Adverse reactions to skin prick testing in children - prevalence and possible risk factors

Area of Science:

• Allergy and Immunology
• Pediatric Dermatology
• Clinical Research

Background:

• Skin prick testing (SPT) is a common diagnostic tool for allergies.
• While generally safe, rare cases of severe adverse reactions have been reported.
• The prevalence and risk factors for these reactions in pediatric populations require further investigation.

Purpose of the Study:

• To prospectively determine the prevalence of adverse reactions to SPT in children.
• To identify specific risk factors associated with generalized allergic reactions (GARs) and vasovagal reactions (VVRs) during SPT.
• To inform clinical practice regarding patient selection and monitoring during SPT.

Main Methods:

• A prospective study involving 5,908 pediatric patients (< or =18 years) across 11 centers.
• Adverse reactions were categorized as Generalized Allergic Reactions (GARs) or Vasovagal Reactions (VVRs).
• Statistical analysis was used to identify risk factors, including age, sex, eczema status, and number of skin pricks.

Main Results:

• Overall adverse reactions occurred in 0.24% of patients (14/5,908).
• The risk for GARs was 0.12% (7/5,908), with risk ratios of 6.28 for age <1 year and 16.98 for active eczema.
• The risk for VVRs was also 0.12% (7/5,908), with risk ratios of 7.32 for female sex and a significant association with multiple skin pricks (p < 0.05).

Conclusions:

• Generalized allergic reactions (GARs) to SPT, though rare (0.12%), necessitate preparedness for emergency management.
• Infants under 1 year and children with active eczema are at increased risk for GARs.
• Female patients and those undergoing multiple skin pricks are more susceptible to VVRs, highlighting the need for tailored attention.