Methods: Allergy skin prick test, and nasal and bronchial provocation tests using HDM Dermatophagoides farinae were done in 35 young men (19~28 years-old) who wanted a military certification for asthma. The nasal responses to HDM were scored according to the severity of 3 nose symptoms (rhinorrhea, sneezing, and nose itching).
Results: The prevalence of positive skin test (≥3+) to HDM was not significantly different between the patients with (n=23) and without (n=12) a positive response (early or late) to bronchial challenge (87.0% vs. 66.7%, P=0.200). However, the nasal response score was significantly higher in the responders than the others (1.00±0.24 vs. 0.25±0.13, P=0.011). The concordance of positive response not to the skin test (k=0.225, P=0.154) but to the nasal test (cutoff score: ≥2) (k=0.306, P=0.012) was significant with the positive bronchial response. The diagnostic sensitivity of the nasal test (47.8% at cutoff≥1, 39.1% at cutoff≥2) was lower, but the specificity (75.0% and 100%, respectively) was higher than that of the skin test (sensitivity: 87.0%, specificity: 33.3%).
Conclusion: The skin test is more sensitive, whereas the nasal test is more specific for predicting a positive bronchial response to HDM in asthma.