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Standard Patch Series Around the World. Different Place, Different Patches
AB154 Abstracts
501
Diagnosis of Food and Environmental Allergies in Patients Referred from Dermatology Clinic to Allergy/Immunology Clinic in a Tertiary Care Pediatric Center
Samantha Knox1, Rebecca Scherzer, MD, FAAAAI1, Elizabeth A. Erwin, MD2, Joy Mosser-Goldfarb2; 1Nationwide Children’s Hospital, Columbus, OH, 2Nationwide Children’s Hospital. RATIONALE: There is overlap between pediatric dermatology and allergy/immunology in care of atopic skin disorders. Studies confirmed the relationship between certain foods and eczema. We hypothesized that a large percentage of children referred to Allergy from Dermatology would have positive skin-prick testing to environmental and food allergens. METHODS: We retrospectively reviewed 166 charts of patients referred from Dermatology to Allergy at Nationwide Children’s Hospital from January 2012 - December 2014. Demographics and clinical information including referral and final diagnoses and skin testing results were collected and differences analyzed using SPSS version 2.1 and Mann Whitney U test. RESULTS: Of 114 patients who were scheduled and kept their appointment; 45% were female and ages ranged from 3 months - 21 years. The most common referral diagnosis was eczema (95/114). Skin prick testing was performed in 91/114 and 64 patients had positive results. Of the 95 with eczema, 80 patients were tested and 52 had positive results. The most common food sensitizations in eczema patients were peanuts, tree nuts, and egg. The most common aeroallergens sensitivities were dust mite, tree pollen, and cats. Patients with positive testing to foods ranged from 3 months - 9 years of age (median52) while patients with sensitization to aeroallergens were age 5 months-13 years (median55). This difference was statistically significant (p50.001). CONCLUSIONS: Among pediatric eczema patients referred to allergy/ immunology from dermatology, 65% had food or environmental sensitizations by skin testing, reinforcing the benefit of allergy evaluation for these patients.
SUNDAY
502
Standard Patch Series Around the World. Different Place, Different Patches
Jose L. Garcıa-Abujeta1, Monica Anton Girones2, Carlos Hernando de Larramendi1, Javier Montoro3, Leticia de las Vecillas4, Sandra Vicario1, Fernando Rodrıguez4; 1Hospital Marina Baixa, Villajoyosa, Spain, 2Hospital de Vinalop o, Elche, Spain, 3Hospital Arnau de Vilanova, Valencia, Spain, 4Hospital Universitario Marques de Valdecilla, Santander, Spain. RATIONALE: The baseline series (BS) of patch tests include those allergens considered to be frequent cause of allergic contact dermatitis (ACD). In a previous study we analyzed and compared different European BS. METHODS: We analyzed the BS used in 2015 in different countries (EEUU, Brazil, China, Japan, India, Korea and Australia), geographic areas (Europe, Latin-America) and the International Contact Dermatitis Group (ICDRG) BS. RESULTS: The analysed batteries include different 119 allergens. The minimal BS of the ICDRG includes 32 allergens and the extended one 87. The number of substances range between 24 (Japanese BS) and 60 (Australian and Chinese BS), mean 38. Only eleven allergens (9%) are present in all BS: PTB formaldehyde, cobalt, colophonium, formaldehyde, Peru balsam, nickel, chrome, pphenylendiamine and the fragrance I, paraben and thiuram mixes. Another six haptens appear in almost all BS: mercaptobenzothiazole (except Japanese), epoxy resin (except Korean), mercapto mix (except Brazilian), kathon CG (except Indian), neomicine (except Chinese) and quaternium-15 (except Indian and Japanese). Forty allergens (33.6%) are present only in one BS: 12 in Australian, 10 in Chinese, 6 in Brazilian, 3 in Latin-American, Indian and Japanese and one in the North American BS.
J ALLERGY CLIN IMMUNOL FEBRUARY 2016
The concentrations used varied in 18 substances (15%). CONCLUSIONS: There are important differences between the different BS, in the number of tested substances, in their composition and in the concentrations used. The variations regarding BS components used are probably in relation to the different occupational activities, usual topical drugs used, use or not of mixes substances and in recent studies.
