GRAMINEAE POLLEN AS TRIGGER FACTORS OF ATOPIC ECZEMA - EVALUATION OF DIAGNOSTIC MEASURES USING THE ATOPY PATCH TEST

After contact with grass pollen, seasonal exacerbations of eczematous skin lesions have been described in a subgroup of patients with atopic eczema (AE), Epicutaneous patch testing with aeroallergens (atopy pat ch test, APT) has been used to investigate these patients, We performe d comparative APT in 79 patients with AE and 20 control subjects (14 n on-atopic volunteers and six patients with grass pollen allergic rhino conjunctivitis). Subjects were tested with grass pollen allergen extra ct in petrolatum and with unprocessed native dry pollen of Dactylis gl omerata. Results after 48 h were compared with the patient's history, corresponding skin prick test and specific IgE, Fifteen of the 79 AE p atients showed clear-cut eczematous reactions to unprocessed D, glomer ata pollen; 14 of these had an elevated serum IgE to D. glomerata and 13 had a positive skin prick test. Twenty patients had a positive APT reaction to grass pollen allergen extract, including 12 of the D. glom erata reactive subjects (P<0.001). Positive patch test reactions to D, glomerata were seen in 66.7% of cases with and 10.5% of patients with out a predictive history of exacerbations during the pollen season. Fo r the standardized extract, these percentages were 75% vs. 16.4% (P < 0.001). No side-effects were observed, Control subjects showed no posi tive reactions, We conclude that grass pollen preparations map be used to investigate trigger factors for eczematous skin lesions in a subgr oup of patients with AE.