Table 3.

Testing procedures for NRLA diagnosis

Testing procedures
Type of test	Test	Description
Skin Tests	Prick testsa	Method of choice to confirm or rule out latex allergy. Intradermal tests are not recommended.
	Patch tests	Used in suspected delayed-type hypersensitivity reactions, most of which are attributable to additives.
Laboratory Tests	Latex-specific IgE	Two serologic methods, currently in use worldwide, as the ImmunoCAP and the IMMULITE autoanalyzer, both have a diagnostic sensitivity of 80% and a specificity of >95%.
Challenge Tests (With suggestive medical history but negative skin and laboratory tests)	Glove use test	Put a latex glove on one finger, from 15 min to 2 h. If the result is negative, the full glove is placed on one hand and a vinyl, or nitrile glove, on the other hand. The test is considered positive when it causes itching, erythema, vesicles or respiratory symptoms.
	Rubbing test	The rubbing test gives false positives and is not standardized. Thus, its diagnostic yield is very low and it is not used.
	Specific bronchial provocation test	Are classified into those, the ones that use an aqueous latex extract (with a nebulizer or in a chamber with aerosolized glove extract) and those consisting in handling or shaking gloves to generate a dust aerosol. The lung functions and the occurrence of bronchial symptoms are then evaluated.
	Conjunctival provocation and nasal challenge	They have been used in some studies, however they have little significance.

^aStandardized allergens are recommended