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Background: The skin-prick and intradermal tests are the main diagnostic methods used to identify the causative agent in patients with suspected perioperative anaphylaxis. Although the intradermal test is more sensitive than the skin-prick test, multiple intradermal injections can be painful for children. Here, we present the case of a child with autism and suspected perioperative anaphylaxis. The causative agent was successfully identified using the intradermal test under general anesthesia. Case presentation: An 8-year-old boy with autism developed anaphylaxis during general anesthesia for the fourth cleft lip and palate surgery. An allergic workout was performed, but both the skin-prick and basophil activation tests for suspected causative agents yielded negative results. The patient was afraid of multiple injections, and an intradermal test was performed under general anesthesia by anesthesiologists and allergists. Piperacillin was confirmed as the causative agent, and subsequent surgery using the same anesthetic agents without piperacillin was uneventful. Conclusions: Concerted efforts should be made to identify the causative agent for diagnosing perioperative anaphylaxis. [ABSTRACT FROM AUTHOR]

Post‐orgasmic illness syndrome (POIS) is a rare disease characterized by flu‐like symptoms persisting for 2–7 days after ejaculation. POIS has been chiefly attributed to allergic reactions to autologous seminal plasma. However, the exact pathophysiology remains unclear, and there is no effective treatment. We present the case of a 38‐year‐old man with a 10‐year history of recurrent episodes of flu‐like symptoms of 1‐week duration after ejaculation. The patient was diagnosed with irritating bowel syndrome because of fatigue, myalgia, and lateral abdominal pain. After starting infertility treatment and increasing the frequency of intercourse with his wife, the patient noticed these symptoms after ejaculation. Based on these episodes and symptoms, POIS was suspected. To diagnose POIS, a skin prick test and an intradermal test were performed using his seminal fluid, with the latter yielding a positive result. The patient was diagnosed with POIS, and treatment with antihistamines was continued. Due to its rarity, POIS is often underdiagnosed and underreported; however, the skin test can be a valid diagnostic tool. In this case, the intradermal test result was positive according to the broadly accepted criteria for POIS. Although quality of life is often severely affected in patients with POIS, a lack of a clear understanding of the pathogenesis of POIS prevents early diagnosis. To make diagnoses earlier, it is undoubtedly important to take a detailed medical history and perform skin allergy tests, although the latter requires further validation. [ABSTRACT FROM AUTHOR]

Caprine tuberculosis (TB) is a zoonotic disease caused by members of the Mycobacterium tuberculosis complex. TB eradication programs in goats are based on the single and comparative intradermal tuberculin tests (SITT and CITT, respectively). Antibody-based diagnostic techniques have emerged as potential diagnostic tools for TB. P22 ELISA has been previously evaluated using samples collected after the intradermal tuberculin tests to maximize the sensitivity, a phenomenon known as booster effect. However, there is no information available on whether the use of this diagnostic strategy could lead to a decrease of its specificity (Sp). The aim of the present study was to elucidate the interference effect of a recent CITT on the Sp of the P22 ELISA in serum and milk samples collected at different times after the CITT from a TB-free herd (n = 113). The number of reactors to P22 ELISA was significantly higher (p < 0.01) on serum samples collected 15 days post-CITT compared to day 0, showing a decrease in Sp from 99.1% (95% CI; 95.2-99.8%) to 88.5% (95% CI; 81.3-93.2%). The number of reactors and the quantitative values of P22 ELISA were significantly higher (p < 0.01) in serum samples compared to milk. No significant (p > 0.05) changes in the Sp of the P22 ELISA were observed throughout the different time samplings using milk No significant (p > 0.05) changes were observed on days 30 and 60 post-CITT. In conclusion, the booster effect strategy may significantly decrease the Sp of P22 ELISA in TB-free herds when serum samples are used but not when milk is tested. [ABSTRACT FROM AUTHOR]

