Safety of intradermal skin tests for inhalants and foods: a prospective study

Int Forum Allergy Rhinol. 2013 Mar;3(3):171-6. doi: 10.1002/alr.21091. Epub 2012 Oct 8.

Abstract

Background: Intradermal skin testing is a useful allergy diagnostic tool. Although considered safe when properly performed, systemic reactions have been reported. This is the first large, prospective study to record and evaluate all systemic reactions from intradermal skin testing (IDT) to inhalant or food antigens.

Methods: A 24-month prospective study by 40 physician practices, recording all IDT tests, including reactions, symptoms, severity, time after injection, and reaction treatments.

Results: Eighty systemic reactions (22 major) occurred among 20,530 patients (878,583 wheals). Nine had epinephrine treatment, 4 were observed in an emergency department, and there were no hospitalizations or fatalities. The overall systemic reaction risk was 0.009%. The risk of having a major reaction was 0.003%, or 1 reaction per 933 patients.

Conclusion: Intradermal skin tests for inhalants or foods, when performed with appropriate precautions, have a safety profile comparable to skin prick tests.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Allergens* / immunology
  • Anaphylaxis / etiology
  • Anaphylaxis / prevention & control*
  • Desensitization, Immunologic / adverse effects
  • Feasibility Studies
  • Food / adverse effects
  • Food Hypersensitivity / complications
  • Food Hypersensitivity / diagnosis*
  • Food Hypersensitivity / immunology
  • Food Hypersensitivity / therapy
  • Humans
  • Inhalation
  • Intradermal Tests / adverse effects
  • Intradermal Tests / methods*
  • Particulate Matter / adverse effects
  • Particulate Matter / immunology
  • Patient Safety
  • Practice Guidelines as Topic
  • Prospective Studies
  • Risk

Substances

  • Allergens
  • Particulate Matter