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Comparison of skin test reactivity to histamine on back and forearm in young children

Araya Yuenyongviwat1, Duangrachanee Koonrangsesomboon, Pasuree Sangsupawanich

  • 1Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand. taraya@medicine.psu.ac.th

Asian Pacific Journal of Allergy and Immunology
|February 12, 2013
PubMed

Insights

Young children show different skin reactions to allergy tests depending on the location. The upper back is more sensitive than the forearm for skin prick testing (SPT) in infants.

Area of Science:

  • Pediatric Allergy and Immunology
  • Dermatology
  • Clinical Diagnostics

Background:

  • Skin prick testing (SPT) interpretation relies on standardized controls.
  • Data on skin reactivity to controls in young children is limited.
  • This study addresses the lack of information regarding pediatric skin responses.

Purpose of the Study:

  • To determine skin reactivity to standardized positive and negative controls in young children.
  • To compare skin responses on the upper back versus the forearm.
  • To establish the optimal site for SPT in pediatric populations.

Main Methods:

  • Skin prick tests performed on 133 children aged 6-25 months.
  • Utilized histamine hydrochloride (positive control) and glycerol-saline (negative control).
  • Evaluated reactions on both the upper back and forearm, alongside common allergens.

Main Results:

  • Significant differences in wheal and flare responses to histamine were observed between the upper back and forearm (p < 0.0001).
  • The upper back demonstrated greater reactivity to both positive and negative controls compared to the forearm.
  • Negative control reactions also showed statistically significant differences between the two sites (p = 0.007 for wheal, p < 0.0001 for flare).

Conclusions:

  • Regional variations in skin reactivity to SPT controls exist in young children.
  • The upper back is a more reactive site than the forearm for SPT in this age group.
  • The upper back is recommended as the preferred site for skin prick testing in young children.
Abstract

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