Name of the Procedure:

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

Summary

This procedure involves injecting small amounts of allergenic extracts just under the skin to test for allergic reactions that develop over an extended period, typically 48-72 hours.

Purpose

• Medical Condition: Detects delayed-type hypersensitivity (DTH) reactions to specific allergens.
• Goals: Identify allergens causing immune response and guide allergy management and treatment.

Indications

• Symptoms/Conditions: Chronic allergic symptoms, unexplained skin rashes, or delayed allergic reactions.
• Patient Criteria: Suitable for patients suspected of having contact allergies, allergic dermatitis, or other delayed-type allergic reactions.

Preparation

• Instructions: Avoid antihistamines and medications that may affect the test results for several days prior. Consult with a healthcare provider about any ongoing medications.
• Diagnostic Tests: Review medical history and possibly perform preliminary allergy screening tests.

Procedure Description

1. Step-by-step:
   1. Clean the test area, usually the forearm or back.
   2. Inject a small amount of allergenic extract intradermally using a fine needle.
   3. Mark and record the injection site for accurate reading.
2. Tools/Equipment: Syringe with a fine needle, allergenic extracts, and marking pen.
3. Anesthesia/Sedation: Typically, no anesthesia is required, but topical numbing creams may be used for sensitive patients.

Duration

Approximately 15-30 minutes for the initial injections; reading the results occurs after 48-72 hours.

Setting

Outpatient clinic or doctor's office.

Personnel

Allergist or trained healthcare professional such as a nurse.

Risks and Complications

• Common: Mild pain, redness, or swelling at the injection sites.
• Rare: Severe allergic reactions or infection at the injection site.

Benefits

• Expected Benefits: Accurate identification of specific allergens causing delayed-type hypersensitivity.
• Realization: Results are typically read and explained within 48-72 hours.

Recovery

• Post-procedure Care: Monitor injection sites for signs of severe reactions; avoid scratching or applying medications unless advised.
• Expected Recovery Time: Minimal recovery time; normal activities can usually be resumed immediately.
• Follow-up: Return to the clinic for reading and interpretation of the test results.

Alternatives

• Other Options: Patch testing, ELISA tests, and blood tests for specific IgE antibodies.
• Pros and Cons: Alternatives may be less invasive but might not be as specific for delayed-type reactions.

Patient Experience

• During: Mild discomfort from injections, similar to a mosquito bite.
• After: Slight itching or swelling at injection sites, managed with topical treatments or cold compresses.
• Pain Management: Over-the-counter pain relievers or antihistamines, if needed, for minor discomforts.