Does the reaction size of skin prick test associated with the allergic rhinitis symptom severity?

Skin prick test (SPT) has the best positive predictive value to diagnose respiratory atopic diseases, including allergic rhinitis (AR), but the association of severity of allergic symptom and SPT reaction size has not been clearly determined yet.

In this a cross- sectional investigation, the severity of disease is classified using a visual analog scale for main symptoms, and SPT was conducted according to the principles of the European Academy of Allergy and Clinical Immunology.

Thirty seven percent of the participants had at least one severe symptom. Patients with sensitivity to Alternaria (common allergens in humans) or tree pollens had more severe symptoms. We found that in patients who had sensitivity to Russian thistle pollen, wheal size >6 mm, was associated with more severe symptoms.

Despite previous conflicts to rely on SPT test for starting immunotherapy, we recommend this test especially for patients sensitive to Alternaria, weed pollens, and tree pollens, considering the size of wheal in association with AR symptom severity.