Skin Prick Test and Patch Test: Environmental and Chemical Allergen Reactivity Pattern Among Yemeni Patients in Sana’a City, Yemen

Authors

  • Abdulbasit A Al-Ghoury Emirates International University image/svg+xml Author
  • Jamil M A S Obaid Emirates International University image/svg+xml Author
  • Waheed A Ali Department of Microbiology and Immunology, Faculty of Medicine and Health Sciences, Taiz University, Taiz, Yemen; Author
  • Mohammed A Al-Shaybani Elaj Medical Center, Sana’a, Yemen Author

DOI:

https://doi.org/10.2147/JAA.S538601

Keywords:

Yemen , allergens , atopy , delayed hypersensitivity , immediate hypersensitivity , patch test , skin prick test

Abstract

Background: The prevalence of hypersensitivity reactions to different allergens varies according to the population studied and is subject to environmental and lifestyle factors. Early and delayed hypersensitivity are diagnosed with skin prick test and patch test.
Objective: This study aimed to identify the common environmental and chemical allergens sensitizing Yemeni allergic patients.
Subjects and Methods: A retrospective study was conducted using registries of patients who attended Elaj Medical Center in Sana’a city, Yemen, from January 1st to December 31st 2023. The collected data included sex, age, and the clinical laboratory test results of the skin prick test and the patch test.
Results: The skin prick test was performed on sixty-five patients compared to twenty-two who were tested with a patch test. Most of the positive participants were male, aged between 18 and 40 years. The most frequent environmental allergens causing immediate hypersensitivity were Dermatophagoides farinae and Dermatophagoides pteronyssinus mites (64.6% and 69.2%, respectively), Aspergillus (47.7%), cat dander and dog dander (43.1% and 35.4%, respectively). Dermatophagoides farinae mites mostly sensitized females with an odds ratio of 3.43 (95% CI, 1.13– 10.42, p=0.05). The most common chemical allergens that caused delayed hypersensitization were paraphenylenediamine (45.5%), potassium bichromate (45.5%), cobalt sulfate (36.4%), thiuram mix (27.3%), Vaseline (27.3%), and nickel sulfate (27.3%). Polysensitization was more frequent. The age of patients was directly proportional to the number of allergens responsible for immediate hypersensitivity (r-0.298, p=0.016).
Conclusion: Yemeni patients exhibited high sensitization to aeroallergens and chemical allergens. Females showed a higher propensity for polysensitization. The pattern of sensitization to environmental and chemical allergens in Yemen differs somewhat from neighboring Arab and Asian countries. Further multi-center studies are needed to support and establish a standard country-specific allergens panel for testing.

Author Biography

  • Abdulbasit A Al-Ghoury, Emirates International University
    • Laboratory Medicine Department, Faculty of Medicine and Health Sciences, Emirates International University, Sana'a, Yemen.

References

1. GBD 2019 Allergic Disorders Collaborators, Shin YH, Hwang J, Kwon R, et al. Global, regional, and national burden of allergic disorders and their risk factors in 204 countries and territories, from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019. Allergy. 2023;78(8):2232–2254. doi:10.1111/all.15807.

2. Owen JA, Punt J, Stranford SA, Jones PP. Kuby Immunology. Seventh sedition ed. New York, USA: W. H. Freeman and Company; 2013.

3. Justiz Vaillant AA, Vashisht R, Zito PM. Immediate Hypersensitivity Reactions. In: StatPearls. In: StatPearls Publishing, Treasure Island (FL); 2023.

