Optimizing the Use of a Skin Prick Test Device on Children

Abstract

Background: Studies comparing skin prick test (SPT) devices have revealed varying results in performance and there is little known about their use on children. Methods: We performed 2 complementary studies to test the sensitivity, reproducibility and acceptability of commercially available SPT devices (Stallerpoint, Antony, France) using different application techniques. In the first part, histamine/saline was put on as a drop by use of a vial (V), and in the second part it was transferred from a well with the aid of the test device (W). The techniques were as follows: apply vertical pressure (Stallerpoint-VP or Stallerpoint-WP), apply vertical pressure with 90° clockwise rotation (Stallerpoint-VC or Stallerpoint-WC) and apply vertical pressure with 90° clockwise and counter-clockwise rotations (Stallerpoint-VCC or Stallerpoint-WCC). For comparison, ALK Lancet was used with a technique of ‘drop and apply vertical pressure'. Results: In the first part, sensitivities of the Stallerpoint-VC (96.6%), Stallerpoint-VCC (95.5%) and ALK Lancet (93.2%) techniques were superior (p < 0.001) to the other Stallerpoint-VP and Stallerpoint-WP techniques (76.1 and 46.6%). Intrapatient coefficient of variation (CV) values were 15.0, 18.9, 15.4, 22.4 and 48.5%, respectively. Interpatient CV ranged between 22.8 and 55.1%. In the second part, the Stallerpoint-WC (98.8%), WCC (97.5%) and ALK Lancet (98.8%) techniques yielded high sensitivities, whereas the sensitivity of Stallerpoint-WP (28.7%) was very low. There were false-positive reactions in the Stallerpoint-VCC and WCC techniques. Conclusion: In children, the SPT technique was found to be as important as the testing device. Stallerpoint-VC and WC techniques are reliable, tolerable and comparable with the ALK Lancet technique.

How to diagnose mould allergy? Comparison of skin prick tests with specific IgE results

“…The accuracy of these tests depends on a broad range of factors, including allergen potency, allergen content and stability of the allergen test solution, individual skills of the tester (e.g. depth of puncture), status of skin reactivity, application devices , patients’ medication and others . In our previous study , a biochemical analysis of mould SPT solutions revealed both quantitative and qualitative differences depending not only on the mould species, but more specifically on the manufacturer.…”

Skin prick tests and specific IgE in 10‐year‐old children: Agreement and association with allergic diseases

“…found that the Stallerpoint ® device is less sensitive than the ALK lancet or IV needle, but that the 90° clockwise rotation improves the sensitivity of this technique. However, this technique was described by Buyuktiryaki et al . to be reliable, tolerable, and comparable with the ALK lancet technique.…”

“…The AUCs obtained with SPT were not different from those obtained with sIgE, except for a significantly lower AUC with SPT for AH by seasonal aeroallergens and for food allergy by peanut ( found that the Stallerpoint â device is less sensitive than the ALK lancet or IV needle, but that the 90°clockwise rotation improves the sensitivity of this technique. However, this technique was described by Buyuktiryaki et al 16 to be reliable, tolerable, and comparable with the ALK lancet technique. As reported in the EAACI position paper on skin prick testing, 17 the protein and antigen content can differ from one commercial SPT solution to another.…”

Allergy Skin Tests: Where, When, How and How Many?

“…Bu aletlerin duyarlılık ve özgüllüğünü karşılaştıran araştırmalar farklı sonuçlar ve yetersizlikler rapor etmektedir (12)(13)(14). Önemli olan; kullanılacak aletin her bir klinik tarafından pozitif ve negatif kontroller kullanılarak test edilmesi ve uygun kullanma metodunun ortaya konmuş olmasıdır (15). Benzer şekilde testleri uygulayacak sağlık çalışanı eğer bir allerji ve klinik immünolojisi uzmanı olamayacaksa o sağlık çalışanının uygun eğitim teknikleri açısından yetiştirilmiş olması ve yeterliliğinin düzenli aralıklarla (örneğin yılda bir) değerlendirilmesi gerekir.…”