Skin prick testing

This is the primary mode of testing for immediate IgE-mediated allergy. It is widely practised and can provide high-quality information when performed optimally and interpreted correctly.

Small amounts of allergen are introduced into the epidermis and interact with specific IgE bound to cutaneous mast cells. Histamine and other mediators are released, leading to a visible “wheal-and-flare” reaction peaking after about 15 minutes. Skin prick testing should be used to confirm the diagnosis of allergy when added to the history and clinical examination. It differentiates allergic diseases from other mimicking conditions. It may lead to allergen avoidance strategies, improved use of medications, and for some patients, Immunotherapy.

“Skin prick testing is usually the first test recommended when an allergy is suspected. The advantages are that it is a simple, quick (providing results within 15-20 minutes) and inexpensive form of testing.”

Allergy UK

The UK guideline “Good Allergy Practice” contains the following statement:

“A diagnosis of allergy is based first and foremost on a careful clinical history.

Skin tests should be used to support (or otherwise) a diagnosis of allergy. The skin prick test is the method of choice for the diagnosis of immediate-type hypersensitivity.”