What molds to select for skin prick testing?

The following molds should be selected for a general screening panel for skin prick testing in the U.S.:

- Alternaria alternata
- Aspergillus fumigatus
- Penicillium chrysogenum (notatum)
- Cladosporium herbarum, C. cladosporiodes, C.sphaerospermum (Hormodendrum hordei (consider mix) - Drechslera (Curvularia) spicifera or Bipolaris sorokiniana (Helminthosporium sativum)
- possibly Epicoccum nigrum



Various fungi including Penicillium and Aspergillus spp. growing in axenic culture. Image source: Wikipedia, Dr. David Midgley Cultures: Dr. David Midgley University of Sydney, Australia, Creative Commons License.

The following molds should be added for an expanded panel for skin prick testing in the U.S.:

- Fusarium species - solani, vasoinfectum, moniliforme (consider mix). Fusarium has been implicated in food allergy to quorn (meatless foods based on mycoprotein)
- Mucor racemosus
- Aureobasidium (Pullularia) pullulans
- Aspergillus species - flavus, niger (consider mix)
- Trichophyton tonsurans
- Chaetonium globosum
- +/- Candida albicans
- Phoma and Stemphyllium share allergens with Alternaria. Aspergillus and Penicillium have cross-reactive allergens.

References

Appropriate molds for skin testing. AAAAI Ask the Expert, 2011.
Aspergillus niger and its role in human diseases
Allergic reaction after consumption of "meat-free chicken” (Quorn mycoprotein) by a patient with mold allergy
Infectious Fungus Common In Household Drains (Fusarium) - NPR, 2011. "Meatless chicken" (Quorn) is made of Fusarium.
Immunotherapy to molds - the only two molds which have been studied extensively are Alternaria and Cladosporium http://buff.ly/VkpH8Y
Ethyl-chloride spray prevents itching secondary to allergy skin test, without masking the results http://buff.ly/1EFsQ0v