Intracutaneous test

In a broad evaluation also the sulfosuccinate disodium laureth sulfosuccinate (DLSS) was a part of a variety of surfactants tested for their dermatological mildness, and some different test methods were applied [16]. Products were compared applying in vitro methods (Zein test, hemolysis) and in vivo methods (Duhring-Chamber test, skin mildness by intracutaneous test on mice and topical application on hairless mice, mucous membrane irritation according to the Draize procedure on rabbit eyes). In the Duhring-Chamber test the DLSS elicited no reactions in the animal tests it ranged in the least irritant third of the 15 products tested. 

USP (1995). Intracutaneous Test, United States Pharmacopoeia, USP Convention, Rockville, MD, pp. 1201-1202. 

Koppelman, S J., Wensing, M., Ertmann, M., Knulst, A.C., and Knol, E.F. 2004. Relevance of Ara hi, Ara h 2, and Ara h 3 in peanut-allergic patients, as determined by immunoglobulin E Western blotting, basophil-histamine release and intracutaneous testing Ara h 2 is the most important peanut allergen. Clin Exp Allergy 34 583-590. 

Biological tests. USP 24 lists two levels of biological tests—the in vitro tissue culture test and the in vivo systemic injection and intracutaneous tests. A parenteral closure must pass either type of test to meet USP requirements. 

Similar to in vitro testing, three tests comprise in vivo biological testing (viz., systemic injection test, intracutaneous test, and implantation test). The tests selected for use should be appropriate for the intended use of the product and should reflect a reasonable assessment of risks to the patient. Each test has specified a minimum quantity of material, and this quantity is crucial to the validity of the test. 

The second test measures a slightly different biological response. This test, the intracutaneous test, uses the same extraction solution prepared for the systemic injection test. However, for this evaluation, two rabbits are shaved and injected with the solution intracuta-neously. Each animal is injected into the skin lateral to the spine with five samples of extract on one side and five samples of control solution on the other. Animals are evaluated three times over the next three... 

A 32-year-old woman with Crohn s disease, who had taken prednisone 20 mg/day and azathioprine 150 mg/day, switched to budesonide 9 mg/day because of weight gain, and 5 minutes after the first capsule her tongue and throat swelled, accompanied by wheeziness and diarrhea. She was given clemastine and recovered after 4 ays. Intracutaneous tests with diluted budesonide suggested a non-IgE-mediated reaction. She had a previous history of a similar reaction to mesalazine. One year later her tongue and throat swelled after intravenous dexa-methasone. 

An exudative granulomatous reaction started 2 days after the injection of hyaluronic acid (Hylaform) (dose not stated) for perioral wrinkles (7). The eczematous papular skin changes disappeared completely within 6 weeks, and could be provoked by intracutaneous testing with Hylaform (dose not stated). Histological examination showed a foreign body granuloma. 

As with interferon alfa, pegylated interferon alfa has been associated with injection site skin necrosis (285). Severe local reactions after subcutaneous injections mostly consist of ulceration and skin necrosis, but a variety of reactions have been described. Prominent suppuration and granulomatous dermatitis at the injection sites of interferon alfa have been reported in two patients (286). Three patients who had severe rashes while receiving pegylated interferon alfa-2a or 2b had positive intracutaneous tests to both pegylated forms of interferon alfa but not to standard interferon alfa-2a or 2b (287). One of these patients subsequently tolerated standard interferon alfa. Cutaneous ulcers have also been reported in patients treated with peginterferon alfa-2b (288,289). In the latter case, the lesions healed under local therapy and the same dose of interferon was maintained. 

In contrast to previous claims, even low-dose interferon beta-lb can produce severe local reactions and cutaneous necrosis, with no recurrence after interferon alfa injection and expected better tolerance to interferon beta-la (52-55). The mechanisms of interferon beta-induced local skin reaction might involve a local vascular inflammatory process or platelet-dependent thrombosis, but positive intracutaneous tests to interferon beta have also been found (56). 

Most systemic reactions after intravenous fluorescein are allergic, but in the past some were due to contamination with dimethylformamide, an industrial solvent (14). It is difficult to predict adverse effects by intracutaneous testing. A delayed allergic response, developing a few hours after intravenous fluorescein dye injection, can occur (15). It is recommended that a complete allergy evaluation be performed in aU patients who have adverse reactions to fluorescein, in order to differentiate true allergic reactions from other tjrpes of reactions (16). 

A 26-year-old man developed a fixed drug eruption on his hands and inguinal and gluteal areas after oral treatment of onychomycosis with terbinafine 250 mg/day. The rash showed the characteristic distribution of the baboon syndrome. Although epicutaneous and intracutaneous tests were negative, the rash recurred 20 hours after oral rechallenge with terbinafine. 

