Skin prick tests (SPT) represent indispensable tools in allergy, even more than 30 years after their introduction in clinical practice (note: skin prick testing has been used in the U.S. for a lot longer than 30 years).
A wheal with multiple pseudopods and a satellite lesion in the upper left. Image source: Modified from Sakurako Kitsa's photostream, Flickr (used with the author's permission).
Four instruments were investigated in this European study:
- 23G intravenous (IV) needle
- ALK Lancet - SoluPrick SQ (TM)
- Stallergenes (STG) Prick Lancet
- Stallerpoint (using two different methods)
In terms of sensitivity, the IV needle (100%) and metal lancets (96% for the ALK Lancet and 98% for the STG Prick Lancet) were superior to the two Stallerpoint® methods (20% and 57%).
The instruments that were best tolerated by the patients were the IV needle and the two metal lancets.
The authors concluded that metal needles and/or lancets are the tools of choice for skin prick testing. The study did not include some of the most popular devices for SPT in the U.S. such as:
- ComforTen (PDF)
- Multi-Test II (instructions)
Comparison of diagnostic methods for peanut, egg, and milk allergy - skin prick test (SPT) vs. specific IgE (sIgE) (click to see the spreadsheet). Sensitivity of blood allergy testing is 25-30% lower than that of skin testing, based on comparative studies (CCJM 2011).
Skin prick test vs. serum IgE
Skin testing correlates better with nasal allergen challenge (the gold standard) than blood testing for the diagnosis of inhalant allergy. According to current guidelines, skin tests are the preferred method for diagnosing IgE-mediated sensitivity to inhalants (CCJM 2011).
Comparison of five techniques of skin prick tests used routinely in Europe. Masse MS, Granger Vallée A, Chiriac A, Dhivert-Donnadieu H, Bousquet-Rouanet L, Bousquet P-J, Demoly P. Comparison of five techniques of skin prick tests used routinely in Europe. Allergy 2011; DOI: 10.1111/j.1398-9995.2011.02679.x.
Practical guide to skin prick tests in allergy to aeroallergens (free full text). Allergy, 2011.
Comparison of the Multi-Test II and ComforTen allergy skin test devices. Dykewicz MS, Dooms KT, Chassaing DL. Allergy Asthma Proc. 2011 May;32(3):198-202.
Skin prick tests (SPT)