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Principles of Allergy Skin Testing

  • Özlem Naciye Şahin
  • Cemal Cingi
  • Jennifer Derebery
Chapter

Abstract

For the diagnosis of allergic rhinitis (AR), the allergen-specific IgE is assumed to be the factor responsible for eliciting inflammation and the symptoms. Therefore, the objective of the diagnostic test is to determine whether IgE-mediated allergy is involved in a sensitized patient who has symptoms consistent with allergy. Interestingly, the recognition of IgE specifically does not indicate allergic symptoms. In addition, many people may be sensitized and not allergic clinically. In patients with AR symptoms, testing is necessary for the diagnosis of IgE-mediated reactions. For IgE specificity, a skin prick tests or a blood test (in vitro test) can be used. Presently, skin prick tests are the gold standard for the detection of allergies due to their non-invasiveness and affordability. The skin prick test for AR is reproducible and should be executed using thorough methods. Briefly, skin prick tests should be recorded by measuring the widest diameter of erythema at the test site 10–15 min after test application. A positive score is recorded based on EAACI recommendations. The interpretation must be backed by clinical history to verify diagnosis. False positives may occur by weak extract potency, poor technique, and/or current medication. The IgE-mediated response to skin prick test is reliant on acute phase mediators, which precedes the late response. The acute reaction will typically be seen within 10–15 min of skin test application, while the late phase reaction may be seen within 2–6 h of testing and subsides at 24 h. The late phase reaction is associated with an influx of T cells, rather than IgE-mediated. In this chapter, principles of allergy skin testing are presented.

Keywords

Allergic rhinitis Allergen-specific IgE Allergy skin testing Principles Acute reaction Late phase reaction 

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Özlem Naciye Şahin
    • 1
  • Cemal Cingi
    • 2
  • Jennifer Derebery
    • 3
  1. 1.Department of PediatricsAcıbadem Mehmet Ali Aydınlar Medical FacultyIstanbulTurkey
  2. 2.Eskişehir Osmangazi University, Medical FacultyDepartment of OtorhinolaryngologyEskisehirTurkey
  3. 3.Department of Otolaryngology-Head and Neck SurgeryHouse Ear Clinic and Institute, David Geffen School of Medicine, University of California at Los AngelesLos AngelesUSA

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