Hansson H, Moller H. Intracutaneous test reactions to tuberculin containing merthiolate as a preservative. Scand ] Infect Dis 1971 3 169-172. 

Intracutaneous test (rabbits). Cardiovascular (cat) toxicity—infusions. 

Tissue Culture— MEM Elution Intracutaneous Test (Rabbits) Systemic Toxicity (Mice)... 

Intracutaneous test Thin-skinned albino rabbits Inject extracts of materials intracutaneously at one side of the animal and a blank at the other side Skin reaction such as erythema, eschar, and edema formation... 

Intracutaneous tests, scratch tests, and prick tests can be performed with the drugs as such or with their conjugates, for example penicilloyl-polylysine. Type I reactions are the main field of usefulness, but the tests are also suitable for demon-... 

For routine skin testing, tetracycline solutions in concentrations of 0.05-0.5 mg/ml for scratch and intracutaneous tests and 10 mg/ml for patch tests have been used. Positive results were obtained in some cases of highly sensitized patients. Zelger and Seidl (1969) obtained a positive scratch test with oxytetracycline in a highly sensitized nurse. Fellner and Baer (1966) reported a positive skin test of the immediate type in a penicillin- and tetracycline-sensitive patient using intracutaneous application of tetracycline. Patch tests gave positive reactions more readily, especially among medical staff and factory workers (Korossy 1976). 

In every case of drug allergy we should proceed systematically, carrying out first an epicutaneous test and a friction test and then a prick test, a scratch test, and perhaps an intracutaneous test. Active substances are taken in a 1%-10% solution in physiological NaCl solution. In especially high sensitization, general reactions (including the anaphylactic shock) are yielded by the epicutaneous and intracutaneous tests. If one test is positive, other tests can mostly be dispensed with. 

In anaphylactic reactions, the friction, prick, and intracutaneous tests are most easily positive in drug fever, the epicutaneous and intracutaneous tests. 

In the intracutaneous test, 0.005 ml of solution is transfused intradermally in the region of the deltoid muscle or the lower arm. The result is read after 15 min. 

Intracutaneous skin tests with 0.05 ml 0.5% HSA solution were performed on six patients with reactions to HSA (Ring et al. 1974). Four of these gave a positive immediate skin response. In 20 volunteers similar intracutaneous tests were all negative. Skin tests seem to have a certain predictive value, especially in early HSA reactions. 

Exposiue to or contact with even minute amounts of potential leachables in medical devices or biomaterials can result in allergic or sensitization reactions. Sensitization tests estimate the potential for contact sensitization of medical devices, materials, and/or their extracts, are usually carried out in guinea pigs, and should reflect the intended route (skin, eye, mucosa) and nature, degree, frequency, duration, and conditions of exposure of the biomaterial in its intended clinical use. Emphasis is placed on utilizing extracts of the biomaterials to determine the irritant effects of potential leachables. Intracutaneous (intradermai) reactivity tests determine the localized reaction of tissue to extracts of medical devices, biomaterials, or pros-theses in the final product form. Irritation and intracutaneous tests may be applicable where determination of irritation by... 

In the sensitization with potassium bichromate, we obtained clear positive reactions only with the intracutaneous tests. The infiltrate is extremely dense, but does not... 

There are several standards that medical polymers must adhere to. One of the most common standards observed for polymeric materials is published by the United States Pharmacopeia (USP), which necessitates using animal models (in vivo) to test toxicity of elastomers, plastics, and other polymeric materials, prior to clinical use. The standard and forms of testing it outlines is considered in the medical industry as the minimum requirement for a polymeric material before it is considered for use in healthcare applications. According to the standard the biological response of the test animals are measured and determined via three main techniques (1) Systemic toxicity test Evaluates the effects of leachables of intravenously or intraperitoneally injected materials on systems such as the nervous or immune system (2) Intracutaneous test Evaluates local response to materials injected under the skin (3) Implantation test Both local tissue microscopic and macroscopic parameters evaluated at material implant sites. 

Patch testing with serial dilution of nickel sulfate is sometimes used to gain more information on the degree of sensitivity and to discriminate between allergic reactions and irritant ones (Andersen et al. 1993 Wahlberg 1995). Open tests to study the concentration threshold have been carried out with nickel sulfate or chloride as single or repeated applications (Menne and Calvin 1993 Allenby and Basketter 1994). Intracutaneous testing with nickel sulfate is used at some centres (Moller 1989). 

Heyl et al. (1970) carried out a carefiil investigation of a group of 28 bakers 18 of 21 who only had skin symptoms - usually hand eczema - had immediate-type hypersensitivity to flour. For two of these patients, inhalation of flour caused a flare of hand eczema. Systemic dermatitis of this type among bakers was also seen by Wiithrich (1977). Heyl and Reinert-Dilthey (1968) suggested that an intracutaneous test with flour was more sensitive than the prick test. 

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