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Copyright of Veterinary Dermatology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Veterinary Dermatology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Intradermal test is used to detect causative allergens in IgE‐mediated hypersensitivity. The surfactant polysorbate 80 can be added to intradermal test solutions to more reliably dissolve the allergen and ensure a constant bioavailability of the injected allergen. Polysorbate 80 has, however, some histamine‐releasing properties which could blur the difference to the histamine‐induced wheal. Routinely serving as a control. Objective: Allergen‐free polysorbate 80 containing (0.005%) test solutions were therefore systematically tested at different injection volumes to see whether polysorbate can falsify skin reactions and if yes whether conditions can be identified to avoid this. Methods: In a partly blinded study, 30 patients were tested intracutaneously at the back: each received at three separate sites 0.05 mL of polysorbate‐containing solvent, 0.02 mL polysorbate‐containing solvent as well as 0.02 mL polysorbate‐free solvent. After 15 min, wheal and erythema were documented and planimetrically quantified. Results: Unexpectedly 23 of 30 (77%) patients showed false‐positive test reactions to the volume of 0.05 mL of the polysorbate‐containing solvent whereas the polysorbate‐containing solvent with 0.02 mL and the polysorbate‐free solvent with 0.02 mL injection volume had no reinforcing effect on skin test reaction. Conclusions: Different volumes of polysorbate‐containing solutions, all recommended by manufacturers for intradermal tests, may significantly influence test results. The study shows that a polysorbate 80 used at 0.005% in solvents for intradermal test to provide a better bioavailability of allergens produces false‐positive reactivity in a surprising and a hitherto unknown 77% if the 0.05 mL volume is injected. It is, therefore, mandatory to strictly adhere to an intradermal test volume of 0.02 mL as only then falsifying effects of the polysorbate additive are avoided, and comparable test results are ensured. [ABSTRACT FROM AUTHOR]

Copyright of Asthma Allergy Immunology / Astim Allerji Immunoloji is the property of Turkish National Society of Allergy & Clinical Immunology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The water buffalo (Bubalus bubalis) is susceptible to bovine tuberculosis (TB), which receives increased attention in areas where buffalo breeding is prevalent, such as in Southern Italy, especially in the Campania region, where 70% of the buffalo stock is bred. Since 2012, TB testing in buffalo herds has been conducted using the Single Intradermal Test (SIT), with the Comparative Intradermal test (CIT) used in cases of inconclusive results. From 2012 to 2016, the interferongamma (IFN-γ) test was occasionally employed experimentally in herds with TB outbreaks to expedite eradication efforts. A local TB eradication program was implemented in officially TB-free buffalo herds between 2017 and 2019. This program involves initial screening with SIT, followed by confirmatory tests, including CIT and IFN-γ, for positive reactions. Since June 2019, the IFN-γ test has replaced the CIT in officially TB-free herds upon positive SIT reactions. Additionally, in suspected and confirmed TB-outbreak herds, the IFN-γ test was used at the discretion of the competent authority. Between 2017 and 2019, approximately 295,000 buffaloes in Campania were screened annually with in vivo tests provided by TB eradication programs. During this period, 32,040 animals from 855 herds were tested using the IFN-γ test and 4,895 tested positive. Since 2020, the use of IFN-γ testing has increased, and has become a prerequisite for the acquisition of TB-free status and is being systematically applied for TB outbreak-extinction procedures. The test was performed in all breeding buffaloes in cases of doubtful SIT results in TB-free herds and when TB lesions are detected at slaughter in animals from TB-free herds. This combined approach helped detect more TB outbreaks, and thereby led to a reduction in the TB prevalence and incidence rates. By 2022, the prevalence had decreased to 1.56%, and the incidence had decreased to 0.73%, after the increased use of the IFN-γ test. This study highlights the effectiveness of implemented strategies in reducing TB in this region. Overall, the data demonstrate the successful impact of TB eradication measures and surveillance activities in reducing bubaline TB prevalence and incidence in the Campania region. [ABSTRACT FROM AUTHOR]

Anaphylaxis is a potentially life-threatening systemic allergic reaction that can result in fatal outcomes if not promptly and appropriately treated. The diagnosis of the cause of anaphylaxis during anesthesia can be challenging due to the complexity of the perioperative environment. Propofol-induced perioperative anaphylaxis is uncommon, occurring in perioperative anaphylactic shock cases. We present a case of perioperative anaphylactic shock in a patient with no known allergies who had been exposed to the same anesthetic agents, propofol, rocuronium, and remifentanil, three times previously without incident. Cardiac arrest occurred 50 min after induction, which showed pulseless electrical activity with decreasing saturation without bronchial spasm and skin erythema or edema. After prompt and appropriate management including cardiopulmonary resuscitation, the patient recovered without complications. The diagnosis was confirmed as propofol-induced anaphylactic shock by an elevated serum tryptase level, measured in a timely manner, and by skin tests (skin prick test and intradermal test), which revealed strong hypersensitivity to propofol. This case is notable for the cardiovascular collapse that occurred without respiratory symptoms or skin manifestations, as well as the delayed onset of anaphylaxis (>50 min). This case underscores the importance of vigilance for anaphylaxis, even with repeated exposure to previously well-tolerated drugs, as sensitization can lead to more severe reactions. It also highlights the potential for anaphylaxis to occur outside the acute phase and without typical clinical features. [ABSTRACT FROM AUTHOR]

