W T Corder1, N W Wilson. 1. Department of Pediatrics, West Virginia University, Morgantown, USA.
Abstract
BACKGROUND: The Greer DermaPIK is a plastic disposable device used for epicutaneous allergy skin testing. Various methods have been proposed for applying this device. The recommended methods are to use it as either a punch or scratch device. A third method- the prick, uses the device similarly to standard prick testing with the bifurcated needle. OBJECTIVE: To compare three methods of using the DermaPIK for epicutaneous skin testing with the bifurcated needle. METHODS: Twenty volunteers with a mean age of 30 years (range 6 to 45) were skin tested using saline and histamine. Each test was done in triplicate on the back. Discomfort for each technique was rated on a scale from 0 to 100. Wheal and erythema were measured at 15 minutes and a photograph was taken. RESULTS: The scratch method was rated highest in discomfort. The mean coefficient of variation for the punch method was 39.2% for erythema which was significantly higher than for the other methods (P < .0001). The scratch method had a mean wheal and erythema to saline of 3.85 +/- 1.3 and 6.23 +/- 2.2 that was significantly larger than the other methods (P < .001). There was no difference between the prick method and the bifurcated needle for discomfort or size of wheal/erythema to saline or histamine. CONCLUSIONS: The punch method is too imprecise and the scratch method produces considerable dermatographism. The prick method was comparable to the bifurcated needle in discomfort, sensitivity and precision.
BACKGROUND: The Greer DermaPIK is a plastic disposable device used for epicutaneous allergy skin testing. Various methods have been proposed for applying this device. The recommended methods are to use it as either a punch or scratch device. A third method- the prick, uses the device similarly to standard prick testing with the bifurcated needle. OBJECTIVE: To compare three methods of using the DermaPIK for epicutaneous skin testing with the bifurcated needle. METHODS: Twenty volunteers with a mean age of 30 years (range 6 to 45) were skin tested using saline and histamine. Each test was done in triplicate on the back. Discomfort for each technique was rated on a scale from 0 to 100. Wheal and erythema were measured at 15 minutes and a photograph was taken. RESULTS: The scratch method was rated highest in discomfort. The mean coefficient of variation for the punch method was 39.2% for erythema which was significantly higher than for the other methods (P < .0001). The scratch method had a mean wheal and erythema to saline of 3.85 +/- 1.3 and 6.23 +/- 2.2 that was significantly larger than the other methods (P < .001). There was no difference between the prick method and the bifurcated needle for discomfort or size of wheal/erythema to saline or histamine. CONCLUSIONS: The punch method is too imprecise and the scratch method produces considerable dermatographism. The prick method was comparable to the bifurcated needle in discomfort, sensitivity and precision.
Authors: Janice K Kiecolt-Glaser; Kathi L Heffner; Ronald Glaser; William B Malarkey; Kyle Porter; Cathie Atkinson; Bryon Laskowski; Stanley Lemeshow; Gailen D Marshall Journal: Psychoneuroendocrinology Date: 2009-01-15 Impact factor: 4.905
Authors: Kathi L Heffner; Janice K Kiecolt-Glaser; Ronald Glaser; William B Malarkey; Gailen D Marshall Journal: Ann Allergy Asthma Immunol Date: 2014-04-13 Impact factor: 6.347