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To the Editor.—
In the May Archives, Uehara and Ofuji presented an evaluation of the abnormal vascular reactions in atopic dermatitis (113:627-629, 1977). In their discussion of the methacholine reaction, they stated that all of their patients showed normal reactions to methacholine when the tests were performed on normal skin.I believe that this is misleading, since the test was performed with the use of a topical application of methacholine rather than with the intradermal injection that represents the standardized methacholine test.In a study of IgE levels in atopic dermatitis (Arch Dermatol 108:806-811, 1973), 58 patients with a diagnosis of atopic dermatitis received a methacholine test administered in the standard fashion: 0.1 ml of methacholine chloride diluted 1:1,000 in isotonic saline solution applied to an uninvolved area of the back, if such an area was to be found. In 78% of the cases, a moderate to strongly positive delayed
Stone SP. Atopic Dermatitis Reactions to Methacholine. Arch Dermatol. 1977;113(9):1301. doi:10.1001/archderm.1977.01640090149046