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Related Experiment Video

Updated: Oct 15, 2025

Precision Implementation of Minimal Erythema Dose MED Testing to Assess Individual Variation in Human Inflammatory Response
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Diurnal Variations in Skin Prick Testing.

Elisa Ochfeld1,2, Brian Cheng2, Nina Bowsher3

  • 1Pediatric Allergy-Immunology, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.

Pediatric Allergy, Immunology, and Pulmonology
|October 29, 2021
PubMed
Summary

Skin prick testing (SPT) results show no significant difference in wheal size based on time of day. This allergy test can be reliably performed at any time, regardless of whether it is morning or afternoon.

Keywords:
circadian rhythm in allergic diseasediurnal variationpediatricsskin prick testing

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Area of Science:

  • Allergy and Immunology
  • Dermatology
  • Clinical Research

Background:

  • Previous studies suggested potential diurnal variations in skin prick testing (SPT) reactions.
  • The clinical significance of these potential variations remains unclear.

Purpose of the Study:

  • To investigate whether the time of day affects the size of reactions in skin prick testing.
  • To determine if SPT results are reliable when performed at different times.

Main Methods:

  • Retrospective chart review of 12,982 patient SPT results from June 2008 to June 2017.
  • Patients' tests were grouped into four time intervals throughout the day.
  • Analysis focused on histamine, food allergen, and aeroallergen wheal and erythema sizes.

Main Results:

  • No significant difference in histamine, food allergen, or aeroallergen wheal size was observed between morning and afternoon testing.
  • Histamine erythema size was significantly increased in the afternoon (P ≤ 0.01).
  • Food and aeroallergen erythema sizes showed a trend toward increase in the afternoon.

Conclusions:

  • Skin prick testing wheal sizes do not significantly vary based on the time of day.
  • Erythema reactions may show some diurnal variation, but wheal size remains consistent.
  • SPT is a reliable diagnostic tool that can be performed effectively at any time of day.