Name of the Procedure:

Intracutaneous (Intradermal) Tests with Allergenic Extracts, Immediate Type Reaction

Summary

The intracutaneous (intradermal) test, also known as allergy skin testing, involves injecting small amounts of allergenic extracts just under the skin to identify immediate allergic reactions. The test helps in diagnosing allergies to substances such as pollen, pet dander, mold, and insect venom.

Purpose

The test is designed to diagnose allergic reactions by exposing the skin to potential allergens and observing for an immediate reaction, typically within 15 to 20 minutes. The goal is to identify specific substances to which a patient is allergic, aiding in the development of effective treatment plans.

Indications

• Suspicion of allergic conditions such as asthma, allergic rhinitis, or urticaria.
• Symptoms including sneezing, runny nose, itchy eyes, skin rashes, or difficulty breathing.
• Evaluation of reactions to insect stings that cause local swelling and redness.

Preparation

• Patients should avoid antihistamines and certain other medications for several days before the test as they can interfere with results.
• Patients may need to complete a medical history form and have a physical examination before the procedure.

Procedure Description

1. The patient's forearm or back is cleaned with an antiseptic solution.
2. Small amounts of diluted allergenic extracts are injected just under the skin using a fine needle.
3. Multiple injections are typically performed to test different allergens.
4. The testing site is observed for an immediate reaction, usually within 15 to 20 minutes.
5. Each injection site is monitored for signs of redness, swelling, or formation of a raised bump.

Duration

The entire procedure typically takes about 30 to 40 minutes, including preparation and observation time.

Setting

The procedure is usually performed in an outpatient clinic or doctor's office equipped for allergy testing.

Personnel

• Allergist or Immunologist (specialist doctor)
• A trained nurse or medical assistant

Risks and Complications

• Minor pain or discomfort at the injection sites.
• Risk of a severe allergic reaction (anaphylaxis), which is rare but requires immediate medical attention.
• Localized swelling, redness, or itching at the testing sites.

Benefits

• Accurate identification of specific allergens causing symptoms.
• Helps in creating a targeted treatment plan, including avoidance strategies or immunotherapy.
• Potential for immediate improvement in allergy management.

Recovery

• Minimal post-procedure care; patients can resume normal activities immediately.
• Patients may be advised to avoid scratching the test sites.
• Observation for any delayed allergic reactions, though immediate reactions are the focus.

Alternatives

• Blood tests (e.g., RAST or ELISA) to identify specific allergen antibodies.
• Skin prick tests, which are less invasive but may be less sensitive for some allergens.
• Symptomatic treatment with medications such as antihistamines or corticosteroids.

Patient Experience

• Patients might feel minor discomfort or a slight sting from the needle.
• Itching or redness at the injection sites is common and usually temporary.
• Pain management is typically unnecessary, but comfort measures include cold compresses or anti-itch creams for minor reactions.