Intradermal positivity after negative prick testing for inhalants

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Abstract

OBJECTIVE:

Examine the incidence of positive intradermal tests after a negative skin prick test for 24 inhalant antigens.

STUDY DESIGN AND SETTING:

Retrospective study. Charts from patients who underwent modified quantitative testing (MQT) over a 3-year period were reviewed. Patients were initially tested with Multi-Test II. Subjects with negative wheals to a specific allergen were then tested with a 1:500 weight:volume intradermal injection of that allergen.

RESULTS:

One hundred thirty-three patients underwent MQT for 24 antigens. Allergens with the highest incidence of positive intradermal wheals after negative prick testing were Dermatophagoides pteronyssinus and Dermatophagoides farinae at 26.67%. Allergens with elevated incidence of positive intradermals included fusarium, cockroach, cocklebur, rough marsh elder, and ragweed, all with incidences of 16% to 19%.

CONCLUSION:

Positive intradermal responses after negative prick testing occur commonly. Future study is needed to determine the generalizability and clinical significance of these findings.

CONCLUSION:

EBM rating: C-4

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