4. Thibaudon M, Besancenot J. Outdoor aeroallergens and climate change. Rev Mal Respir. 2021;38(10):1025–1036. doi:10.1016/j.rmr.2021.08.007

5. Ahluwalia SK, Matsui EC. Indoor environmental interventions for furry pet allergens, pest allergens, and mold: looking to the future. J Allergy Clin Immunol Pract. 2018;6(1):9–19. doi:10.1016/j.jaip.2017.10.009

6. Malling HJ, Allesen-Holm P, Karved LS, Poulsen LK. Proficiency testing of skin prick testers as part of a quality assurance system. Clin Transl Allergy. 2016;6:36. doi:10.1186/s13601-016-0126-7

7. Aquino M, Rosner G. Systemic Contact Dermatitis. Clin Rev Allergy Immunol. 2019;56(1):9–18. doi:10.1007/s12016-018-8686-z

8. Lazzarini R, Mendonça RF, Hafner MFS. Allergic contact dermatitis to shoes: contribution of a specific series to the diagnosis. An Bras Dermatol. 2018;93(5):696–700. doi:10.1590/abd1806-4841.20187370

9. M.c D. Classification of hypersensitivity reactions. Allergy Asthma Proc. 2019;40:470–473. doi:10.2500/aap.2019.40.4274

10. Garg V, Brod B, Gaspari AA. Patch testing: uses, systems, risks/benefits, and its role in managing the patient with contact dermatitis. Clin Dermatol. 2021;39(4):580–590. doi:10.1016/j.clindermatol.2021.03.005

11. Oh J, Kim S, Kim MS, GBD 2021 Asthma and Allergic Diseases Collaborators. Global, regional, and national burden of asthma and atopic dermatitis, 1990-2021, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021. Lancet Respir Med. 2025;13(5):425–446. doi:10.1016/S2213-2600(25)00003-7

12. Nur Husna SM, Tan HT, Md Shukri N, Mohd Ashari NS, Wong KK. Allergic Rhinitis: a Clinical and Pathophysiological Overview. Front Med Lausanne. 2022;9:874114. doi:10.3389/fmed.2022.874114

13. Tang X, Lin L, Yu F, Ma Y, Liu Z, Xu X. Allergic-related skin diseases: global disease burden from 1990 to 2021 and future trends. World Allergy Organ J. 2025;18(7):101072.

14. Bahaj S, Moharem A, Kaid A. Prevalence of asthma and allergic diseases among high school students in urban and rural communities, Yemen. Egypt J Med Microbiol. 2012;38:1–5.

15. Masjedi M, Ainy E, Zayeri F, Paydar R. Assessing the prevalence and incidence of asthma and chronic obstructive pulmonary disease in the Eastern Mediterranean Region. Turk Thorac J. 2018;19:56–60. doi:10.5152/TurkThoracJ.2018.17051

16. Ali WAM, Obaid JMAS. Sensitization Pattern to common Inhalant allergens among patients with Allergic Rhinitis in Taiz, Yemen. AL - Saeed J Humanities Appl Sci. 2019;3(2):15–23.

17. Heinzerling L, Mari A, Bergmann KC, et al. The skin prick test - European standards. Clin Transl Allergy. 2013;3(1):3. doi:10.1186/2045-7022-3-3

18. Lazzarini R, Duarte I, Ferreira AL. Patch tests. An Bras Dermatol. 2013;88(6):879–888. doi:10.1590/abd1806-4841.20132323

19. Hong SJ. Report of Korean ISAAC epidemiologic study for asthma and allergic diseases in children. Pediatr Allergy Respir Dis. 2007;17(Suppl 1):S55–S66.

20. Ariano R, Canonica GW, Passalacqua G. Possible role of climate changes in variations in pollen seasons and allergic sensitizations during 27 years. Ann Allergy Asthma Immunol. 2010;104:215–222. doi:10.1016/j.anai.2009.12.005

21. Momtazmanesh S, Rezaei N. Hypersensitivity. In: Rezaei N, editor. Encyclopedia of Infection and Immunity. Elsevier; 2022:243–258.

