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Skin testing and food challenges in allergy and immunology practice

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Summary

Skin tests by prick technique offer considerable guidance in the diagnosis of food allergy. Negative prick skin tests are powerful evidence against food allergy. Positive food skin tests are slightly to moderately predictive of reaction to a food on DBPCFC. Oral food challenge is necessary for confirmation of food allergy, except where the history is overwhelmingly convincing. Open, incremental food challenge as described is diagnostic if negative, but only 50% of all positive open challenges are confirmed on blinded challenge. DBPCFC can be designed for any food with simple blinding techniques. The technique of DBPCFC can be modified for investigation of atypical symptoms.

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Authors and Affiliations

  1. Division of Pediatric Allergy and Immunology, Duke University School of Medicine, 27710, Durham, NC

    Larry W. Williams (Associate Professor of Pediatrics)

  2. University of Colorado Health Sciences Center, Denver, CO

    S. Allan Bock (Clinical Professor of Pediatrics)

Authors
  1. Larry W. Williams
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  2. S. Allan Bock
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Williams, L.W., Bock, S.A. Skin testing and food challenges in allergy and immunology practice. Clinic Rev Allerg Immunol 17, 323–338 (1999). https://doi.org/10.1007/BF02737614

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  • DOI: https://doi.org/10.1007/BF02737614

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