Background: The WHO strategy for eradication of tuberculosis (TB) by 2035 (The End TB Strategy) is aimed at an early and precise diagnosis and subsequent effective treatment of TB patients. Currently, there is no gold standard for the diagnosis of latent TB infection. This study evaluated the diagnostic capabilities of a new intradermal test using recombinant TB allergen (Diaskintest) compared with tuberculin skin test (TST) and commercial TB interferon-gamma release assays (IGRAs). Methods: A post-hoc data analysis that involved examining 860 HIV-negative, bacillus Calmette-Guérin (BCG)-vaccinated persons aged 1-65 years who visited the TB health-care institutions of Saint Petersburg to rule out or confirm an active TB was conducted from 2011 to 2016. Results: A high degree of consistency of the Diaskintest results with the enzyme-linked immunospot and QuantiFERON-TB Gold In-Tube test (ELISPOT and QFT) results was observed in the examined pediatric population (n = 696), with a Diaskintest cutoff ≥5 mm: the kappa consistency indices were 1.000 and 0.937, for ELISPOT and QFT, respectively. A high sensitivity of Diaskintest, comparable with the IGRA tests, was observed in patients with a confirmed TB diagnosis in all age groups. The sensitivity of Diaskintest in patients of the TB/MTB + group aged 18 years and older was 88.7%; of ELISPOT, 90.6%; of QFT, 87.0%. The conducted analysis has shown a high concordance of results of the commercial TB tests in adult HIV-negative patients (n = 164) with a Diaskintest cutoff ≥5 mm: the kappa indices were 0.805 and 0.636 (Diaskintest vs. ELISPOT and QFT, respectively) among BCG-vaccinated people. Conclusion: According to the WHO recommendations, replacing the TST by IGRAs is not recommended as a public health intervention in resource-constrained settings because the IGRA tests are more costly and technically complex to conduct than the TST. Diaskintest has comparable complexity to the TST and its performance is close to that of IGRA in a BCG-vaccinated population. Thus, our study demonstrates that replacing the TST by Diaskintest can be recommended as a public health intervention in resource-constrained and universal BCG vaccination settings. [ABSTRACT FROM AUTHOR]

Copyright of Veterinary Dermatology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Portuguese Journal of Dermatology & Venereology is the property of Sociedade Portuguesa de Dermatologia & Venereologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Veterinary Dermatology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract We compared the effect of propofol and saline control on intradermal test reactions in dogs with atopic dermatitis undergoing outpatient intradermal testing (IDT). Nineteen dogs were used in this clinical study. Patients were randomly allocated to receive either intravenous (IV) propofol or IV 0.9% saline, and IDT was performed on the right or left (randomized) lateral thorax. One investigator, unaware of the treatments, interpreted all IDT results. Injection sites were analysed using a subjective and objective method. A value of P ≤ 0.05 was considered significant. When all injection sites were subjectively analysed for reactions ≥ 1+ on all dogs, significantly more positive sites were apparent during propofol sedation than during saline administration. In addition, the greater number of individual dogs experiencing more positive reactions ≥ 1+ during propofol sedation was significant. When subjectively analysing reactions ≥ 2+, the greater number of positive reactions and the greater number of dogs with more positive reactions observed during propofol treatment was not significantly different from the saline control. When analysed objectively, the greater number of positive reactions observed during propofol sedation was not significant. A greater number of dogs had higher subjective scores and larger objective measurements during propofol sedation compared with saline administration. In summary, propofol sedation was associated with an overall greater number of positive IDT reactions compared with the saline control. Although not always significant, this difference should be considered when choosing propofol for skin testing dogs with atopic dermatitis. [ABSTRACT FROM AUTHOR]

The effect of the repeated delayed-type hypersensitivity (DTH) testing (an intradermal test - ID) on virus neutralizing (VN) antibody and DTH responses has been studied. Repeated intradermal injection of inactivated BHV-1 antigen elicited neither the virus neutralizing antibody nor positive skin reaction in cattle free from BHV-1 infection. On the other hand, the same manipulation carried out in a herd infected with BHV-1 provoked seroconversion and/or positive DTH reaction in some of the animals without detectable pre-existing VN antibody. Cattle initially positive by VN and intradermal tests showed steady increase in antibody titre, and some of them developed little or no skin reaction following repeated DTH testing. [ABSTRACT FROM AUTHOR]

