DIFFERENCES IN SKIN-PRICK AND PATCH-TEST REACTIVITY ARE RELATED TO THE HETEROGENEITY OF ATOPIC ECZEMA IN INFANTS

Current data indicate an obvious relation between food allergy and ato pic eczema in infants. However, diagnostic methods for food allergy ne ed to be supplemented. The objective was to study the relevance of foo d patch testing in the detection of food allergy in correlation with o ral food challenge and skin prick tests in atopic infants. Infants wit h atopic eczema (n=113) aged 2-24 months were studied. Each patient wa s subjected to double-blind, placebo-controlled, or open cow's milk ch allenge, and skin prick and patch tests. Polysensitization, as judged from skin test results, was common in patients with atopic eczema (79/ 113). Cow's milk challenge was positive in 54/113 infants; reactions w ere immediate in 36/54 and delayed in 18/54. Immediate-type reactions were associated with skin prick test positivity and delayed reactions with patch test positivity. Altogether 26% of the cow's milk-allergic infants were detected by patch testing only. Patch testing improved th e accuracy of skin testing in the diagnosis of food allergy in infants with atopic eczema, but it needs to be standardized. Polysensitizatio n appears to be more common than generally believed among infants with atopic eczema.