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Testing Intake
Intradermal Testing
Advanced skin testing method used when additional sensitivity assessment is needed.
When usedrisksinterpretation
Overview
Intradermal testing involves injecting a small amount of allergen extract just beneath the skin surface. It's more sensitive than skin prick testing but also has a higher risk of false positives.
when Used
indications
- Negative skin prick test but high clinical suspicion
- Insect venom allergy evaluation
- Drug allergy testing (selected medications)
- Occupational allergy evaluation
- When more sensitive testing is needed
not First Line
Usually performed after skin prick testing, not as initial test
process
description
- Small amount of allergen extract injected just under skin
- Usually performed on upper arm
- More invasive than skin prick testing
- Results read after 15-20 minutes
comparison
More sensitive but less specific than skin prick testing
risks
local
- Larger local reactions than skin prick testing
- More discomfort at injection site
- Bruising possible
systemic
- Higher risk of systemic reactions than skin prick testing
- Requires medical supervision
- Emergency equipment must be available
false Positives
More likely to have false positive results than skin prick testing
interpretation
positive
- Wheal and flare reaction at injection site
- Must be interpreted in context of clinical history
- False positives more common than with skin prick testing
negative
Suggests no IgE-mediated sensitization to that allergen
factors
- Reaction size
- Clinical correlation essential
- Comparison with skin prick results
preparation
- Similar medication holds as skin prick testing
- May need to stop additional medications
- Discuss all medications with provider
after Care
- Monitor for local and systemic reactions
- May have more significant local reactions
- Follow provider's instructions for care
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