503
Dermatographism, Atopic Dermatitis and Other Atopic/Related Non-Atopic Disorders
Alanna G. Wong, MD1, Johnson T. Wong, MD, FAAAAI2; 1Montefiore Medical Center, Bronx, NY, 2Division of Rheumatology Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA. RATIONALE: We wish to quantify our observed frequent concurrence of dermatographism (DG ) and atopic dermatitis (AD) as both conditions can synergize in causing pruritic inflammatory skin discomfort. We also wish to study the incidence of atopic/related non-atopic backgrounds in patients with DG. METHODS: Records of 50 recent patients from an academic outpatient practice that have confirmed moderate to severe chronic DG were reviewed in regards to the presence of AD and various other atopic/related nonatopic disorders. RESULTS: The majority of these patients had a pruritic skin disorder as their presenting complaint whereas others had coexisting DG or developed this condition during the evaluation and treatment of other atopic/related non-atopic disorders. 31/50(62%) have concurrent AD. Of these patients, 8/12(67%) that were questioned specifically found that treatment of the AD was helpful in controlling the DG. Only 2/50 (4%) also have other physical urticarias (PUO) and only 1/50 (2%) have delayed pressure urticaria (DPU). 20/50 (40%) have nonphysical urticaria (NPU) and 13/50 (26%) have angioedema. 40/50 (80%) of the patients have rhinosinusitis/ conjunctivitis and 33/50 (66%) have asthma. 14/50 (28%) have concurrent food sensitivity. CONCLUSIONS: Most DG patients have concurrent AD with treatment of the AD helpful in controlling the DG. Most DG patients do not have concurrent PUO or DPU but many have NPU. However, most DG patients have respiratory/ocular diseases and a significant number have food sensitivity, though this is not necessarily causative. Dermatographism, in addition to atopic dermatitis, should be considered as a potential dermatologic manifestation of atopic/related non-atopic disorders.
501
Diagnosis of Food and Environmental Allergies in Patients Referred from Dermatology Clinic to Allergy/Immunology Clinic in a Tertiary Care Pediatric Center
Samantha Knox1, Rebecca Scherzer, MD, FAAAAI1, Elizabeth A. Erwin, MD2, Joy Mosser-Goldfarb2; 1Nationwide Children’s Hospital, Columbus, OH, 2Nationwide Children’s Hospital. RATIONALE: There is overlap between pediatric dermatology and allergy/immunology in care of atopic skin disorders. Studies confirmed the relationship between certain foods and eczema. We hypothesized that a large percentage of children referred to Allergy from Dermatology would have positive skin-prick testing to environmental and food allergens. METHODS: We retrospectively reviewed 166 charts of patients referred from Dermatology to Allergy at Nationwide Children’s Hospital from January 2012 - December 2014. Demographics and clinical information including referral and final diagnoses and skin testing results were collected and differences analyzed using SPSS version 2.1 and Mann Whitney U test. RESULTS: Of 114 patients who were scheduled and kept their appointment; 45% were female and ages ranged from 3 months - 21 years. The most common referral diagnosis was eczema (95/114). Skin prick testing was performed in 91/114 and 64 patients had positive results. Of the 95 with eczema, 80 patients were tested and 52 had positive results. The most common food sensitizations in eczema patients were peanuts, tree nuts, and egg. The most common aeroallergens sensitivities were dust mite, tree pollen, and cats. Patients with positive testing to foods ranged from 3 months - 9 years of age (median52) while patients with sensitization to aeroallergens were age 5 months-13 years (median55). This difference was statistically significant (p50.001). CONCLUSIONS: Among pediatric eczema patients referred to allergy/ immunology from dermatology, 65% had food or environmental sensitizations by skin testing, reinforcing the benefit of allergy evaluation for these patients.