Background: Adverse drug reactions to iodinated contrast media (ICM) have risen due to their increasing use in x‐ray‐based imaging modalities. Delayed hypersensitivity reactions are mainly caused by nonionic monomeric compounds and represent an issue impacting the diagnostic–therapeutic pathways of cancer, cardiology and surgery patients. Objectives: To prospectively evaluate the usefulness of skin tests in delayed hypersensitivity reactions to ICM and to evaluate the tolerability of iobitridol, a monomeric nonionic low osmolality compound, as a possible safe alternative. Methods: Patients with delayed hypersensitivity reactions to ICM referred to us from 2020 to 2022 were prospectively enrolled in the study. All patients underwent patch test and, if negative, intradermal test with the culprit ICM and iobitridol as alternative. Results: A total of 37 patients (females 24, 64.9%) were enrolled in the study. Iodixanol and iomeprol were the most frequently involved ICM (48.5% and 35.2%, respectively); 62.2% of patients presented maculopapular eruption, while 37.8% reported delayed urticaria‐like rash. Skin tests resulted positive to the culprit ICM in 19 patients (51.4%), 16 to patch test and 3 to intradermal test. Skin tests with iobitridol, tested as alternative, resulted positive in 3/19 patients (15.8%). All 16 patients with negative results to iobitridol were administered this ICM and tolerated it. Conclusions: In at least half of patients, delayed‐type hypersensitivity was demonstrated by skin tests, particularly by patch test. This diagnostic approach resulted simple, cost‐effective and safe, not only to confirm the culprit ICM but also to identify iobitridol as feasible alternative. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 46-year-old non-atopic woman, who was referred because of a maculopapular eruption following administration of amoxicillin for acute pharyngitis 20 years earlier. Topics include flare-up of previously negative patch test and intradermal test with amoxicillin after oral provocation and skin tests with amoxicillin performed on the woman and laboratory results, including blood count, liver enzymes, serum creatinine were within normal limits.

A clinical study to evaluate the Makari Intradermal Test (MIT) involved 180 patients seen with sympotoms suggestive of malignant disease, 85 of whom were subsequently shown to have carcinoma of the large bowel, and 66 asymptomatic volunteers. The prognostic value of initial and serial studies relative to patient-survival rate and the efficacy of serial studies in detecting disease in long-term follow-up of patients with resected malignant lesions were evaluated. On the basis of this study, the MIT appears to merit further investigation, not as a definitive diagnostic procedure, but as a survey for identifying patients with early malignancy or individuals at high risk to malignant epigenesis. [ABSTRACT FROM AUTHOR]

Background: Metamizole is a pyrazolone derivative, and its most common reactions are IgE-mediated reaction and idiosyncratic reactions. Non-immediate reactions are poorly described and there are very few reports on non-immediate reactions to pyrazolones. Materials and methods: We evaluated 12 patients (nine men) who consulted for a non-immediate reaction after metamizol administration. We performed cutaneous tests (skin prick tests and immediate and delayed intradermal tests) and epicutaneous tests, and, if necessary, an oral challenge test. Results: All skin prick and intradermal tests, if necessary, were negative in immediate reading. Delayed intradermal tests were positive in six of 10 patients (60%) and epicutaneous tests were positive in four of 11 patients (36%). Three cases (25%), were diagnosed by a positive oral challenge test. Discussion: Delayed-reading intradermal tests and patch tests are useful tools in the diagnosis of nonimmediate reactions to pyrazolones and should be considered the first step when evaluating these type of reactions. Intradermal test appears to be more sensitive than patch test. The positivity of skin tests suggests an immunological reaction, probably mediated by T lymphocytes, but further studies are required. [ABSTRACT FROM AUTHOR]

Background/aim: We aimed to investigate the relationship between serum antidrug antibodies (ADAbs), systemic hypersensitivity, or local injection site reactions to tumor necrosis factor (anti-TNF) drugs and to detect the role of skin tests in the diagnosis of hypersensitivity reactions (HSRs) against anti-TNFs. Materials and methods: Sixty-nine ankylosing spondylitis (AS) and 46 rheumatoid arthritis (RA) patients taking infliximab (IFX), adalimumab (ADA), and etanercept (ETN) were enrolled. The demographical data, erythrocyte sedimentation rate (ESR), and c-reactive protein (CRP) levels of the patients were determined, and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) assessment for AS patients and DAS28 (disease activity score) for RA patients were assessed. Serum levels of anti-TNFs and ADAbs to these agents were measured with ELISA. These blood samples were taken 24 h before the next drug dose. The patients with anti-TNF-associated HSRs were evaluated with a skin-prick test (SPT) and intradermal test (IDT). Readings for the SPT and IDT were conducted after 15 min and 24, 48, and 72 h. Heel diameter of 3 mm or more greater than the negative control was considered positive for SPT, and if the size of the initial wheal had increased by at least 3 mm in diameter and was surrounded by erythema it was considered positive for IDT. Symptoms such as urticaria/angioedema and flushing were considered immediate-type HSRs. Findings developed at the injection site such as swelling and erythema were considered injection-site reactions (ISRs). An overall p < 0.05 was considered statistically significant. Results: A statistically significant association was found between HSRs (immediate type and ISRs) and IDT reported by patients taking biological drugs (p = 0.001). In the subgroup analysis, a statistically significant association was found between ISRs and IDT in those taking ADA and ETN (respectively p = 0.012, p = 0.013). No relationship was found between skin test positivity and the presence of IgG ADAbs to anti-TNFs or disease activity scores. Conclusion: This study demonstrates that patients who exhibit ISRs to anti-TNFs produce notably positive results to IDT without maintaining a direct relationship to serum levels of ADAbs. [ABSTRACT FROM AUTHOR]

