Diagnostic Methods: Cutaneous Provocation Tests in Contact Urticaria Syndrome
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Skin tests are important in the diagnosis of contact urticaria syndrome and can usually be carried out quickly, inexpensively, and safely. The skin prick test remains the investigation of choice for most patients with immunological contact urticaria in addition to its wider application in the diagnosis of allergic rhinoconjunctivitis, asthma, and food allergy. If skin prick tests and in vitro tests for allergen-specific IgE are negative, a provocation/challenge test may ultimately be required for diagnosis. Nonstandardized tests for contact urticaria include open testing, closed chamber testing, and scratch and scratch-chamber testing. Correct technique is essential to avoid false-negative results, which may put the patient at ongoing risk of exposure, and false-positive results, which can have important social, occupational, and medicolegal consequences. Staff carrying out these procedures should be appropriately trained and equipped to handle severe allergic reactions including anaphylaxis.
KeywordsSkin prick test Open test Scratch test Scratch-chamber test Nonimmunological contact urticaria Immunological contact urticaria Immediate-type hypersensitivity Challenge/provocation/usage test
I am grateful to Dr Sophie Farooque, Consultant Allergist, for her helpful comments on this manuscript.
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