Systemic Reactions to Skin Prick Test with Food Allergens in Children

Abstract

Objective: Although skin prick tests (SPTs) are generally considered safe, limited studies have specifically evaluated reactions related to SPTs with all allergens. In contrast to these studies, our aim is to exclusively evaluate systemic reaction (SR) occurrences with food allergens during SPTs in children. Materials and Methods: All patients who underwent skin prick and/or prick-to-prick (PtoP) tests with food allergens at our clinic between January 2010 and January 2020 were included in the study. The occurrence of SR during SPTs was evaluated based on patient records. Results: The study included 1852 patients, with 57% males and a median age of 31 months (1-210). Skin tests were most commonly conducted for the indication of atopic dermatitis (29.3%). During the study, 11.2% had repeat SPTs for tolerance and a new allergy diagnosis. No local reactions or SRs occurred during SPTs. Among those with PtoP tests, 3 patients (0.16%) experienced SRs—1 had anaphylaxis (0.05%), the rest had angioedema. Legumes and sea bass caused these reactions. In patients with severe index reactions and those who underwent PtoP testing, SR development was significantly higher (P < .001 for both), and anaphylaxis occurrence was significantly higher among those undergoing PtoP testing compared to prick testing alone (P = .03). Conclusion: The prevalence of both SR and anaphylaxis due to SPT with food allergens was found to be quite low in children. However, it is important to consider the possibility of SR development before conducting SPT with food allergens, especially in patients who will undergo the PtoP test and those with severe index reactions.