Background: Accurate diagnosis of allergic sensitization is essential in clinical practice and allergy research, and the choice of assessment method may have an important impact. The PASTURE study (Protection against Allergy: Study of Rural Environment) examines the influence of exposure to a dairy farm environment on the occurrence of allergy in a cohort of rural European children from birth to 10 years. The aim of our study was to analyze agreement between skin prick tests (SPTs), to aeroallergens and food allergens, and specific IgE and to evaluate the association of SPT with atopic dermatitis in the 204 French children of the PASTURE study. Methods: SPT, atopic dermatitis assessment, and specific IgE measurements were performed at 1, 4.5, and 6 years. Results: A total of 137 children attended all three visits. The agreement between SPTs and specific IgE was poor except for perennial aeroallergens at 6 years and for an IgE cutoff greater than 0.7 IU/ml (κ = 0.69, 0.5202 - 0.8621). The prevalence of positive SPTs increased with age. Positive SPTs were transient at 1 year, whereas they were persistent between 4.5 and 6 years. Positive SPTs at 1 year were predictive of the occurrence of atopic dermatitis during follow-up. Conclusion: SPTs did not have good agreement with serum-specific IgE in early childhood. Both tests (SPT and specific IgE) should be used. Skin allergenic reactivity increased with age and was transient at 1 year but associated with the occurrence of atopic dermatitis.

1.
Holgate ST, Lack G: Improving the management of atopic disease. Arch Dis Child 2005;90:826-831.
2.
Asarnoj A, Ostblom E, Kull I, Lilja G, Pershagen G, Hedlin G, et al: Sensitization to inhalant allergens between 4 and 8 years of age is a dynamic process: results from the BAMSE birth cohort. Clin Exp Allergy 2008;38:1507-1513.
3.
Bousquet P-J, Chatzi L, Jarvis D, Burney P: Assessing skin prick tests reliability in ECRHS-I. Allergy 2008;63:341-346.
4.
Kjaer HF, Eller E, Høst A, Andersen KE, Bindslev-Jensen C: The prevalence of allergic diseases in an unselected group of 6-year-old children. The DARC birth cohort study. Pediatr Allergy Immunol 2008;19:737-745.
5.
Schoos A-MM, Chawes BLK, Følsgaard NV, Samandari N, Bønnelykke K, Bisgaard H: Disagreement between skin prick test and specific IgE in young children. Allergy 2015;70:41-48.
6.
Mutius E, Schmid S; The PASTURE project: EU support for the improvement of knowledge about risk factors and preventive factors for atopy in Europe. Allergy 2006;61:407-413.
7.
Pfefferle PI, Büchele G, Blümer N, Roponen M, Ege MJ, Krauss-Etschmann S, et al: Cord blood cytokines are modulated by maternal farming activities and consumption of farm dairy products during pregnancy: the PASTURE Study. J Allergy Clin Immunol 2010;125:108-115.e1-3.
8.
Severity scoring of atopic dermatitis: the SCORAD index. Consensus Report of the European Task Force on Atopic Dermatitis. Dermatology 1993;186:23-31.
9.
Roduit C, Frei R, Loss G, Büchele G, Weber J, Depner M, et al: Development of atopic dermatitis according to age of onset and association with early-life exposures. J Allergy Clin Immunol 2012;130:130-136.e5.
10.
Herzum I, Blümer N, Kersten W, Renz H: Diagnostic and analytical performance of a screening panel for allergy. Clin Chem Lab Med 2005;43:963-966.
11.
Masse MS, Granger Vallée A, Chiriac A, Dhivert-Donnadieu H, Bousquet-Rouanet L, Bousquet P-J, et al: Comparison of five techniques of skin prick tests used routinely in Europe. Allergy 2011;66:1415-1419.
12.
Buyuktiryaki B, Sahiner UM, Karabulut E, Cavkaytar O, Tuncer A, Sekerel BE: Optimizing the use of a skin prick test device on children. Int Arch Allergy Immunol 2013;162:65-70.
13.