Background: Tranexamic acid (TXA) is commonly considered a safe drug to mitigate bleeding during and after various surgical settings among adults and children. In recent decades, anaphylaxis induced by TXA has been increasingly reported in adults. However, among pediatrics, there are fewer reported cases. Case presentation: We report a case of a 6-year-old female who experienced anaphylaxis after receiving intravenous TXA following unilateral cleft lip and palate repair surgery. She exhibited clinical symptoms involving the cardiovascular system, respiratory system, and skin. Following the administration of epinephrine, corticosteroid, and anti-histamine, the patient's symptoms were relieved. A few months after discharge, an intradermal test, yielded a positive result, confirming TXA as the culprit drug. Conclusion: Our report emphasizes the importance of considering anaphylaxis as a potential adverse reaction to TXA in pediatric patients, showing the criticality of rapid diagnosis and appropriate management for a successful outcome. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Epidemiological studies of paracoccidioidomycosis have been based on surveys achieved with intradermal tests, and paracoccidioidin is the most common antigen used in most cases. The glycoprotein of 43-kDa (gp43) has been used in intradermal tests. It is the most antigenic component of Paracoccidioides brasiliensis, and it provides greater specificity to evaluate infection for this fungus. In this study, the prevalence of P. brasiliensis infection was estimated with intradermal tests involving gp43 for 695 people in rural Central-West Brazil. The infection rate was 45.8 % (95 % CI = 42.1-49.5), and the average age of those infected was 45.8 ± 18.2 years. The prevalence did not show gender-based differences but increased with age. The results demonstrate the importance of P. brasiliensis infection in rural settlements and the early exposure of children in the region to the fungus. Despite the high antigenicity and specificity of gp43, its usage must be standardized, so that epidemiological surveys will be comparable and more accurately reflect P. brasiliensis infection in endemic areas. [ABSTRACT FROM AUTHOR]

An intradermal (ID) test (a delayed-type hypersensitivity test) was used for the diagnosis of BHV-1 infection in cattle. A threshold value for the test positive results was established based on the analysis of the agreement between the results of ID test and those of virus neutralization (VN 24) assay. Linear regression analysis revealed no correlation between the intensity of the skin reaction (expressed as an increase in skin-fold thickness) and the VN 24 antibody titre. The sensitivity and specificity of the ID test compared to VN 24 one, were 86.6 % and 98.3 % respectively. Of the 487 cattle with an age of over 6 months, 25 (5.1 %) reacted discordantly by ID and VN 24 tests, i.e. 19 seropositive animals expressed little or no skin reaction, whereas 6 seronegative individuals were positive by ID. Neither of the calves, with passively acquired antibodies in contrast to experimentally infected ones, showed distinctive skin reaction. [ABSTRACT FROM AUTHOR]

Forty-eight cattle were sensitised to Brucella antigens either by vaccination with Brucella abortus strain 19 (S19) or B. abortus 45/20 (S45/20) and 24 of these and 12 unvaccinated cattle were subsequently challenged with virulent B. abortus strain 544 (S544). All these cattle (n=60), together with 12 control cattle which were neither vaccinated nor challenged, were subsequently subjected to an intradermal test using a S45/20 protein antigen. Reactions were interpreted subjectively by observation and palpation and were measured to the nearest mm with calipers at 48 and 72 hours after injection of protein antigen. Ten weeks later the cattle were slaughtered and tissues cultured for the presence of B. abortus. Two of the 48 vaccinated cattle died, 40 of the remaining 46 gave a positive response to the intradermal test at 48 hours and 36 were positive at 72 hours. In the controls any increase in the skin thickness had disappeared by 72 hours. An increase in skin thickness was still present at 72 hours in all other cattle except those vaccinated with S19 only. The intradermal test was found to be sensitive but not specific in detecting infected cattle and both sensitive and highly specific if used (with the exception of S19) to detect exposure to Brucella antigen. [ABSTRACT FROM AUTHOR]

Nineteen healthy beagles, eight healthy basset hounds and 17 basset hounds with dermatitis were tested intradermally with two extracts of . One healthy beagle and two affected basset hounds showed wheal and flare reactions 15 minutes after the injection. Delayed reactions, consisting of erythematous macules and plaques, were commonly observed 24 hours after the injection in both the healthy and affected basset hounds, but occurred infrequently in the beagles. At 24 hours the diameters of the lesions in the healthy and affected basset hounds were significantly (P<0.01) greater than those in the healthy beagles, but the diameters in the healthy and affected basset hounds did not vary significantly. Delayed reactions in six of the basset hounds with dermatitis were characterised histologically by superficial perivascular and periadnexal infiltrates of neutrophils and lymphocytes. [ABSTRACT FROM PUBLISHER]

