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Table 2: Reasons for False Negative and False Positive Reactions in Intradermal Test Reactions Reasons for False Negative Reactions Reasons for False Positive Reactions Subcutaneous injections Too little allergen Testing with mixes Outdated allergens Allergens too dilute Too small volume of allergen injected Drug interference (Glucocorticoids, antihistamines, tranquilisers, progestational compounds, any drugs that lower blood pressure significantly) Anergy (testing during peak of hypersensitivity reaction) Inherent host factors (estrus, pregnancy, severe stress – systemic disease, fright, struggling) Off-season testing (1-2m after clinical signs have disappeared) Histamine ‘hyporeactivity’ 28 Irritant test allergens Allergen too concentrated Contaminated test allergens (bacteria, fungi) Skin-sensitising antibody only (prior clinical or present subclinical sensitivity – these reactions would be more appropriately termed clinically insignificant) Poor technique (trauma in needle placement, blunt needles, too large a volume injected, air injected) ‘Irritable’ skin (large reactions seen to all injected substances, including saline control) Dermatographism Ectoparasitism (cross reactions with house dust mite extracts) Mitogenic allergen As further information about skin testing in horses comes to light, more accurate or reliable skin test results and useful assumptions about the results can be expected. At this stage, intradermal testing is still just one of the diagnostic modalities in the workup of allergy cases and the importance of other details in the case such as clinical signs, history, season of testing and other test results should not be overlooked. ACVSC Proceedings Dermatology Chapter Science Week 2005
References 1. Scott DW, Miller WH: Skin Immune System and Allergic Skin Disorders. In: Equine Dermatology. Saunders, Missouri, 2003 2. Littlewood JD, Paterson S, Shaw SC. Atopy-Like Skin Disease in the Horse. In: Kwochka KW et al (eds). Advances in Veterinary Dermatology III. Butterworth-Heinemann, Boston, 1998 p 563 3. Barbet JL et al: Diseases of the skin. In: Colahan PT et al (Eds). Equine Medicine and Surgery IV, Vol II. American Veterinary Publications, Inc, Goleta 1991, p 1569 4. Byars DT: Allergic skin diseases in the horse. Vet Clin N Am Large Anim Pract 6: 87, 1984 5. Rosenkrantz WS, Frank LA: Therapy of equine prusitus. In Ihrke RJ, et al (eds). Advances in Veterinary Dermatology II. Pergamon Press, Oxford, 1993, p433 6. Fadok VA: Overview of Equine pruritus. Vet Clin N Am Equine Pract 11:1, 1995 7. Jose-Cunilleras E, Kohn CW, Hillier A, Saville WJA, Lorch, G: Intradermal testing in healthy horses and horses with chronic obstructive pulmonary disease, recurrent urticaria, or allergic dermatitis. J Am Vet Med Assoc 219:1115, 2001 8. Rosenkrantz WS et al: Responses in horses to intradermal challenge of insects and environmental allergens with specific immunotherapy. In: Kwochka KW, et al (Eds). Advances in Veterinary Dermatology III. Butterworth-Heinemann, Boston, 1998, p 200 9. Morris DO, Lindborg, S: Determination of ‘irritant’ threshold concentrations for intradermal testing with allergenic extracts in normal horses. Veterinary Dermatology 14:31-36, 2003 10. Willemse A, Van Den Brom WE: Evaluation of the intradermal allergy test in normal dogs. Research in Veterinary Science 32:57-61, 1982 11. Fadok VA: Update on equine allergies. Vet Allergy Clin Immunology 5:68, 1997 12. Evans AG et al: Intradermal Testing of horses with chronic obstructive pulmonary disease and recurrent urticaria. Am J Vet Res 53:203, 1992 13. Delger JM: Intradermal testing and immunotherapy in horses. Vet Med 92:635, 1997 14. Halliwell REW: The role of allergy in chronic pulmonary diseases of horses. J Am Vet Med Assoc 174:277, 1979 ACVSC Proceedings Dermatology Chapter Science Week 2005 29
Page 1 and 2: Australian College of Veterinary Sc
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Page 5 and 6: 3.00 Afternoon tea 3.30 How I treat
Page 7 and 8: Dr Jennifer A. Charles BVSc MVS Dip
Page 9 and 10: Scientists in Feline Medicine in 19
Page 11 and 12: IgE-bearing cells have been demonst
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Page 17 and 18: References: Evans AG, Paradis MR, &
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Page 21 and 22: TABLE 1: CURRENT ALLERGENS SELECTED
Page 23 and 24: AmericanCockroach Cockroach mix
Page 25 and 26: Patient Preparation Drug Withdrawal
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Page 33 and 34: TABLE 2 Additional allergens used i
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Page 41 and 42: Introduction Diagnostic Approach to
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Page 45 and 46: References Evans AG, Paradis MR & O
Page 47 and 48: Introduction: Equine Chronic Urtica
Page 49 and 50: Acute treatment - Epinephrine 1:100
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Page 53 and 54: an 80:20 mixture of evening primros
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Page 59 and 60: Equine sarcoidosis Sonya Bettenay T
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Page 67 and 68: Introduction The equine sarcoid: an
Page 69 and 70: Clinical Presentation Small fibrous
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any anatomic location but commonly
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epidermis may be histologically nor
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References D.C. Knottenbelt, S. Edw
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indicated. Each sample for culture
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Proper dosage and proper duration a
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2. Affect on the horse and 3. Affec
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Affected horses usually scratch and
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• Cattle ear tags impregnated wit
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How I treat: equine pemphigus folia
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Treatment of pemphigus foliaceus in
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SCOTT, D.W., WALON, D.K., SLATER, M
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Diagnosis History of access of hors
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These vaccines are not manufactured
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References Alfaro AA & Mendoza L (1
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y a variety of fungal metabolites.
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Authors recommendations: 1. Both Im
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chorioptic mange by the author (Lit
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Clinical Disease The clinical resul
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treatment options have been used. P
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Notes ACVSC Proceedings Dermatology
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