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Original Article


Diagnostic Performance of the Atopy Patch Test With Inhalant Allergens


Fuiano N1, Diddi G1, Delvecchio M2, Incorvaia C3

1Pediatric Allergy Service, ASL Fg, Torremaggiore, Italy
2Department of Biomedical Sciences and Human Oncology, Giovanni XXIII Pediatric Hospital, Bari, Italy
3Allergy/Pulmonary Rehabilitation, ICP Hospital, Milan, Italy

J Investig Allergol Clin Immunol 2015; Vol. 25(1): 34-39



Background: This study evaluated the diagnostic performance of the atopy patch test (APT) compared with skin prick testing (SPT) and in vitro IgE measurement in a large group of patients with atopic dermatitis (AD) with or without respiratory symptoms (RS).

Methods: The study included 521 patients (292 males, 229 females; age, 0.5-18 years; median age, 6 years) with AD and RS with different clinical presentations: current AD, 47 patients (Group A); current AD and RS, 72 patients (Group B), past AD and RS, 69 patients (Group C); and RS only, 280 patients (Group D). Fifty-three healthy individuals served as controls. All participants underwent the APT, SPT, and CAP/RAST with the most common inhalant allergens. The presence of a control group allowed calculation of specificity and positive and negative predictive values.

Results: A significant difference was found for a positive APT versus both SPT and CAP/RAST (P<.0001) but not for SPT versus CAP/RAST. The differences for APT were significant in all group comparisons except group B vs C and group C vs D. In the control group, the APT was positive in 2% of cases (specificity of 96.2%), SPT was positive in 6% of cases (specificity of 88.4%), and CAP/RAST was positive in 4% of cases (specificity of 92.5%).

Conclusions: In young patients sensitized to inhalant allergens with AD in addition to RS, the APT has a superior diagnostic performance to SPT and in vitro IgE measurement.

Key words: Atopy patch test. Skin prick test. In vitro IgE test. Diagnostic performance. Specificity.