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Simultaneous intradermal testing with hymenoptera venoms is safe and more efficient than sequential testing
B Strohmeier1, W Aberer, D Bokanovic
1Division of Environmental Dermatology and Venerology, Department of Dermatology, Medical University of Graz, Graz, Austria.
Background:
According to current guidelines, skin testing for hymenoptera venom allergy should be performed in a stepwise manner, maintaining 15- to 20-min intervals between the injections of venom. Given the long-winded procedure of sequential skin testing, we retrospectively explored the safety of simultaneous intradermal testing.
Methods:
Four hundred and seventy-eight consecutive patients with a convincing history of an anaphylactic reaction after a hymenoptera sting were tested. All venom concentrations (0.02 ml of 0.001, 0.01, 0.1, and 1.0 μg/ml of honey bee and wasp venom) were administered simultaneously to the skin.
Results:
Four hundred and seventy-two (98.7%) patients tolerated the simultaneous intradermal test without any side-effects. Only three subjects (0.6%) had a presumed allergic reaction during the test; another three reactions were considered vasovagal.
Conclusion:
Our skin test protocol with four simultaneously injected concentrations of two hymenoptera venoms is safe and permits the investigator to draw rapid conclusions about the individual's sensitization pattern.
