Skin Prick Testing with Aeroallergen Extracts: What Is the Optimal Panel for Children and Adolescents?

The skin prick test (SPT) is the standard tool for the diagnosis of IgE-mediated allergic diseases. History of Allergy: in 1869, to investigate his own hay fever, Charles Blakely performed the first skin test. 

This study from Turkey tried to determine the minimum test battery panel necessary to cover at least 95% of the cases of SPT sensitization in children and adolescents (2-18 years).

A total of 2,500 children with a median age of 6.8 years were subjected to SPT during a 2.5-year period. 35% children were sensitized to at least one of the 30 aeroallergen extracts tested.

The most common sensitizations were to:

- grasses (Festuca pratensis, Phleum pratense, Dactylis glomerata, and Lolium perenne)
- house dust mites (Dermatophagoides pteronyssinus and Dermatophagoides farinae)
- cat
- weeds (Chenopodium, Plantago, and Artemisia)
- molds (Alternaria and Cladosporium)

The sensitization rates increased with an increase in age.

Testing with 12, 8, and 7 allergens was sufficient to identify over 95% of the sensitized preschool children, school children, and adolescents, respectively.

An SPT panel covering 12 allergen extracts was sufficient to detect most of the sensitized children and adolescents with recurrent respiratory symptoms. As the patients grow older, a smaller test panel was required compared to the panels used at younger ages.

What to expect when visiting an allergy clinic

The current allergy skin tests are virtually painless. This video by Dr. Bassett, a board-certified allergist from New York City, shows what to expect when visiting an allergy clinic for diagnosis and treatment:



References:

Skin Prick Testing to Aeroallergen Extracts: What Is the Optimal Panel in Children and Adolescents in Turkey? Int Arch Allergy Immunol. 2011 Nov 25;157(4):391-398.

Image source: Skin prick testing on the left side of the back shows a negative control (1), a positive control (2) and multiple positive tests to trees and grass (3-20).

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