Prick/Puncture Testing

Diagnostic testing is an essential tool for the evaluation of the allergic patient. Percutaneous skin testing ranks first in confirming the presence of IgE-mediated sensitization in the clinician’s office. Prick or scratch testing (also referred to as percutaneous) is minimally invasive, and when it is performed correctly it has good reproducibility, is easily quantified, and allows for the evaluation of multiple allergens in one session.1

HollisterStier Allergy offers a wide-range of diagnostic products, including 5mL scratch vials of allergenic extracts, Histamine positive control, and 50% Glycerin negative control. In addition, HollisterStier offers two unique skin test systems. Our skin test devices are equipped with 1.2 mm stainless surgical steel tips that penetrate uniformly to obtain reproducible, well-defined reactions with minimal discomfort and trauma to your patients.

C10ComforTen® Multiple Skin Test System

QUINTEST® Multiple Skin Test System

Prick/Puncture Testing

  1. Skin is prepared for testing. Wipe area with an alcohol pad and when dry mark skin into sections.
  2. The allergens are put into a labeled tray
  3. Using a skin test device, the nurse/technician will dip into the allergens tray and apply the device to the skin according to the manufacturer instructions. This allows a tiny amount of the allergen solution to enter the skin just below the surface
  4. Wait 10 minutes for Histamine and 15 minutes for allergen and measure results.
  5. Procedure is valid if a histamine wheal reaction of – 3mm or larger than the negative control is observed
  6. If an allergen wheal reaction is 3mm or larger than the negative control then this is classed as positive
  7. If an allergen wheal reaction is less than 3mm than the negative control then this is classed as negative
  8. If the allergen reaction is equivocal or is negative but clinical history strongly suggests sensitivity intradermal testing may be required.

HollisterStier Package Insert: ComforTen® Multiple Skin Test System

Intradermal Testing

  1. Skin is prepared for testing. Wipe area with an alcohol pad and when dry mark skin into sections.
  2. Prepare allergens and label syringes
  3. Small amounts of allergen 0.02 – 0.05 mL are injected under the skin at least 2.5 cm apart
  4. A similar volume of a suitable negative control is injected under the skin
  5. Wait 15-20 minutes and measure the results for swelling and redness larger than the negative control.

HollisterStier Package insert: Allergenic Extracts for Intradermal Testing

Intradermal Testing

Intradermal testing (IDT) is performed by injecting a small amount of an allergen extract into the skin, with a syringe and a needle. The reading is performed after 10-15 minutes assessing the resulting papule and redness.2 Intradermal testing (IDT) is far more sensitive than prick/puncture testing, which means that it requires less concentrated extracts than those used for prick/puncture testing to achieve a similar response.1 However, intradermal tests are performed one allergen at a time and can cause more pain to the patient compared to percutaneous skin testing.2

HollisterStier Allergy offers intradermal syringes and syringe trays for use in IDT. Visit our product catalog or our Intradermal Allergy Extract Preparation Guide  to learn more.

References

1Oppenheimer et al. “Allergy Diagnostic Testing.” World Allergy Organization. http://www.worldallergy.org/professional/allergic_diseases_center/allergy_diagnostic/ Accessed March 9, 2018.

2Mazon, Angel. “Intradermal Testing.” European Academy of Allergy and Clinical Immunology. https://patients.eaaci.org/intradermaltest/ Accessed February 18, 2019