The incidence and features of systemic reactions to skin prick tests.

Skin prick testing (SPT) has been regarded as a safe procedure with few systemic reactions.
To evaluate the rate of systemic reactions and their associations after SPT in the largest population to date.
In this study reactions were recorded prospectively in a specialist UK allergy clinic for 6 years (2007-2013). An estimated 31,000 patients underwent SPT.
Twenty-four patients (age range 7 months to 56 years, mean 23.5 years, 17 female patients, 12 with asthma) had systemic reactions. The rate of systemic reactions to SPT was 0.077%. The likely allergens causing the reaction were foods (18; peanut, 7; walnut, 1; Brazil nut, 2; pistachio, 1; lupin, 1; cow's milk, 2; shrimp, 1; spinach, 1; legume, 1; soy, 1), aeroallergens (4; rabbit, 1; rat, 1; ragwort, 1; grass pollen, 1), wasp venom (1), and Tazocin (1). The causative SPT wheal was larger than 8 mm in 75%. The reaction to Tazocin was severe, with anaphylaxis occurring minutes after SPT. Reactions were treated immediately in the clinic and did not require further medical care.
In this largest single-center study, the rate of systemic reactions after SPT was 77 per 100,000 patients. It is the first study to identify foods as a common and important cause (75%), with nuts posing the highest risk. This study reports the first systemic reaction to venom SPT and the first anaphylactic reaction after drug SPT. There was an association with a history of severe reactions and large skin test reaction. There are risks, albeit small, when undertaking SPT.
AuthorsPriya Sellaturay, Shuaib Nasser, Pamela Ewan
JournalAnnals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology (Ann Allergy Asthma Immunol) Vol. 115 Issue 3 Pg. 229-33 (Sep 2015) ISSN: 1534-4436 [Electronic] United States
PMID26254972 (Publication Type: Journal Article)
CopyrightCopyright © 2015 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.
Chemical References
  • Allergens
  • piperacillin, tazobactam drug combination
  • Penicillanic Acid
  • Piperacillin
  • Adolescent
  • Adult
  • Allergens (immunology)
  • Anaphylaxis (immunology)
  • Child
  • Child, Preschool
  • Erythema (immunology)
  • Female
  • Food Hypersensitivity (immunology)
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Nut Hypersensitivity (immunology)
  • Penicillanic Acid (analogs & derivatives, immunology)
  • Piperacillin (immunology)
  • Prospective Studies
  • Retrospective Studies
  • Skin Tests (adverse effects)
  • Urticaria (immunology)
  • Young Adult

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