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Evaluation of Skin Prick Test Reading Time at 10 versus 15 min in Young Infants
Anine Lie1,2, Sabina Wärnberg Gerdin3,4, Ingebjørg Skrindo5
1Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
Insights
Reading skin prick tests (SPT) at both 10 and 15 minutes detects more allergic sensitization (AS) in infants than a single reading. Neither time point was superior for diagnosing AS, suggesting both readings are valuable for infant allergy assessment.
Area of Science:
- Pediatric Allergy and Immunology
- Dermatology
- Clinical Diagnostics
Background:
- The optimal timing for reading skin prick tests (SPT) to assess allergic sensitization (AS) in infants remains undefined.
- Current guidelines do not specify a single optimal reading time point for infant SPT.
Purpose of the Study:
- To determine if a 10-minute or 15-minute reading time point is superior for detecting allergic sensitization in 6-month-old infants.
- To compare the diagnostic yield of SPT readings at 10 minutes versus 15 minutes in early infancy.
Main Methods:
- A population-based cohort of 1,431 6-month-old infants underwent SPT for common allergens.
- Mean wheal diameter (MWD) was measured at both 10 minutes and 15 minutes post-application.
- Allergic sensitization was defined by SPT MWD ≥2 mm greater than the negative control.
Main Results:
- 10.4% of infants showed sensitization at either 10 or 15 minutes.
- 138 infants (9.6%) were positive at 10 min, and 141 (9.9%) at 15 min.
- The mean histamine MWD was significantly larger at 10 min (3.8 mm) compared to 15 min (3.6 mm).
Conclusions:
- Reading SPT at both 10 and 15 minutes increases the detection of AS in infants compared to a single time point.
- Neither 10 nor 15 minutes alone proved superior for AS detection, indicating the value of dual readings.
- The larger histamine MWD at 10 min suggests a potential need to reappraise SPT reading protocols in infancy.
Introduction:
The optimal time point for reading the mean wheal diameter (MWD) of a skin prick test (SPT) in infants is not established. We aimed to assess if either of two reading time points of the SPT, 10 or 15 min, was superior to detect allergic sensitization (AS) in 6-month-old infants.
Methods:
In 1,431 6-month-old infants from the population-based Preventing Atopic Dermatitis and ALLergies in children (PreventADALL) mother-child cohort, the SPT was performed with standard solutions for egg, cow's milk, peanut, wheat, soy, birch, timothy, dog, and cat. The MWD was measured after 10 and 15 min. AS was defined as a positive SPT with MWD ≥2 mm larger than the negative control.
Results:
Overall, 149 (10.4%) infants were sensitized to at least one allergen at 10 and/or 15 min, while 138 (9.6%) had a positive SPT at 10 min and 141 (9.9%) at 15 min. A total of 12,873 allergen pricks were performed with 212 (1.6%) being positive at any time point, 194 (1.5%) positive at 10 min, and 196 (1.5%) positive at 15 min. The mean (95% CI) histamine MWD of 3.8 (3.8, 3.9) mm at 10 min was significantly larger than the 3.6 (3.6, 3.7) mm at 15 min.
Discussion/Conclusions:
Reading the SPT after both 10 and 15 min increased the number of 6-month-old infants with documented AS compared to reading after one time point only. As neither 10 nor 15 min reading time was superior to the other in detecting AS, our results indicate that readings at both time points should be considered. However, the histamine MWD was significantly larger at 10 min compared to 15 min. Reappraisal of SPT reading in infancy may be warranted.
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