title: Skin prick reaction and nasal provocation response in diagnosis of nasal allergy to the house dust mite.
abstract: BACKGROUND
  The allergen skin test is commonly used to ensure the diagnosis of allergic rhinitis even though positive results do not necessarily indicate that rhinitis is of allergic origin.
  
  
  OBJECTIVE
  To determine the association between skin prick reactions and nasal provocation responses to Dermatophagoides pteronyssinus (Der p) allergen extract.
  
  
  METHODS
  Twenty-six patients with perennial rhinitis and 25 controls underwent skin prick and nasal provocation tests to standardized Der p allergen extract. With the use of allergen extract titration delivered by a metered dose pump, nasal stuffiness, itching, and sneezing were noted, the amount of secretions measured, and nasal airway resistance was recorded by active anterior rhinomanometry.
  
  
  RESULTS
  The majority of the patients with rhinitis (20/26), but none of the controls, exhibited strong skin test positivity (4+) to Der p allergen extract. In addition, the majority of the patients with 4+ skin reactions (16/20) had moderate to severe rhinitis. Significantly increased nasal reactivity to the allergen was also observed among those with 4+ skin test positivity. The controls exhibited nasal provocation responses only with significantly higher end-point doses of the allergen extract regardless of the skin test results.
  
  
  CONCLUSIONS
  Only 4+ skin test positivity was closely associated with increased nasal reactivity to Der p allergen among the patients with perennial rhinitis. The nasal provocation technique would be a useful adjunct testing to ensure the diagnosis of nasal allergy to the Der p mite, particularly among those patients with rhinitis with only mild to moderate skin test positivity.
authors.affiliation: Department of Pharmacology, Chiang Mai University, Faculty of Medicine, Thailand.
authors.forename: S
authors.initials: S
authors.lastname: Kanthawatana
authors.forename: W
authors.initials: W
authors.lastname: Maturim
authors.forename: S
authors.initials: S
authors.lastname: Fooanan
authors.forename: M
authors.initials: M
authors.lastname: Trakultivakorn
mesh_terms: D000293:Adolescent; D000328:Adult; D000485:Allergens / Q000008:administration & dosage; D000818:Animals; D039741:Antigens, Dermatophagoides; D002648:Child; D004306:Dose-Response Relationship, Immunologic; D004391:Dust / Q000009:adverse effects; D005260:Female; D006023:Glycoproteins / Q000276:immunology; D006801:Humans; D008297:Male; D008925:Mites / Q000276:immunology*; D009299:Nasal Provocation Tests; D012130:Respiratory Hypersensitivity / Q000175:diagnosis*; D012221:Rhinitis, Allergic, Perennial / Q000175:diagnosis; D006255:Rhinitis, Allergic, Seasonal / Q000175:diagnosis; D012882:Skin Tests
chemical_list: D000485:Allergens; D039741:Antigens, Dermatophagoides; D004391:Dust; D006023:Glycoproteins