Copyright of Veterinary Dermatology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Skin tests are one of the most widely used diagnostic tools for suspected drug allergies in children. Studies on systemic reactions occurring during skin testing with allergens have mostly been conducted in pediatric and adult patient groups together. However, data on adverse reactions including allergic reactions after drug skin tests in children are scarce. It is aimed to determine the adverse reactions after skin test in children with suspected drug allergy. Methods: Patients who underwent a drug skin test due to the suspicion of drug allergy between May 2017 and June 2020 were evaluated, retrospectively. Data about adverse reactions seen after skin testing at the testing area in the clinic were analyzed. Results: The study included 1,073 children (585 [54.5%] boys and 488 [45.5%] girls) with a median age of 7.5 years. A total of 12 (1.1%) reactions were detected after skin testing, and 4 (0.4%) of them were allergic reactions. Of the allergic reactions, three were anaphylaxis and one was urticaria. Two of the reactions (1 anaphylaxis and 1 urticaria) were detected after the skin prick test and the remaining 2 were detected after intradermal test. Three of the nonallergic reactions were considered as vasovagal reactions and seven were considered as nonspecific and anxiety-related reactions. Conclusion: Although drug skin tests were generally well-tolerated and adverse reactions were rare, severe allergic reactions including anaphylaxis may ensue. Skin tests should be necessarily performed in clinical settings in experienced centers. [ABSTRACT FROM AUTHOR]

The literature dealing with the intradermal test in whooping cough has been reviewed, and the claims as to the specific value of the test have been investigated in 1300 cases.A method for the extraction of endotoxin from Haemophilus pertussis has been described and the intradermal response to this preparation compared with that following whole vaccine.The findings in this investigation do not support the claim that the intradermal response to Sauer's vaccine in the strength commonly employed (10,000 million organisms per c.c.) is of value either in demonstrating immunity to whooping cough or in the early diagnosis of this disease. The bacterial content of this vaccine appears to be too high for skin-testing purposes, giving rise to inflammatory lesions of a non-specific character rather than to allergic reactions of specific value. These reactions are less apparent when the vaccine is employed in a diluted form.The intradermal response to pertussis endotoxin, on the other hand, though not invariably consisting of a clear-cut reaction (and in this respect falling short of the ideal as a reagent) is more consistent with the development of the allergic state towards H. pertussis, reactions presumably of this nature being present in the skin of approximately 85% of children with a past history of whooping cough. Similar reactions, however, can be elicited in the skin of about 30% of individuals with no history of the disease; but in view of the fact that, unlike the more invasive virus diseases, many individuals never develop whooping cough in spite of almost certain exposure when young, it is suggested that latent immunization or recent contact with the causative organism might account for this phenomenon. Whether these reactions indicate merely sensitization or a definite immunity to pertussis must remain, for the time being, sub judice.The onset of bacterial hypersensitiveness, as judged by the pertussis endotoxin test, appears about the 10th day of whooping cough and becomes heightened during the subsequent course of the disease. Ultimately this cutaneous allergy undergoes a regression, which, however, is not always complete. For this reason the pertussis endotoxin test would appear to be of some value in assessing the immune state of the individual, and also as a diagnostic reaction in early, atypical or late cases of whooping cough where bacteriological findings by the cough plate method have proved disappointing. [ABSTRACT FROM PUBLISHER]

Objective: Identification of allergens by intradermal test in patients with asthma, allergic rhinitis, and eczema. Materials and Methods: Intradermal test was performed in 100 patients of Ambala over an 8-year period to identify the common allergens. A total of 197 allergens including 50 types of pollen, 19 fungi, 17 insects, 14 types of dust, 6 animal dander, 7 types of fabric and feather and 82 types of foods, dust mite, and parthenium were tested. Results: In this study, the major allergens were pollen (51%) followed by foods (28.9%), insects (26.9%), fungus (12.6%), dusts (6.7%). Among pollen allergens, Brassica campestris (8%) was a major allergen followed by Ageratum conyzoides (7%) and Artemisia scoparia (6%) Cannabis sativa, Cynodon dactylon and Maerua arenaria (5%). Among the fungal group, Alternaria tenuis, Aspergillus flavus, Aspergillus fumigates, Candida albicans, Penicillium sp., Rhizopus nigricans (3%), Fusarium solani (2%) were found. In the insect group, mosquito (7%), ant (6%), grasshopper (5%), locust (male), moth, and house fly (4%) were the major allergens. Among the dust allergens, grain dust rice (3%), straw dust, house dust, and grain dust bajra (2%) were found. Among the food allergens, prawn (5%), almonds, Baker's yeast, Bengal gram (3%) and mushroom, mango ripe, rajma, cinnamon, chocolate, beans fresh, and areca nut (2%) were found. Conclusion: It can be said that the knowledge may help to create a mapping of allergens in this area and help to treat patients by immunotherapy or avoidance strategy. [ABSTRACT FROM AUTHOR]

