Iranian Journal of Dermatology

Vol. 20, No. 80, Summer 2017
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Evaluation of the utility of autologous serum skin test and the efficacy of autologous serum therapy in chronic spontaneous urticaria
Niyati Parekh, Kailash Bhatia, Satguru Dayal, Rajesh Kataria, Hitesh Lokwani, Gagan Goyal, Rini Sharma, Amin Syed, Jushya Bhatia, Ankur Sarin, Lavin Bhatia

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Date Received: 2017 / Jun / 09 Date Revised: 2017 / Jun / 09 Date Accepted: 2017 / Oct / 26

Background: Autologous serum skin test (ASST) evaluates the presence of any serum histamine-releasing factors and histamine-releasing autoantibodies. Autologous serum therapy (AST) is a therapy in which repeated injections of autologous serum are administered intramuscularly for treatment of chronic
spontaneous urticaria (CSU). The aim of this study is to evaluate the advantages and compare the results of the ASST and the efficacy of AST in CSU patients.
Methods: We included a total of 39 patients that presented with urticaria of more than 6 weeks duration in this study. Patients who suffered from acute urticaria, urticarial vasculitis, physical urticaria, and other systemic diseases known to cause urticaria were excluded. Standard tools and techniques were used to prepare autologous serum, injection of the serum, and interpretation of the results. The test result was implicated as positive and negative ASST.
Results: Out of 39 patients, 11 (27.5%) patients exhibited positive ASST reactions. Based on the urticaria total severity score (TSS), 10 patients were characterized as moderate severity whereas 29 patients were characterized as severe. There was no observed association of severity with ASST positivity. There was a significant
decline in TSS at 15 weeks in both the ASST positive and negative groups. Study patients had a statistically significant response to AST, although differences between ASST positive and negative groups were not significant. This indicated the effectiveness of AST in both groups, irrespective of positive ASST results.
Conclusion: ASST was found to be an easy, useful, inexpensive test to detect autoimmune urticaria and classify CSU. AST is an easy, economic, and safe therapeutic tool for patients of refractory CSU with minimal discomfort, and no observed complications within the study period.

Keywords: autologous serum skin test (ASST), chronic spontaneous urticaria (CSU), autologous serum therapy (AST), chronic autoimmune urticaria (CAU)

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