Atopic dermatitis (AD) is an inflammatory skin condition that causes itching and eczematous skin lesions over a long period. PEANUT ALLERGY is an immunological reaction mediated by immunoglobulin E (IgE) that often manifests in childhood and can cause anything from moderate skin reactions to anaphylaxis. This study evaluated the accuracy of a skin prick test (SPT) using local PEANUT allergen extract compared with standard allergen extract in diagnosing PEANUT ALLERGY or sensitization involving 30 adult atopic dermatitis patients. The patients underwent history taking and SPT tests with local and standard allergen extracts at separate times at 1-week intervals. The local allergen extract was produced by Dr. Soetomo General Academic Hospital Surabaya, Indonesia. There were three patients with positive results from the standard PEANUT SPT. Meanwhile, no positive results were detected with the local PEANUT SPT. The specificity of local PEANUT SPT was 93.3%, while the negative predictive value was 100%. The compatibility of local PEANUT SPT to the patient’s history was 93.33%, which consisted of patients with no previous history of PEANUT ALLERGY who got negative results. The local PEANUT allergen extract for SPT had reasonable specificity and can be considered an alternative diagnostic tool to exclude PEANUT ALLERGY in AD.

Studies suggest that children who start solid foods early are at risk for developing food allergies. Herein, we evaluated the effects of the introduction of PEANUTs to the diets of children on emerging PEANUT allergies. Children with allergic rhinitis and asthma were enrolled in the present study and evaluated in four stages. In the first stage, a clinical history was completed for all participants. In the second stage, skin tests were conducted to detect the sensitization to PEANUTs. In the third stage, the parents were interviewed about the PEANUT-eating habits of their children. In the fourth stage, children with a convincing history of ALLERGY or a positive PEANUT skin test result were subjected to an open oral food challenge (OOFC). Three hundred children in four groups were included, 58. 2% of the subjects were male, and the mean age was 7. 3± 3. 9 years. The median age of first exposure to PEANUTs in patients with PEANUT allergies was greater than that in children without PEANUT allergies (2 years versus 1 year; p=0. 009). The multivariate analysis, including only those children subjected to the OOFC, revealed that the consumption of PEANUTs after the age of ≥ 2 years is a risk factor for developing a PEANUT ALLERGY (odds ratio=8. 0, 95% confidence interval 1. 3-50. 0, p=0. 026). The results of the present study showed that the late introduction of PEANUTs to children increases the risk of developing a PEANUT ALLERGY.

Emerging data suggest that measurement of serum IgE to PEANUT components can be clinically helpful and more accurate than IgE to whole PEANUT to predict PEANUT ALLERGY. Not all studies have used prospective samples, multiple components and oral challenges. Currently, there are no data on this topic involving Italian children.32 patients (23 males; median age 9 years) with reported history for PEANUT ALLERGY and evidence of PEANUT sensitization (skin prick test to PEANUT extract 3mm) have been analyzed for serum IgE to whole PEANUT and recombinant allergen components Ara h 1, 2, 3, 8, and 9 with Immuno CAP and completed an open oral food challenge with PEANUT.12 (37.5%) children had a positive challenge to PEANUT and were considered allergic. No differences were seen between the median values of IgE to PEANUT, Ara h 1, 3, 8 and 9 in allergic and tolerant children to PEANUT challenge. Noteworthy, 5 of 20 tolerant children had IgE to PEANUT>15 kUA/l which is commonly considered a predictive value of PEANUT ALLERGY. Conversely, a significant difference was seen when comparing the median value of IgE to Ara h 2 in the two groups: 0.75 kUA/l (IQR: 0.22-4.34 kUA/l) in allergic children versus 0.1 kUA/l (IQR: 0.1-0.12 kUA/l) in tolerant ones (P<0.001). IgE levels to Ara h 2 are significantly higher in children that react to oral PEANUT challenge. Our findings in Italian children have been in line with recent reports in various populations of Northern Europe, the US and Australia and add confirmatory evidence that analysis of IgE to Ara h 2 could reduce the need for PEANUT challenge in suspected allergic patients.