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Diagnostic Tests – Allergy Testing (Skin Prick / Intradermal Testing)
1. For which clinical scenario is this test used?
Allergy testing involves subdermal or skin exposure to small amounts of suspected allergens, followed by observation for a localized hypersensitivity reaction. It is used when a patient has allergic symptoms and the specific trigger is unclear, such as:
2. When is allergy testing contraindicated?
Allergy testing is contraindicated in patients with:
High anaphylaxis risk or unstable asthma → do NOT perform skin allergy testing
3. What medication must be stopped before allergy testing?
Beta blockers (e.g., propranolol) must be stopped prior to allergy testing or desensitization when possible.
Why?
Allergy testing + beta blocker = dangerous combination
1. For which clinical scenario is this test used?
Allergy testing involves subdermal or skin exposure to small amounts of suspected allergens, followed by observation for a localized hypersensitivity reaction. It is used when a patient has allergic symptoms and the specific trigger is unclear, such as:
- Allergic rhinitis (runny nose, sneezing, watery eyes)
- Suspected allergies to:
- Foods
- Pets
- Aeroallergens (pollens, dust mites, molds)
- Venoms (bees, wasps)
2. When is allergy testing contraindicated?
Allergy testing is contraindicated in patients with:
- A high risk of anaphylaxis based on prior severe reactions
- Uncontrolled or severe asthma, due to increased risk of life-threatening reactions during testing
High anaphylaxis risk or unstable asthma → do NOT perform skin allergy testing
3. What medication must be stopped before allergy testing?
Beta blockers (e.g., propranolol) must be stopped prior to allergy testing or desensitization when possible.
Why?
- If anaphylaxis occurs, epinephrine is the life-saving treatment
- Beta blockers blunt the response to epinephrine, making treatment of anaphylaxis less effective
Allergy testing + beta blocker = dangerous combination
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