title: Wheal and flare reactions in skin prick tests of patients treated with montelukast alone or in combination with antihistamines.
abstract: BACKGROUND
  Because antileukotrienes may inhibit inflammation, it is plausible that montelukast administered for a long time could suppress skin wheal and flare reaction, and thus, it should be discarded prior to the tests. This study assessed the effect of long-lasting treatment with montelukast alone or in combination with antihistamines on wheal and flare in skin pricks tests (SPT) in patients sensitized to perennial allergens.
  
  
  METHODS
  We conducted a 32-week, double-blind, placebo-controlled, cross-over and randomized trial that implicated two arms: arm A, 20 patients received levocetirizine, montelukast with or without levocetirizine or placebo; arm B, 20 patients received desloratadine, montelukast with or without desloratadine or placebo. All treatment periods lasted 6 weeks and were separated by 2-week washouts. At baseline and on the last day of each treatment period, SPT were performed in all participants.
  
  
  RESULTS
  Both levocetirizine and desloratadine in monotherapy, or in combination with montelukast, were effective in reducing wheal and flare in SPT. Monotherapy with montelukast did not change the size of the wheal for either histamine or for house dust mites, in either arm of the study, but significantly reduced the size of flare for histamine in arm A. Addition of montelukast to antihistamine did not exceed efficacy of monotherapy with antihistamine in both arms of the study.
  
  
  CONCLUSIONS
  Since the size of wheal determines the results of SPT, montelukast, even taken for a long time, does not have to be discarded prior to the tests.
authors.affiliation: Department of Internal Medicine and Diabetology, Medical University of Lodz, Lodz, Poland.
authors.forename: Malgorzata Gorska
authors.initials: MG
authors.lastname: Ciebiada
authors.forename: Marcin
authors.initials: M
authors.lastname: Barylski
authors.forename: Maciej
authors.initials: M
authors.lastname: Ciebiada
mesh_terms: D000085:Acetates / Q000494:pharmacology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000941:Antigens; D039741:Antigens, Dermatophagoides / Q000276:immunology; D017332:Cetirizine / Q000494:pharmacology; D018592:Cross-Over Studies; D003521:Cyclopropanes; D004311:Double-Blind Method; D005260:Female; D006633:Histamine Antagonists / Q000494:pharmacology*; D006801:Humans; D020024:Leukotriene Antagonists / Q000494:pharmacology*; D017336:Loratadine / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011804:Quinolines / Q000494:pharmacology*; D012221:Rhinitis, Allergic, Perennial / Q000175:diagnosis / Q000276:immunology; D012867:Skin / Q000473:pathology*; D012882:Skin Tests; D013440:Sulfides; D055815:Young Adult
chemical_list: D000085:Acetates; D000941:Antigens; D039741:Antigens, Dermatophagoides; D003521:Cyclopropanes; D006633:Histamine Antagonists; D020024:Leukotriene Antagonists; D011804:Quinolines; D013440:Sulfides; D017336:Loratadine; C093875:montelukast; D017332:Cetirizine