WISC, Dubai, Dec 2010 Allergy Skin Testing Techniques Sami Bahna, MD, DrPH Professor of Pediatrics & Medicine Chief of Allergy/Immunology Section Louisiana State University Health Sciences Center Shreveport, Louisiana [email protected] Who should be skin tested ? • Significant allergy symptoms that are not optimally controlled with “conservative” pharmacologic therapy and the offending allergens could not be identified through the: - medical history, - environmental manipulation, - dietary elimination-challenge. • Screening for persistent drug or insect sting allergy. Allergy Skin Testing Techniques • Epicutaneous • Percutaneous: prick, puncture, (scratch) • Intradermal (intracutaneous) • Patch (primarily for type IV) Percutaneous Skin Testing Procedure • Verify no antihistaminic medications. • Cleanse skin. • Space 1-2 inches apart. • Apply allergen extracts with appropriate device. • Include positive (histamine ) & negative controls. • Measure or grade reactions at 15-20 min. • Check early for histamine response & large reactions. • Record reactions. • May apply soothing cream after reading for itching. Morrow Brown disposable needle Puncture by bifutcated needle Multi-Test Multi-Test