Atopy patch test--reproducibility and elicitation of itch in different application sites

Abstract

We evaluated the reproducibility of atopy patch test reactions and the quality and quantity of itch in 16 patients with atopic eczema and a history of a positive atopy patch test reaction, comparing three different application sites. The allergen was re-applied simultaneously on both forearms and the back. Intensity and quality of pruritus were evaluated using a visual analogue scale and the Eppendorf itch questionnaire, respectively. The atopy patch test reaction was highly reproducible, occurring in 15/16 (94%) patients. Pruritus was reported by 14/16 (88%) patients. There was no significant difference in either the intensity or quality of itch between the two forearms and the back (p>0.05). The mean peak visual analogue scale itch score was comparable across all three test sites (range 28.3-31.9). Regarding quantification of test reactions, a positive reaction was more frequent on the back (94% versus 69% on the arms) and the peak atopy patch test score was higher on the back compared with the arms (right forearm, p=0.0018 and left forearm, p=0.0683). Allergens should preferably be applied on the back for the atopy patch test. However, the atopy patch test can induce atopic itch irrespective of the application site.