PURPOSE: These days 5 TU purified protein derivative (PPD) is substituted with 2 TU PPD for the tuberculin skin test, a test essential in the diagnosis of tuberculosis in pediatric population. However, there had been no adequate criteria for the positivity of 2 TU PPD skin test. This study was performed to clarify the criteria of positive reactivity of 2 TU PPD skin test. The reactivity of 2 TU PPD was compared to that of 5 TU PPD. METHODS: One hundred and six medical students were tested with Mantoux method. Diameters of induration were measured 72 hours after the intradermal injections of 2 TU and 5 TU PPDs. Past history and family history of tuberculosis, history of BCG administration and the presence of BCG scar were recorded. RESULTS: One hundred and three subjects completed the study. Mean diameter of 2 TU tuberculin test was 10.3 mm and that of 5 TU test was 14.4mm, which was significantly different (P<0.001). The diameters were 0-24mm in the 2 TU test and 0-25mm in the 5 TU test. The diameter of induration in 2 TU test was positively correlated to that in 5 TU test (r2=0.63). Eighty-six subjects (83.5%) in the 2 TU test and 92 subjects (89.3%) in the 5 TU test had diameters of induration of 5mm or more; 59 (57.3%) subjects in the 2 TU test and 83 (80.6%) subjects in the 5 TU test had diameters of induration of 10 mm or more; 27 (26.2%) in the 2 TU test and 64 (62.1%) in the 5 TU test had diameters of induration of 15mm or more. Seventy-six of 103 subjects (73.7%) had greater diameters of induration in 5 TU test than in 2 TU, 22 (21.4%) had the same diameters, and 5 (4.9%) had greater diameters of induration in 2 TU test than in 5 TU test, and the last 5 subjects had indurations of more than 10mm diameter in both 2 TU and 5 TU tests. CONCLUSION: The criterion of positivity in 2 TU PPD skin test, essential for the diagnosis of tuberculosis, is different from that in 5 TU test. In this study, 6 mm or more was adequate for the criterion of positivity and 10mm or more for the criterion of strong positivity. Further studies should be done to establish a criterion for the pediatric population.
Cicatrix ; Diagnosis ; Humans ; Injections, Intradermal ; Mycobacterium bovis ; Skin Tests* ; Skin* ; Students, Medical ; Tuberculin ; Tuberculin Test ; Tuberculosis

Iodinated contrast media (CM) can cause immediate and late reactions. We treated a patient with a recurrent generalized maculopapular rash and a fever that occurred within two days of exposure to iodinated CM, iopromide (Ultravist(R)), for chest computed tomography. We performed skin testing including prick tests, intradermal tests, and patch tests. Our findings indicated a late skin reaction to Ultravist(R) in addition to cross-reactions to other iodinated CM such as ioversol (Optiray(R)), iohexol (Iobrix(R)), and iobitridol (Xenetix(R)). In this study, we report the case of a patient diagnosed with a late adverse reaction to Ultravist(R) in addition to cross-reactions to other iodinated CM.
Contrast Media ; Exanthema ; Fever ; Humans ; Intradermal Tests ; Iohexol ; Patch Tests ; Skin ; Skin Tests ; Thorax ; Triiodobenzoic Acids

BACKGROUND: Althogh drug euption refers to a common dermatological condition, there are numerous holdbacks on the diagnosis. OBJECTIVE: This study atternpts to define the clinical features and causavite drug of the patients with drug eruptions, and to evalarate the diagnostic value of various skin tests. METHOD: 130 patients with drug eruptions were reviewed clinically. In 54 patients, intradermal test, patch test, and scratch patch test were performed using suspected drugs. Result : The exanthematous eruption(53.0%), fixed drug eruptior.(29.2%), and urticaria(6.2%) were the common types of the drug eruption. The common causative agenst of drug eruptions were antibiotics/antimicrobials, antipyretics/NSAIDs, and CNS depressants. 28 paitients out of the 54 patients on skin tests with suspected drugs had positive results in at least one slinest. CONCLUSION: In our study, we were able to obtain somewhat meaningfi 1 results based on data from the combination of various skin tests.
Central Nervous System Depressants ; Diagnosis ; Drug Eruptions* ; Humans ; Intradermal Tests ; Patch Tests ; Skin Tests* ; Skin*

