A safe and quick diagnostic test in which allergic sensitivity is evaluated using small drops of allergen extracts applied to the skin.
Indication
- Diagnosis of allergic rhinitis (hay fever) and identification of allergens
- Identification of triggering allergens in patients with asthma
- Allergen screening associated with atopic dermatitis
- Sensitivity testing in suspected food allergy
- Investigation of sensitivity to pet dander, pollen, and house dust mites
- Treatment planning before subcutaneous immunotherapy (SCIT)
- Assessment in cases with a history of drug or bee sting allergy
Preparation
- Antihistamines must be discontinued 5-7 days in advance
- Use of systemic corticosteroids should be reported to the physician
- No cream or moisturizer should be applied to the skin on the day of the test
- The test may be postponed during a severe attack or widespread eczema flare
- The procedure may be performed if there is no active infection
How it's performed
- The test is applied to the inner forearm or back
- The skin is wiped with antiseptic, and allergen drops are marked at specified intervals
- The skin is superficially scratched with sterile plastic lancets (no bleeding)
- Positive control (histamine) and negative control (saline) are added
- After 15-20 minutes, the developing wheal (papule) and redness are measured
- Results are evaluated relative to the positive control
Post-procedure
- The test area may itch within 24 hours; cold compresses provide relief
- Results are evaluated together with the clinical history
- Recommendations to avoid the trigger are made based on positive results
- If needed, confirmation with specific IgE blood testing
- A treatment plan (avoidance, medication, immunotherapy) is determined
Risks
- Transient itching and redness at the test site (expected reaction)
- Local swelling (resolves within hours)
- Very rare systemic allergic reaction (anaphylaxis — performed in a prepared setting)
- Late-type reactions (after 24-48 hours)
- False-negative result (if antihistamines are being used)
FAQ
Is the test painful?
There is a mild pinprick sensation with the lancet scratches; it is mostly not bothersome.
When are results available?
Results are obtained within 15-20 minutes during the test.
Can it be performed on children?
It is generally performed safely in children over 2 years old. Alternative tests are preferred in infants.
I am taking an antihistamine; can the test be performed?
To prevent the medications from causing a false-negative result, they must be discontinued 5-7 days in advance.
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