SUNDAY
502
Standard Patch Series Around the World. Different Place, Different Patches
Jose L. Garcıa-Abujeta1, Monica Anton Girones2, Carlos Hernando de Larramendi1, Javier Montoro3, Leticia de las Vecillas4, Sandra Vicario1, Fernando Rodrıguez4; 1Hospital Marina Baixa, Villajoyosa, Spain, 2Hospital de Vinalop o, Elche, Spain, 3Hospital Arnau de Vilanova, Valencia, Spain, 4Hospital Universitario Marques de Valdecilla, Santander, Spain. RATIONALE: The baseline series (BS) of patch tests include those allergens considered to be frequent cause of allergic contact dermatitis (ACD). In a previous study we analyzed and compared different European BS. METHODS: We analyzed the BS used in 2015 in different countries (EEUU, Brazil, China, Japan, India, Korea and Australia), geographic areas (Europe, Latin-America) and the International Contact Dermatitis Group (ICDRG) BS. RESULTS: The analysed batteries include different 119 allergens. The minimal BS of the ICDRG includes 32 allergens and the extended one 87. The number of substances range between 24 (Japanese BS) and 60 (Australian and Chinese BS), mean 38. Only eleven allergens (9%) are present in all BS: PTB formaldehyde, cobalt, colophonium, formaldehyde, Peru balsam, nickel, chrome, pphenylendiamine and the fragrance I, paraben and thiuram mixes. Another six haptens appear in almost all BS: mercaptobenzothiazole (except Japanese), epoxy resin (except Korean), mercapto mix (except Brazilian), kathon CG (except Indian), neomicine (except Chinese) and quaternium-15 (except Indian and Japanese). Forty allergens (33.6%) are present only in one BS: 12 in Australian, 10 in Chinese, 6 in Brazilian, 3 in Latin-American, Indian and Japanese and one in the North American BS.
J ALLERGY CLIN IMMUNOL FEBRUARY 2016
The concentrations used varied in 18 substances (15%). CONCLUSIONS: There are important differences between the different BS, in the number of tested substances, in their composition and in the concentrations used. The variations regarding BS components used are probably in relation to the different occupational activities, usual topical drugs used, use or not of mixes substances and in recent studies.
503
Dermatographism, Atopic Dermatitis and Other Atopic/Related Non-Atopic Disorders
Alanna G. Wong, MD1, Johnson T. Wong, MD, FAAAAI2; 1Montefiore Medical Center, Bronx, NY, 2Division of Rheumatology Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA. RATIONALE: We wish to quantify our observed frequent concurrence of dermatographism (DG ) and atopic dermatitis (AD) as both conditions can synergize in causing pruritic inflammatory skin discomfort. We also wish to study the incidence of atopic/related non-atopic backgrounds in patients with DG. METHODS: Records of 50 recent patients from an academic outpatient practice that have confirmed moderate to severe chronic DG were reviewed in regards to the presence of AD and various other atopic/related nonatopic disorders. RESULTS: The majority of these patients had a pruritic skin disorder as their presenting complaint whereas others had coexisting DG or developed this condition during the evaluation and treatment of other atopic/related non-atopic disorders. 31/50(62%) have concurrent AD. Of these patients, 8/12(67%) that were questioned specifically found that treatment of the AD was helpful in controlling the DG. Only 2/50 (4%) also have other physical urticarias (PUO) and only 1/50 (2%) have delayed pressure urticaria (DPU). 20/50 (40%) have nonphysical urticaria (NPU) and 13/50 (26%) have angioedema. 40/50 (80%) of the patients have rhinosinusitis/ conjunctivitis and 33/50 (66%) have asthma. 14/50 (28%) have concurrent food sensitivity. CONCLUSIONS: Most DG patients have concurrent AD with treatment of the AD helpful in controlling the DG. Most DG patients do not have concurrent PUO or DPU but many have NPU. However, most DG patients have respiratory/ocular diseases and a significant number have food sensitivity, though this is not necessarily causative. Dermatographism, in addition to atopic dermatitis, should be considered as a potential dermatologic manifestation of atopic/related non-atopic disorders.