Diagnostic methods for drug allergy include the patient's history, in vivo skin test, in vitro laboratory test, and provocation test. However, the history is often not reliable, procedures for in vivo and in vitro tests are not standardized, and provocation tests are sometimes harmful to patients. Generally, skin prick and intradermal tests are useful for immediate reactions; in contrast, patch test and delayed reading of both skin prick and intradermal tests are helpful for delayed reactions. A drug provocation test is the gold standard for both responses, and it is necessary to be aware of exact indications and contraindications with appropriate drugs, doses, and intervals. To date, several methods have been developed to detect culprit agents for drug hypersensitivity reactions, but they are neither completely well validated nor standardized. Based on this awareness and necessity, the Korean Academy of Asthma, Allergy and Clinical Immunology launched the Standardization Committee to review the international guidelines and the literature, and then developed the consensus report on the procedures and applications of diagnostic tests for drug allergy.
Allergy and Immunology ; Asthma ; Consensus ; Diagnostic Tests, Routine* ; Drug Hypersensitivity* ; Humans ; Hypersensitivity ; In Vitro Techniques ; Intradermal Tests ; Patch Tests ; Skin ; Skin Tests

BACKGROUND: Cases of dermatitis induced by the injection of certain drugs have been reported. OBJECTIVE: The aim of this study was to assess the cause and clinicopathologic findings of injection-induced dermatitis, and to reveal whether the reaction has any relation to the patient's age, injection site, drug concentration, and time interval from the injection to the occurrence of the skin lesion. METHODS: In this study, we enrolled 10 patients who developed erythematous skin lesions after the injection of causative drugs. The lesions were compared to each other according to the injection site, time interval from the injection to the occurrence of the skin lesion, and clinical characteristics. We performed intradermal and patch tests in each patient with different concentrations of causative drugs. RESULTS: The most common causative drugs were diclofenac and vitamin K1. The eczematous type was the most frequent clinical type. The intradermal test showed more positive results than the patch test. The patch tests with diclofenac (as is, 2.5%, 5%, and 10%) and vitamin K1 (10%) were all negative in 10 patients. Furthermore, intradermal tests with diclofenac (as is) and vitamin K1 (0.1%, 1%, and 10%) were performed in 8 patients. Six patients had a positive reaction, consisting of erythema, induration, and vesiculation, after 1 and 2 days. CONCLUSION: Our results showed that the most common causative agents were diclofenac and vitamin K1. Moreover, it seems that that intradermal test is more useful than the patch test in the diagnosis of injection-induced dermatitis.
Dermatitis* ; Diagnosis ; Diclofenac ; Erythema ; Humans ; Intradermal Tests ; Patch Tests ; Skin ; Vitamin K ; Vitamin K 1

A 48-year-old woman, who had had tattoo on her eyebrows, was seen with pruitic erythematous indurated plaques on the tattooing sites. The skin react ion was begun to observe about 4 weeks after getting tattoo. Skin biopsy specimens from the indurated lesions showed granulomatous reactions. Intradermal tests by means of multiple pricks and patch test were done on her low back with the same tattoo dye and also 4 others available in Korea. Serial punch biopsy specimens were obtained from the sites of intradermal test at 2nd, 7th, 28th, and 56th day after intradermal test. Granulomatous reactions were found in the spiecimens taken at the 28th and 56th day.
Biopsy ; Eyebrows ; Female ; Humans ; Intradermal Tests ; Korea ; Middle Aged ; Patch Tests ; Skin ; Tattooing

