The Lancet Weight Determines Wheal Diameter in Response to Skin Prick Testing with Histamine.
<h4>Background</h4>Skin prick test (SPT) is a common test for diagnosing immunoglobulin E-mediated allergies. In clinical routine, technicalities, human errors or patient-related biases, occasionally results in suboptimal diagnosis of sensitization.<h4>Objective</h4>Although...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2016-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0156211&type=printable |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849723592851324928 |
|---|---|
| author | Hjalte H Andersen Anna Charlotte Lundgaard Anne S Petersen Lise E Hauberg Neha Sharma Sofie D Hansen Jesper Elberling Lars Arendt-Nielsen |
| author_facet | Hjalte H Andersen Anna Charlotte Lundgaard Anne S Petersen Lise E Hauberg Neha Sharma Sofie D Hansen Jesper Elberling Lars Arendt-Nielsen |
| author_sort | Hjalte H Andersen |
| collection | DOAJ |
| description | <h4>Background</h4>Skin prick test (SPT) is a common test for diagnosing immunoglobulin E-mediated allergies. In clinical routine, technicalities, human errors or patient-related biases, occasionally results in suboptimal diagnosis of sensitization.<h4>Objective</h4>Although not previously assessed qualitatively, lancet weight is hypothesized to be important when performing SPT to minimize the frequency of false positives, false negatives, and unwanted discomfort.<h4>Methods</h4>Accurate weight-controlled SPT was performed on the volar forearms and backs of 20 healthy subjects. Four predetermined lancet weights were applied (25 g, 85 g, 135 g and 265 g) using two positive control histamine solutions (1 mg/mL and 10 mg/mL) and one negative control (saline). A total of 400 SPTs were conducted. The outcome parameters were: wheal size, neurogenic inflammation (measured by superficial blood perfusion), frequency of bleeding, and the lancet provoked pain response.<h4>Results</h4>The mean wheal diameter increased significantly as higher weights were applied to the SPT lancet, e.g. from 3.2 ± 0.28 mm at 25 g to 5.4 ± 1.7 mm at 265 g (p<0.01). Similarly, the frequency of bleeding, the provoked pain, and the neurogenic inflammatory response increased significantly. At 265 g saline evoked two wheal responses (/160 pricks) below 3 mm.<h4>Conclusion and clinical relevance</h4>The applied weight of the lancet during the SPT-procedure is an important factor. Higher lancet weights precipitate significantly larger wheal reactions with potential diagnostic implications. This warrants additional research of the optimal lancet weight in relation to SPT-guidelines to improve the specificity and sensitivity of the procedure. |
| format | Article |
| id | doaj-art-eb992a8cde24433f94740a0d4bdac8e4 |
| institution | DOAJ |
| issn | 1932-6203 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-eb992a8cde24433f94740a0d4bdac8e42025-08-20T03:10:58ZengPublic Library of Science (PLoS)PLoS ONE1932-62032016-01-01115e015621110.1371/journal.pone.0156211The Lancet Weight Determines Wheal Diameter in Response to Skin Prick Testing with Histamine.Hjalte H AndersenAnna Charlotte LundgaardAnne S PetersenLise E HaubergNeha SharmaSofie D HansenJesper ElberlingLars Arendt-Nielsen<h4>Background</h4>Skin prick test (SPT) is a common test for diagnosing immunoglobulin E-mediated allergies. In clinical routine, technicalities, human errors or patient-related biases, occasionally results in suboptimal diagnosis of sensitization.<h4>Objective</h4>Although not previously assessed qualitatively, lancet weight is hypothesized to be important when performing SPT to minimize the frequency of false positives, false negatives, and unwanted discomfort.