Can skin prick tests provoke severe allergic reactions?

BACKGROUND Studies have reported adverse reactions during skin prick tests (SPTs), however such reactions are almost non existent in children. On the contrary, there are controversial data on the effectiveness and reliability of diagnostic tools. SPTs are considered as the more rapid and effective tool for the diagnosis of pediatric allergies. SPTs, when employed either correctly or with standardized extracts, are rapid, safe, sensitive, inexpensive on a per test basis and the results are reliable, since they are largely experimented. OBSERVATIONS SPT is the more employed method for the diagnosis of atopic disease elicited by type I immune reactions, where sensitizing antibodies are present. However, we discuss a study surprisingly reporting six generalized allergic reactions after prick tests with fresh foods in infants less than 6 months of age out of 1,152 tested during three years (0.17% for each year). CONCLUSIONS In this study, all reactions were treated with epinephrine and/or antihistamines, plus steroids in three cases. Purpose of the present study was to assess whether the practice of performing SPTs, either in the usual manner, or in duplicate could be a risk factor in infants with extensive eczema. Moreover, excluding young babies from STPs or even applying only one SPT each visit delays an early diagnosis. In the same period of three years, we have done SPTs in at least 10,000 children, without seeing any generalized allergic reaction.