Fixed drug eruption is a pattern of a drug-induced cutaneous reaction. It is characterized by skin erythematous plaques that recur at the same site each time the drug is administered. Now, we report the case of a 26-year-old woman who presented with 2 ill-defined erythematous patches on her back with itching sensation. The patient had a history of ciprofloxacin medication. The patch test with suspected drugs showed negative reactions, but intradermal tests were positive reactions. The patient was diagnosed with fixed-drug eruption due to ciprofloxacin.
Ciprofloxacin ; Drug Eruptions ; Female ; Humans ; Intradermal Tests ; Patch Tests ; Pruritus ; Sensation ; Skin

A fixed drug eruption (FDE) is a cutaneous reaction caused by various drugs. Mesna is used to decrease urotoxic side effect of cyclophosphamide and there have been no previously reported cases in Korea for any adverse reactions to this drug. Herein, we report a case of a FDE caused by mesna. A 34-year-old woman presented with asymptomatic, brownish macules and patches on the face and back for the past 4 months. She had been treated for SLE with monthly pulses of intravenous cyclophosphamide and mesna for 6 months. She had experienced similar episodes after injection of mesna. The skin biopsy specimen taken from her showed vacuolar degeneration of the basal cell layer and perivascular lymphohistiocyte infiltration in the papillary dermis. We performed prick test, scratch patch test, and intradermal test with mesna and confirmed that a FDE was caused by this drug.
Adult ; Biopsy ; Cyclophosphamide ; Dermis ; Drug Eruptions ; Female ; Humans ; Intradermal Tests ; Korea ; Mesna ; Patch Tests ; Skin

Glatiramer acetate (GA) is a synthetic amino acid polymer, used for relapsing-remitting multiple sclerosis. The most common adverse effect of GA is a skin reaction at the injection site with a probable IgE-mediated mechanism. We report a case of a 45-year-old woman with multiple sclerosis and urticaria to interferon-beta1a, who underwent a challenge test to GA. She presented itching wheals at the intradermal sites. A month later the patient repeated the test and presented the same reactions of the first test. The next day she continued the test with subcutaneous injections. One hour later she presented a flare up of the reactions appeared during the previous 2 tests. No reactions appeared at the subcutaneous injection sites. The patient also presented dyspnea. Flare-up reactions are characterized by the reactivation of previously positive reactions to intradermal or skin tests triggered by patch testing and after systemic provocation with an allergen. The phenomenon is not common to drugs. The mechanisms involved in this reaction seem to be heterogeneous and are not completely understood. To our knowledge this is the first case of allergic reaction to GA manifested as a flare-up reaction during challenge test.
Dyspnea ; Female ; Humans ; Hypersensitivity* ; Injections, Subcutaneous ; Interferons* ; Intradermal Tests ; Middle Aged ; Multiple Sclerosis ; Multiple Sclerosis, Relapsing-Remitting ; Patch Tests ; Polymers ; Pruritus ; Skin ; Skin Tests ; Urticaria

BACKGROUND: Soaps are the most widely used body cleanser and sometimes cause irritation of the skin. OBJECTIVE: Our purpose was to compare the skin irritancy of 6 soaps using noninvasive techniques. METHODS: The skin responses to patch test with 6 soaps were measured by visual scoring, evaporimeter and corneometer. RESULTS: The results are summarized as follows. 1. F soap was shown to cause the least irritancy measured by visual scoring and corneometer. But using evaporimeter, there were no differences in irritancy between the 6 soaps. 2. Through correlation analysis, we found that the evaluation of the evaporimeter was closely related to visual measurement. CONCLUSION: Soap irritancy can be measured by noninvasive techniques, such as the evaporimeter, corneometer, laser doppler flowmetry and visual scoring. Further study of evaluation after short and repeat contacts with soap are needed.
Laser-Doppler Flowmetry ; Patch Tests ; Skin ; Soaps*