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The single intradermal comparative test was used with both avian and bovine tuberculin. Three cattle infected with bovine leukosis virus (BLV) were used as a source of infection. BLV-positive and susceptible animals were tuberculin tested alternately. Fifteen susceptible calves and 15 susceptible sheep were tested. A further three calves and three sheep were used as controls; the needles of the tuberculin syringes were deliberately contaminated with blood from the BLV-infected cattle, before being used in the test. Whereas all three calves and the three sheep inoculated intradermally with contaminated needles developed BLV infections, all of the other 30 animals have remained serologically negative to BLV for 10 months. Transmission of BLV with needles contaminated with BLV-infected blood was prevented by wiping the needles with absorbent cotton wool. [ABSTRACT FROM AUTHOR]

Background: Bovine tuberculosis (bTB) is a chronic disease that results from infection with any member of the Mycobacterium tuberculosis complex. Infected animals are typically diagnosed with tuberculin-based intradermal skin tests according to World Organization of Animal Health which are presently in use. However, tuberculin is not suitable for use in BCG-vaccinated animals due to a high rate of false-positive reactions. Peptide-based defined skin test (DST) antigens have been identified using antigens (ESAT-6, CFP-10 and Rv3615c) which are absent from BCG, but their performance in buffaloes remains unknown. To assess the comparative performance of DST with the tuberculin-based single intradermal test (SIT) and the single intradermal comparative cervical test (SICCT), we screened 543 female buffaloes from 49 organized dairy farms in two districts of Haryana state in India. Results: We found that 37 (7%), 4 (1%) and 18 (3%) buffaloes were reactors with the SIT, SICCT and DST tests, respectively. Of the 37 SIT reactors, four were positive with SICCT and 12 were positive with the DST. The results show that none of the animals tested positive with all three tests, and 6 DST positive animals were SIT negative. Together, a total of 43 animals were reactors with SIT, DST, or both, and the two assays showed moderate agreement (Cohen's Kappa 0.41; 95% Confidence Interval (CI): 0.23, 0.59). In contrast, only slight agreement (Cohen's Kappa 0.18; 95% CI: 0.02, 0.34) was observed between SIT and SICCT. Using a Bayesian latent class model, we estimated test specificities of 96.5% (95% CI, 92–99%), 99.7% (95% CI: 98–100%) and 99.0% (95% CI: 97–100%) for SIT, SICCT and DST, respectively, but considerably lower sensitivities of 58% (95% CI: 35–87%), 9% (95% CI: 3–21%), and 34% (95% CI: 18–55%) albeit with broad and overlapping credible intervals. Conclusion: Taken together, our investigation suggests that DST has a test specificity comparable with SICCT, and sensitivity intermediate between SIT and SICCT for the identification of buffaloes suspected of tuberculosis. Our study highlights an urgent need for future well-powered trials with detailed necropsy, with immunological and microbiological profiling of reactor and non-reactor animals to better define the underlying factors for the large observed discrepancies in assay performance, particularly between SIT and SICCT. [ABSTRACT FROM AUTHOR]

Presents a clinical case of anaphylactoid reaction or serum sickness following an intradermal test of tetanus antitoxin (TAT). Medical history of the patient; Findings of the laboratory examinations; Clinical course and immunological response following the intradermal administration of TAT; Hemagglutination and reagin titers of the patients.

The article provides information on a study that compared the tine test, the Mantoux intradermal test and the Vollmer patch test in diagnosing tuberculosis in children. A comparative study of tuberculin susceptibility was carried out in 200 children three months to 14 years old using the tuberculin tine test, the intradermal Mantoux test and the Vollmer patch test. Agreement between the Mantoux test (10 T.U.) and the tine test was 81.4 per cent for positive reactors and 98.2 per cent for negative reactors. The agreement between the tine test and the Vollmer patch test was 80.0 per cent for positive reactors and 97.1 per cent for negative reactors. The emotional reactions of children to be given the tine test, and its advantages are evaluated in detail.

