TY - JOUR AU - Phanuphak, Nittaya AU - Mahaisavariya, Punkae AU - Manonukul, Jane AU - Kulthanan, Kanokvalai PY - 2020/08/11 Y2 - 2024/03/29 TI - Pathergy Test in Thai Patients with Behcet's Disease : A Clinical, Histopathological and Direct Immunofluorescence Study JF - Siriraj Medical Journal JA - Siriraj Med J VL - 53 IS - 2 SE - Original Article DO - UR - https://he02.tci-thaijo.org/index.php/sirirajmedj/article/view/244056 SP - 70-75 AB - <p><strong>Objective:</strong> To evaluate the clinical, histopathological, and immunopathological findings of the pathergy test in Thai patients with Behcet's disease.<br><strong>Methods:</strong>&nbsp;A pathergy test using the needle prick method with a 20G disposable needle after cleaning with 70% alcohol was performed in 5 patients (4 females and 1 male), with Behcet's disease according to International Study Group (ISG) criteria. The skin was pricked making a 45<sup>o</sup> angle with the skin surface to a depth of 3 mm at an avascular and hairless point of both forearms symmetrically. After 4 and 48 hours, the test sites were evaluated clinically and skin biopsies were performed at a prick site on the right forearm after 4 hours for direct immunofluorescence study and after 48 hours at the prick site on the left forearm for histopathological study.<br><strong>Results:</strong>&nbsp;Clinical pathergy tests were positive (a single papular lesion at the needle prick site) in 3 out of 5 patients at 48 hours. No response was observed at 4 hours. Direct immunoflurorescence study showed no deposition of immnoglobulins (IgG, IgM, IgA) and C<sub>3</sub> in any case. The histopathological findings 48 hours after the test revealed definite neutrophilic infiltration around a superficial vascular plexus in 4 cases, in addition, one of these had endothelial cell swelling with red blood cell extravasation. The rest (1 case) showed nonspecific findings.<br><strong>Conclusion:</strong> We conclude that a pathergy test is a useful tool for the diagnosis of Behcet's disease. The intradermal needle prick method using 20G disposable needle after cleaning the skin with 70% alcohol, yields results of moderately high sensitivity. The results should be evaluated at 48 hours both clinically and histopathologically.</p> ER -