Table 1. General recommendations for skin tests for drug allergy. From [2].
Test | Preparation/concentration | Reading |
---|---|---|
Patch test | Max. of 30% in petrolatum (preferred vehicle), alcohol, or aqua as the highest concentration (storage > 24 hours not recommended). Powder preparations: preferably in petrolatum (or in aqua), liquid preparations in aqua, steroid hormones in alcohol. |
As in patch testing for contact allergens, final reading and evaluation after 72 hours. If necessary, additional reading after 20 minutes in immediate-type reactions. |
Prick test | Ingredients and, if appropriate, additives should be tested separately. Testing with the pure agent is possible; down-titration if patient history is positive for severe reactions. |
Evaluation: as with inhalant allergens Immediate (after 15 minutes): – positive if wheal > 3 mm and concomitant erythema and > negative control (NaCl) Late: palpable infiltration after 24 hours |
Intradermal test | Only if prick test is negative; emergency preparedness Sterile preparation necessary Fresh preparation (< 2 h) Volume of injection 0.02 – 0.04 mL |
Evaluation: no generally accepted standard Immediate (after 15 – 20 minutes): e.g., positive if wheal – increased by > 3 mm as compared to baseline – reaches 2 × the size of the control wheal – is > 8 mm or > 10 mm Late: palpable infiltration after 24 – 72 hours |