Background: We evaluated the value of positive intradermal dilution testing (IDT) after negative skin prick tests (SPT) by retrospectively determining allergy immunotherapy (AIT) outcomes. Methods: This private practice, cohort study compared the relative value of SPT vs. IDT in 371 adults and children with suspected manifestations of allergy: chronic allergic rhinitis (AR), asthma and/or chronic otitis media with effusion (OME). The primary outcome measure was symptom resolution following immunotherapy, as determined by symptom severity questionnaires completed by patients before and after AIT. Results: Positive IDT identified 193 (52%) patients who would not otherwise have been diagnosed. IDT detected 3.7-fold more allergens per patient than SPT (8.56 vs. 2.3; p < 0.01). Patients positive only on IDT responded to AIT equally well as those identifiable by SPT, independent of allergen sensitivity (67% by SPT vs. 62% by IDT; p = 0.69, not significantly different). Conclusion: Intradermal titration can identify patients who will benefit from allergy immunotherapy more accurately than SPT. Outcomes analysis in 371 patients shows that IDT doubled their chance of successful treatment with no greater risk of therapeutic failure. Positive IDT, following negative SPT, is clinically relevant and offers superior sensitivity over SPT for detecting allergens clinically relevant to diagnosis of AIT-responsive atopic disease. [ABSTRACT FROM AUTHOR]

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Background: Identification of culprit drug causing adverse cutaneous drug reactions may not be possible clinically due to the intake of more than one drug. Aim: To compare the sensitivity of skin tests with gold standard oral rechallenge test to detect adverse cutaneous drug reactions. Materials and Methods: This is a prospective interventional hospital-based study of patients with adverse cutaneous drug reactions attending the outpatient department of dermatology and venereology at a tertiary care center over a 12-month period. Skin prick tests, intradermal tests, and oral rechallenge tests were performed in these patients and their sensitivities were compared. The data of quantitative nature is presented in mean and standard deviation, and categorical variables are presented in number and percentage. The sensitivity of skin tests is compared with the gold standard oral rechallenge test. Results: A total of 49 patients with adverse cutaneous drug reactions were evaluated. Clinical spectrum of adverse cutaneous drug reactions ranged from mild to severe, with fixed drug eruption being the commonest (55.1%) followed by maculopapular exanthem (32.7%). The highest incidence was with fluoroquinolones (43.8%) followed by nonsteroidal anti-inflammatory drugs. Fluoroquinolones were the major cause of fixed drug eruption followed by nonsteroidal anti-inflammatory drugs. The sensitivity of skin prick test and intradermal tests were 49% and 73%, respectively and the difference was highly significant (P < 0.001). The difference in sensitivity in skin prick test versus oral rechallenge test and intradermal test versus oral rechallenge test was also highly significant (P < 0.001). Limitations: Small sample size was a major limitation. Histopathological examinations and human leukocyte antigen associations could not be done. Conclusion: Predominant causative drugs were fluoroquinolones followed by nonsteroidal anti-inflammatory drugs. Sensitivities of skin prick test and intradermal test were quite good and these skin tests should be performed before oral rechallenge test in cases of adverse cutaneous drug reactions. [ABSTRACT FROM AUTHOR]

Background. Despite the increasing number of skin adverse drug reactions caused by nadroparin calcium have been reported, mostly, little is known regarding of their details of clinical characteristics, especially for generalized skin adverse drug reactions. We sought to evaluate localized and generalized characteristics of the skin adverse drug reaction to nadroparin calcium injection in pregnant women. Methods. A retrospective study was conducted on 6 pregnant women, who experienced localized and generalized skin adverse drug reactions during long-term nadroparin calcium injection. The patients' clinical and imaging information were retrieved from medical records. The skin prick test, patch test, and intradermal test were performed after they stopped lactation. Causality assessment of suspected adverse drug reactions was performed on these cases. Results. The average total dose of nadroparin calcium injection in the 6 cases was 64.17 ± 22.66. Localized skin adverse drug reaction, manifested as erythema at the injection point, appeared after 47.5 ± 17.4 days of subcutaneous injection of nadroparin calcium. Generalized urticaria-like lesions, progressing from the injection site on the abdomen, appeared in 5.17 ± 3.60 days after the first appearance of localized reaction, while laboratory test results revealed essential peripheral blood eosinophilia. All rashes in the 6 cases subsided in 2–5 weeks after drug withdrawal. After delivery, 5 of 6 cases received complete skin tests to evaluate drug hypersensitivity. Results presented positive in the intradermal test within 7 days. Both the skin prick test and skin patch test were negative. Localized skin reactions and generalized urticaria-like adverse drug reactions were considered as definitely and probably caused by nadroparin calcium injection, respectively. Conclusion. Subcutaneous injection of nadroparin calcium in pregnant women appears to be at risk of localized and generalized urticaria-like adverse drug reaction. It is important to follow up the pregnant woman during nadroparin calcium injection for evaluating adverse drug reactions. Timely detection of symptoms is pivotal in early diagnosis and treatment of adverse drug reactions. [ABSTRACT FROM AUTHOR]

Copyright of Veterinary Dermatology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)