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The skin prick test – European standards

Lucie Heinzerling1*, Adriano Mari2, Karl-Christian Bergmann3, Megon Bresciani4, Guido Burbach3, Ulf Darsow5, Stephen Durham6, Wytske Fokkens7, Mark Gjomarkaj8, Tari Haahtela9, Ana Todo Bom10, Stefan Wöhrl11, Howard Maibach12 and Richard Lockey13

Author Affiliations

1 Department of Dermatology, University Hospital Erlangen, 91054 Erlangen, Germany

2 Board Member of the EAACI Allergy Diagnosis Interest Group, IDI-IRCCS, Center for Molecular Allergology, Rome, Italy

3 Department of Dermatology and Allergy, Charité Universitätsmedizin-Berlin, Berlin, Germany

4 Consiglio Nazionale delle Ricerche, Rome, Italy

5 Department of Dermatology and Allergy Biederstein and Division of Environmental Dermatology and Center of Allergy and Environment (ZAUM), Technical University, Munich, Germany

6 Department of Respiratory Medicine, Royal Brompton Hospital, London, UK

7 Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, Netherlands

8 Consiglio Nazionale delle Ricerche, Palermo, Italy

9 Skin and Allergy Hospital, University Central Hospital, Helsinki, Finland

10 ImunoAlergologia, Coimbra University, Coimbra, Portugal

11 Department of Dermatology, Medical University of Vienna, Vienna, Austria & Floridsdorf Allergy Centre (FAZ), Vienna, Austria

12 Department of Dermatology, University of California, San Francisco, California, USA

13 Division of Allergy & Immunology, University of South Florida College of Medicine, Tampa, Florida, USA

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Clinical and Translational Allergy 2013, 3:3  doi:10.1186/2045-7022-3-3

Published: 1 February 2013

Abstract

Skin prick testing is an essential test procedure to confirm sensitization in IgE-mediated allergic disease in subjects with rhinoconjunctivitis, asthma, urticaria, anapylaxis, atopic eczema and food and drug allergy. This manuscript reviews the available evidence including Medline and Embase searches, abstracts of international allergy meetings and position papers from the world allergy literature. The recommended method of prick testing includes the appropriate use of specific allergen extracts, positive and negative controls, interpretation of the tests after 15 – 20 minutes of application, with a positive result defined as a wheal ≥3 mm diameter. A standard prick test panel for Europe for inhalants is proposed and includes hazel (Corylus avellana), alder (Alnus incana), birch (Betula alba), plane (Platanus vulgaris), cypress (Cupressus sempervirens), grass mix (Poa pratensis, Dactilis glomerata, Lolium perenne, Phleum pratense, Festuca pratensis, Helictotrichon pretense), Olive (Olea europaea), mugwort (Artemisia vulgaris), ragweed (Ambrosia artemisiifolia), Alternaria alternata (tenuis), Cladosporium herbarum, Aspergillus fumigatus, Parietaria, cat, dog, Dermatophagoides pteronyssinus, Dermatophagoides farinae, and cockroach (Blatella germanica). Standardization of the skin test procedures and standard panels for different geographic locations are encouraged worldwide to permit better comparisons for diagnostic, clinical and research purposes.

Keywords:
Sensitization; Inhalant allergens; Skin prick test panel; Aallergies; Type I allergy; Diagnostic test; Asthma