22. Almohideb M. Epidemiological Patterns of Skin Disease in Saudi Arabia: a Systematic Review and Meta-Analysis. Dermatol Res Pract. 2020;2020:5281957. doi:10.1155/2020/5281957

23. Aldakheel FM. Allergic Diseases: a Comprehensive Review on Risk Factors, Immunological Mechanisms, Link with COVID-19, Potential Treatments, and Role of Allergen Bioinformatics. Int J Environ Res Public Health. 2021;18(22):12105. doi:10.3390/ijerph182212105

24. Dor-Wojnarowska A, Liebhart J, Miecielica J, et al. The Impact of Sex and Age on the Prevalence of Clinically Relevant Sensitization and Asymptomatic Sensitization in the General Population. Arch Immunol Ther Exp. 2017;65:253–261. doi:10.1007/s00005-016-0425-7

25. Silvestri M, Rossi GA, Cozzani S, Pulvirenti G, Fasce L. Age-dependent tendency to become sensitized to other classes of aeroallergens in atopic asthmatic children. Ann Allergy Asthma Immunol. 1999;83(4):335–340. doi:10.1016/S1081-1206(10)62674-9

26. Cacheiro-Llaguno C, Mösges R, Calzada D, González-de la Fuente S, Quintero E, Carnés J. Polysensitisation is associated with more severe symptoms: the reality of patients with allergy. Clin Exp Allergy. 2024;54(8):607–620. doi:10.1111/cea.14486

27. Abou Galal DIM, Hany HM, El Sobky MMK, Harbahr NM, El Kerash WM. Morphological identification of house dust mite species in Menoufia Governorate and their antigen effect in immunoglobulin E response in allergic patients. Menoufia Med J. 2019;32:1,14.

28. Hasan HY, Rizwan MA. Prevalence of Inhalant and Food Allergies after Skin Prick Testing in Patients with Resistant Allergic Rhinitis in Warm Humid Weather. Bahrain Med Bull. 2015;37:2. doi:10.12816/0014420

29. Kulalert P, Poachanukoon O, Nanthapisal S, et al. Minimum number and types of allergens for a skin prick test panel in Thai children with allergic respiratory diseases. Allergy Asthma Clin Immunol. 2022;18(1):77. doi:10.1186/s13223-022-00718-7

30. Dou X, Zhao Y, Ni C, Zhu X, Liu L. Prevalence of contact allergy at a dermatology clinic in China from 1990-2009. Dermatitis. 2011;22(6):324–331. doi:10.2310/6620.2011.11051

31. Tunca M, Çalışkan E, Yürekli A. Frequent contact allergens in Ankara/Turkey: a retrospective study of patch test results. Turk Arch Dermatol Venereol. 2019;53(2):49–52.

32. Gopinath VPK, Simi VM, Ahammed KB, Rishad CMA, Farisa PM. Common allergens in patients with contact dermatitis identified using patch test in a tertiary care centre in North Kerala. Int J Res Dermatol. 2019;5(1):78–87. doi:10.18203/issn.2455-4529.IntJResDermatol20185054

33. Aguilar- Bernier M, Bernal-Ruiz AI, Rivas-Ruiz F, Fernández-Morano MT, de Troya-Martín M. Contact Sensitization to Allergens in the Spanish Standard Series at Hospital Costa del Sol in Marbella, Spain: a Retrospective Study (2005–2010). Actas Dermo-Sifiliográficas. 2012;103(3):223–228. doi:10.1016/j.adengl.2011.07.008

10-1

Downloads

Published

2025-10-15

Repository

Section

Articles

Categories


Deprecated: json_decode(): Passing null to parameter #1 ($json) of type string is deprecated in /home/eiuedunetcp/public_html/journals.eiu.edu.ye/plugins/generic/citations/CitationsPlugin.php on line 68

How to Cite

Al-Ghoury, A. A., Obaid, J. M., Ali, W. A., & Al-Shaybani, M. A. (2025). Skin Prick Test and Patch Test: Environmental and Chemical Allergen Reactivity Pattern Among Yemeni Patients in Sana’a City, Yemen. Emirates International University Digital Repository, 1(1). https://doi.org/10.2147/JAA.S538601

Similar Articles

21-30 of 55

You may also start an advanced similarity search for this article.