Wood RA, Segall N, Ahlstedt S, Williams PB: Accuracy of IgE antibody laboratory results. Ann Allergy Asthma Immunol 2007;99:34-41.
14.
Jøhnke H, Norberg LA, Vach W, Høst A, Andersen KE: Patterns of sensitization in infants and its relation to atopic dermatitis. Pediatr Allergy Immunol 2006;17:591-600.
15.
Landis JR, Koch GG: The measurement of observer agreement for categorical data. Biometrics 1977;33:159-174.
16.
Soares-Weiser K, Takwoingi Y, Panesar SS, Muraro A, Werfel T, Hoffmann-Sommergruber K, et al: The diagnosis of food allergy: a systematic review and meta-analysis. Allergy 2014;69:76-86.
17.
Kjaer HF, Eller E, Andersen KE, Høst A, Bindslev-Jensen C: The association between early sensitization patterns and subsequent allergic disease. The DARC birth cohort study. Pediatr Allergy Immunol 2009;20:726-734.
18.
Baldacci S, Omenaas E, Oryszczyn MP: Allergy markers in respiratory epidemiology. Eur Respir J 2001;17:773-790.
19.
Tollerud DJ, O'Connor GT, Sparrow D, Weiss ST: Asthma, hay fever, and phlegm production associated with distinct patterns of allergy skin test reactivity, eosinophilia, and serum IgE levels. The Normative Aging Study. Am Rev Respir Dis 1991;144:776-781.
20.
Rø AD, Saunes M, Smidesang I, Storrø O, Oien T, Moen T, et al: Agreement of specific IgE and skin prick test in an unselected cohort of two-year-old children. Eur J Pediatr 2012;171:479-484.
21.
de Vos G: Skin testing versus serum-specific IgE testing: which is better for diagnosing aeroallergen sensitization and predicting clinical allergy? Curr Allergy Asthma Rep 2014;14:430.
22.
Ege MJ, Frei R, Bieli C, Schram-Bijkerk D, Waser M, Benz MR, et al: Not all farming environments protect against the development of asthma and wheeze in children. J Allergy Clin Immunol 2007;119:1140-1147.
23.
Rhodes HL, Thomas P, Sporik R, Holgate ST, Cogswell JJ: A birth cohort study of subjects at risk of atopy. Twenty-two-year follow-up of wheeze and atopic status. Am J Respir Crit Care Med 2002;165:176-180.
24.
Johnston SL, Clough JB, Pattemore PK, Smith S, Holgate ST: Longitudinal changes in skin-prick test reactivity over 2 years in a population of schoolchildren with respiratory symptoms. Clin Exp Allergy 1992;22:948-957.
25.
von Mutius E, Martinez FD, Fritzsch C, Nicolai T, Reitmeir P, Thiemann HH: Skin test reactivity and number of siblings. BMJ 1994;308:692-695.
26.
Dean T, Venter C, Pereira B, Arshad SH, Grundy J, Clayton CB, et al: Patterns of sensitization to food and aeroallergens in the first 3 years of life. J Allergy Clin Immunol 2007;120:1166-1171.
27.
van Asperen PP, Kemp AS: The natural history of IgE sensitisation and atopic disease in early childhood. Acta Paediatr Scand 1989;78:239-245.
28.
Sampson HA, McCaskill CC: Food hypersensitivity and atopic dermatitis: evaluation of 113 patients. J Pediatr 1985;107:669-675.
29.
García C, El-Qutob D, Martorell A, Febrer I, Rodríguez M, Cerdá JC, et al: Sensitization in early age to food allergens in children with atopic dermatitis. Allergol Immunopathol 2007;35:15-20.
30.
Ricci G, Patrizi A, Baldi E, Menna G, Tabanelli M, Masi M: Long-term follow-up of atopic dermatitis: retrospective analysis of related risk factors and association with concomitant allergic diseases. J Am Acad Dermatol 2006;55:765-771.
31.
Depner M, Ege MJ, Genuneit J, Pekkanen J, Roponen M, Hirvonen M-R, et al: Atopic sensitization in the first year of life. J Allergy Clin Immunol 2013;131:781-788.
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