Patterns of mold sensitivity in the subtropical Gulf Coast

We sought to determine the patterns of mold- and nonmold positive skin tests in a subtropical Gulf Coast climate and to determine whether any particular positive skin tests predict "allergic versus nonallergic" status as shown on the full panel of skin testing.

We conducted a retrospective evaluation of serial endpoint allergy skin test results in 75 consecutive patients from a tertiary referral medical center.

Of the 67 evaluable patients, 58 (86.6%) had a positive skin test to at least 1 antigen. The most common positive skin tests were in response to cockroach, Dermatophygoides farinae, Bermuda grass, false ragweed, mesquite, Stemphylium, Curvularia, short ragweed, and Timothy grass. There were no identifiable groups of antigens that tended to occur together. Screening with a panel of 6 antigens (cockroach, dust mite, cat, rough marsh elder, Timothy grass, and Stemphylium) would have correctly predicted whether the patient would react to any or none of the full panel of antigens.

Cockroach, dust mite, and a grass were the most common positive skin tests among our patients, with many patients also having positive skin tests to molds. Although there is evidence that cross-reactivity exists among different mold species, we were unable to identify any clusters of mold reacting together in individual patients. In our patient population, a 6-allergen screening panel (cockroach, dust mite, cat, rough marsh elder, Timothy grass, and Stemphylium) would have accurately distinguished "allergic" from "nonallergic" patients, as demonstrated on the full panel of skin testing.

A small (6-antigen) screening panel accurately predicted "allergic" versus "nonallergic" as shown by our full panel of skin testing. This is useful clinically when an "allergic versus nonallergic" etiology of sinonasal symptoms affects treatment choices.