Childhood Skin Prick Allergies Remain Predictive of Future Allergies

MedicalResearch.com Interview with:
Maria Pesonen MD, PhD
Specialist in Dermatology
Assistant Chief Medical Officer
Finnish Institute of Occupational Health
Occupational Medicine Helsinki, Finland

Medical Research: What is the background for this study? What are the main findings?

Dr. Pesonen: Skin prick test is a widely used, established methods in assessing immediate (i.e. immunoglobulin E-mediated) sensitization. However, the knowledge on long-term reproducibility and predictive value of skin prick testing in children has been limited. We assessed the predictive value of skin prick testing in the setting of a follow-up study on healthy, unselected newborns, who were followed up to age 20 years with skin prick testing with 11 common allergens, structured interview and clinical examination at ages 5, 11 and 20 years. The reproducibility of skin prick test positivity at age 5 years was 100% at ages 11 and 20 years, i.e. none of the skin prick positive subjects turned negative during the follow-up. Gaining of new sensitizations to aeroallergens was common. Skin prick test positivity at age 5 years predicted allergic symptoms at ages 11 (sensitivity 28%, specificity 94%) and 20 years (sensitivity 23%, specificity 91%), but not atopic dermatitis.

Medical Research: What should clinicians and patients take away from your report?

Dr. Pesonen: Skin prick test positivity at age 5 years strongly predicts later skin prick test positivity and associates with allergic symptoms, especially respiratory symptoms, i.e. allergic rhinoconjunctivitis and recurrent wheezing, at ages 11 and 20 years. However, skin prick test negativity at age 5 years does not exclude sensitization and allergic symptoms at a later age. The practical message is that skin prick test positivity to common aeroallergens at age 5 years often (in our cohort, in all cases) persists, and predicts later development of allergic respiratory symptoms. This implies that skin prick testing in children is useful not only in diagnosing the present allergies but also in predicting future allergic symptoms; however, skin prick test negativity at age 5 years does not exclude the development of allergic symptoms at a later age.

Citation:

Allergen Skin Prick Testing in Early Childhood: Reproducibility and Prediction of Allergic Symptoms into Early Adulthood

Maria Pesonen, MD, PhD Markku J.T. Kallio, MD, PhD, Martti A. Siimes, MD,
Annamari Ranki, MD, PhD The Journal of Pediatrics

Available online 12 November 2014

 

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