respectively). Conclusions Cut-off value for the diagnosis of severe HDM-induced chronic rhinitis was proposed. Rhinitis children who had a higher degree of HDM sensitization had a higher level of FeNO.

Comparison of Subjective and Objective Intradermal Allergy Test Scoring Methods in Dogs with Atopic Dermatitis

2011 ◽  
Vol 47 (6) ◽  
pp. 399-405 ◽  
Author(s):  
Tomeshia L. Hubbard ◽  
Patricia D. White
Keyword(s):  
Atopic Dermatitis ◽  
Skin Tests ◽  
Scoring Methods ◽  
Scoring Method ◽  
Standard Procedures ◽  
Allergy Test ◽  
Wheal Diameter ◽  
Important Diagnostic Tool ◽  
Clinically Significant ◽  
Level Of Agreement

An intradermal allergy test (IDT) is an important diagnostic tool for identifying offending allergens in canine atopic dermatitis. No standardized method of scoring an IDT has been described. The purpose of this study was to determine whether there is a correlation between a conventional, subjective IDT scoring method based on perceived wheal diameter, erythema, and turgor (0–4+) and an objective scoring method based on measuring wheal diameter alone. Thirty-four atopic dogs were skin tested with 68 different allergens. All skin tests were performed according to standard procedures, and any IDT score ≥2+ was considered clinically significant. When the subjective IDT scores were compared with the objective IDT scores in all dogs, there was a moderate level of correlation overall (r=0.457; P &lt;0.0001). The highest level of agreement between subjective and objective scores was noted with the reactions assigned subjective scores of “0” and “2+.” Overall, there was a slight level of agreement between subjective and objective scores based on clinical significance (i.e., subjective scores ≥2+; κ=0.20; P &lt;0.0001). In conclusion, the authors believe that the objective scoring method used in this study may provide a point of reference for inexperienced individuals (dermatology residents, veterinarians, technicians) when learning to grade an IDT.

scholarly journals Type I hypersensitivity promotes Aedes aegypti blood feeding

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Michael J. Conway
Keyword(s):  
Aedes Aegypti ◽  
Blood Feeding ◽  
Feeding Time ◽  
Type I ◽  
Hypersensitivity Reactions ◽  
Itch Sensation ◽  
Mosquito Saliva ◽  
Wheal Diameter ◽  
Type I Hypersensitivity ◽  
The Impact

AbstractMosquitoes play a major role in human disease by serving as vectors of pathogenic microorganisms. Mosquitoes inject saliva into host skin during the probing process. Mosquito saliva contains a number of proteins that facilitate blood feeding by preventing hemostasis. Mosquito saliva also contains potent allergens that induce type I hypersensitivity reactions in some individuals. Type I hypersensitivity reactions in skin involve IgE-mediated degranulation of mast cells, which leads to vasodilation and an itch sensation. We hypothesized that hypersensitivity to mosquito saliva influences blood feeding. To test this hypothesis, we recruited human subjects who consented to Aedes aegypti bites. We measured their first sensation of itch, the strength of their itch sensation, the number of times mosquitoes attempted to feed, the number of times mosquitoes probed their skin, feeding time, engorgement status, and wheal diameter. Here we show that hypersensitive subjects had a stronger itch sensation, and that the time to first itch sensation was inversely correlated with wheal diameter; however, mosquitoes tended to probe less and engorge more on these subjects. Follow-up experiments testing the impact of oral antihistamine treatment on mosquito feeding parameters failed to reveal a statistically significant result. Histamine also failed to promote blood feeding on an artificial membrane feeder. This study suggests that mosquito saliva-induced type I hypersensitivity promotes blood feeding but that this may be independent from histamine or histamine signaling.

scholarly journals Local Anesthetics, Procaine, Lidocaine, and Mepivacaine Show Vasodilatation but No Type 1 Allergy: A Double-Blind, Placebo-Controlled Study

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Stefan Weinschenk ◽  
Caroline Mergenthaler ◽  
Christina Armstrong ◽  
Richard Göllner ◽  
Markus W. Hollmann ◽  
...  
Keyword(s):  
Local Anesthetics ◽  
Controlled Study ◽  
Neural Therapy ◽  
Double Blind ◽  
Wheal Diameter ◽  
The Mean ◽  
General Signs ◽  
Type 1 Allergy ◽  
Double Blinded

Background. Therapy with local anesthetics (LAs), also known as neural therapy, is used in integrative medicine because of its anti-inflammatory properties. Ester-linked LAs are often avoided because of their alleged high allergenicity. Little data supports this assumption and hence the importance of our investigation on type-1 allergies against ester- and amide-linked LAs. We performed a prospective, double-blinded, placebo-controlled observational study. Methods. 177 patients received 340 intracutaneous injections with 1% procaine, 0.5% lidocaine, 1% mepivacaine, or saline solution. Every patient received two different tests on each forearm. Reactions were monitored for 15 minutes. Results. No type-1 allergy was observed. The mean erythema diameter of the wheals after 10 minutes was procaine 8.0±6.4 mm, mepivacaine 7.6±6.3 mm, lidocaine 4.4±4.8 mm, and NaCl 3.7±3.2 mm. The wheal diameter of all substances showed a crescendo-decrescendo phenomenon. The procaine and mepivacaine wheals were significantly larger than those of lidocaine and NaCl. No general signs of hypersensitivity were observed. Diameter and intensity were independent of the injection site, order of injection, age, gender, and body mass index. Conclusion. This study shows no higher type-1 allergenicity of the ester-linked LA procaine, compared to the amide-linked LAs lidocaine and mepivacaine, and supports its use in therapy and short-track surgery.

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