<h4>Methods</h4>Accurate weight-controlled SPT was performed on the volar forearms and backs of 20 healthy subjects. Four predetermined lancet weights were applied (25 g, 85 g, 135 g and 265 g) using two positive control histamine solutions (1 mg/mL and 10 mg/mL) and one negative control (saline). A total of 400 SPTs were conducted. The outcome parameters were: wheal size, neurogenic inflammation (measured by superficial blood perfusion), frequency of bleeding, and the lancet provoked pain response.<h4>Results</h4>The mean wheal diameter increased significantly as higher weights were applied to the SPT lancet, e.g. from 3.2 ± 0.28 mm at 25 g to 5.4 ± 1.7 mm at 265 g (p<0.01). Similarly, the frequency of bleeding, the provoked pain, and the neurogenic inflammatory response increased significantly. At 265 g saline evoked two wheal responses (/160 pricks) below 3 mm.<h4>Conclusion and clinical relevance</h4>The applied weight of the lancet during the SPT-procedure is an important factor. Higher lancet weights precipitate significantly larger wheal reactions with potential diagnostic implications. This warrants additional research of the optimal lancet weight in relation to SPT-guidelines to improve the specificity and sensitivity of the procedure.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0156211&type=printable |
| spellingShingle | Hjalte H Andersen Anna Charlotte Lundgaard Anne S Petersen Lise E Hauberg Neha Sharma Sofie D Hansen Jesper Elberling Lars Arendt-Nielsen The Lancet Weight Determines Wheal Diameter in Response to Skin Prick Testing with Histamine. PLoS ONE |
| title | The Lancet Weight Determines Wheal Diameter in Response to Skin Prick Testing with Histamine. |
| title_full | The Lancet Weight Determines Wheal Diameter in Response to Skin Prick Testing with Histamine. |
| title_fullStr | The Lancet Weight Determines Wheal Diameter in Response to Skin Prick Testing with Histamine. |
| title_full_unstemmed | The Lancet Weight Determines Wheal Diameter in Response to Skin Prick Testing with Histamine. |
| title_short | The Lancet Weight Determines Wheal Diameter in Response to Skin Prick Testing with Histamine. |
| title_sort | lancet weight determines wheal diameter in response to skin prick testing with histamine |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0156211&type=printable |
| work_keys_str_mv | AT hjaltehandersen thelancetweightdetermineswhealdiameterinresponsetoskinpricktestingwithhistamine AT annacharlottelundgaard thelancetweightdetermineswhealdiameterinresponsetoskinpricktestingwithhistamine AT annespetersen thelancetweightdetermineswhealdiameterinresponsetoskinpricktestingwithhistamine AT liseehauberg thelancetweightdetermineswhealdiameterinresponsetoskinpricktestingwithhistamine AT nehasharma thelancetweightdetermineswhealdiameterinresponsetoskinpricktestingwithhistamine AT sofiedhansen thelancetweightdetermineswhealdiameterinresponsetoskinpricktestingwithhistamine AT jesperelberling thelancetweightdetermineswhealdiameterinresponsetoskinpricktestingwithhistamine AT larsarendtnielsen thelancetweightdetermineswhealdiameterinresponsetoskinpricktestingwithhistamine AT hjaltehandersen lancetweightdetermineswhealdiameterinresponsetoskinpricktestingwithhistamine AT annacharlottelundgaard lancetweightdetermineswhealdiameterinresponsetoskinpricktestingwithhistamine AT annespetersen lancetweightdetermineswhealdiameterinresponsetoskinpricktestingwithhistamine AT liseehauberg lancetweightdetermineswhealdiameterinresponsetoskinpricktestingwithhistamine AT nehasharma lancetweightdetermineswhealdiameterinresponsetoskinpricktestingwithhistamine AT sofiedhansen lancetweightdetermineswhealdiameterinresponsetoskinpricktestingwithhistamine AT jesperelberling lancetweightdetermineswhealdiameterinresponsetoskinpricktestingwithhistamine AT larsarendtnielsen lancetweightdetermineswhealdiameterinresponsetoskinpricktestingwithhistamine |