title: Safety of intradermal skin tests for inhalants and foods: a prospective study.
abstract: BACKGROUND
  Intradermal skin testing is a useful allergy diagnostic tool. Although considered safe when properly performed, systemic reactions have been reported. This is the first large, prospective study to record and evaluate all systemic reactions from intradermal skin testing (IDT) to inhalant or food antigens.
  
  
  METHODS
  A 24-month prospective study by 40 physician practices, recording all IDT tests, including reactions, symptoms, severity, time after injection, and reaction treatments.
  
  
  RESULTS
  Eighty systemic reactions (22 major) occurred among 20,530 patients (878,583 wheals). Nine had epinephrine treatment, 4 were observed in an emergency department, and there were no hospitalizations or fatalities. The overall systemic reaction risk was 0.009%. The risk of having a major reaction was 0.003%, or 1 reaction per 933 patients.
  
  
  CONCLUSIONS
  Intradermal skin tests for inhalants or foods, when performed with appropriate precautions, have a safety profile comparable to skin prick tests.
authors.affiliation: Department of Otolaryngology, Cape Cod Hospital, Hyannis, MA, USA. docbruce@comcast.net
authors.forename: Bruce R
authors.initials: BR
authors.lastname: Gordon
authors.forename: David S
authors.initials: DS
authors.lastname: Hurst
authors.forename: John A
authors.initials: JA
authors.lastname: Fornadley
authors.forename: Darrell H
authors.initials: DH
authors.lastname: Hunsaker
mesh_terms: D000485:Allergens / Q000276:immunology; D000707:Anaphylaxis / Q000209:etiology / Q000517:prevention & control*; D003888:Desensitization, Immunologic / Q000009:adverse effects; D005240:Feasibility Studies; D005502:Food / Q000009:adverse effects; D005512:Food Hypersensitivity / Q000150:complications / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy; D006801:Humans; D001239:Inhalation; D007428:Intradermal Tests / Q000009:adverse effects / Q000379:methods*; D052638:Particulate Matter / Q000009:adverse effects / Q000276:immunology; D061214:Patient Safety; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D012306:Risk
chemical_list: D000485:Allergens; D052638:Particulate Matter