IS A PRICK TEST CONSIDERED AN EXPOSURE?

20 replies [Last post]
By M. Mariano on Thu, 05-24-07, 03:12

Hi,
There is a study going on at National Jewish Hospital in Denver, which is completely observational, however it requires a skin prick test (peanut, egg & dairy) every 6 months. I know that severe allergies have the best chance to be owtgrown if COMPLETELY avoided. So I'm wondering if a Skin prick test would be counted as "exposure". Of course the drs say no, but I tend to seek multiple perspectives. What do you think? Does anyone know the research? Thanks!

Groups: None
By lj on Thu, 05-24-07, 13:32

Hi,

I asked a similar question under the thread "Dr wants skin test...what now?". You may want to read some of those answers there.

LJ

Groups: None
By chanda4 on Thu, 05-24-07, 14:04

just mu opinion here...I do scratch tests, it may be an exposure to the skin, but it's not the same as something being consumed(IMO). I live in Denver and was thinking of calling for the milk and egg allergy study at National Jewish....

But this question will be answered from both sides, really I would consider the allergist's opinion before making a decision. Not all exposures make the allergy worse, I have my own son who has had multiple reactions and his numbers have gone down(from a 50 to a 31)....so this would be a very personal decision that you should work with your doctor to finalize your answer. Good luck!

------------------
Chanda(mother of 4)
Sidney-8 (beef and chocolate, grasses, molds, weeds, guinea pig & asthma)
Jake-6 (peanut, all tree nuts, eggs, trees, grasses, weeds, molds, cats, dogs, guinea pig & eczema & asthma)
Carson-3 1/2 (milk, soy, egg, beef and pork, cats, dog, guinea pig and EE)
Savannah-1 (milk and egg)

__________________

Chanda(mother of 4)
Sidney-8 1/2(beef and chocolate, grasses, molds, weeds, guinea pig, hamster & asthma)
Jake-6 1/2(peanut, all tree nuts, all seeds(sesame, sunflower, poppy, pine nut) beef, chicken, eggs, coconut, green beans/all beans, trees, grasses,

Groups: None
By Carefulmom on Thu, 05-24-07, 15:12

My dd was sensitized by a skin test. She was skin tested for egg and was negative. Three days later I gave her two tiny bites of scrambled egg and she went into anaphylaxis. The skin test sensitized her and was her first exposure.

Groups: None
By jtolpin on Thu, 05-24-07, 15:35

Hmm...

Is a SPT an 'exposure'.

To me, the answer is yes.

But really, what's it matter...

Can you react to the SPT? I've heard yes. I've heard no.

Can you react severely to the NEXT exposure of allergen? Sure.

But are you looking at 'My child MIGHT be allergic, and I want to SPT, but I dont want THAT one to be the 'sensitization', when the NEXT time would be severe'.

Look at it as: Child is allergic. Avoid. If you want, a RAST is drawing lbood, no chance of reaction, or sensitization...

Jason

------------------
[b]* Beyond Obsessed * [/b]

__________________

[b]* Beyond Obsessed * [/b]

Groups: None
By Peg541 on Thu, 05-24-07, 15:56

When my son had his skin test at age 5 he had a 4 +++ reaction. A long red streak went up his arm also. The allergist gave him Benadryl and told us his next skin test (if ever) would cause a systemic reaction. He said NO MORE skin tests for my son. We kept to that.
Peg

__________________

Peggy

Son 22 Allergic to peanuts, tree nuts, tomatoes, soy, milk, oats, fish.

Groups: None
By pinkysmom on Thu, 05-24-07, 18:34

I just called my dr. about this. He said that this test is NOT considered an exposure. Only if the food is eaten is it considered an exposure

Groups: None
By Carefulmom on Thu, 05-24-07, 18:45

I`d be curious how he would explain a negative skin test followed by an anaphylactic reaction the first time something is eaten if the skin test is not an exposure.

Groups: None
By Corvallis Mom on Thu, 05-24-07, 19:13

Personally? I don't think this is as simple a question as it might seem.

For [i]some[/i] people, a SPT is probably an 'exposure.'

BUT-- for those same people, sensitization and exposures are probably inevitable anyway. Outside of life in a bubble.

I mean, clearly this must be the case if SPTs can result in systemic reactions in some individuals. And they can. And do.

But for others, it is also clear that they are totally benign.

Problem is that you never really know (and neither does a physician) which group of people you belong to, at least not [i]a priori.[/i]

So I think that allergists who claim "it isn't an 'exposure'..." are really just saying that they don't think it is one that is large enough to 'count.' At least not for MOST people.

So my question has always been--
Is my DD [i]most[/i] people?? [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

Groups: None
By Carefulmom on Thu, 05-24-07, 22:46

Interesting...but for my dd if the real world sensitized her (not in a bubble), then the skin test would have come out positive. But since the skin test was negative, it would seem that the skin test was her first exposure. All those non-bubble experiences did not sensitize her; it was the skin test that did. So it would be hard to say that the skin test was not an exposure.

Groups: None
By DanielaW on Fri, 05-25-07, 01:16

The predictive value of a negative SPT is 95% that the allergy is not present. There's also a 5% chance that a negative skin test is a false one. So just because a person had a negative skin test does not mean anything, there's is still a 5% chance that he/she will indeeed react when exposed to the allergen. People do not get anaphilatic after just being exposed to such a minute amount the first time they where ever exposed to it. There must have been a sensitization to the antigen that was not recognized by the SPT. (Sometimes allergen xtracts lose potency with time if not stored correctly, the technique used didnt put enough pressure in puncturing the skin is afactor, the type of device used to puncture the skin is another one, certain ones tend to give more positive results than others. However the golden standardto confirm a food allergy is a food challange. If a person reacts when ingesting the food, it does not really matter that the test say, it can say negative but if there's clinical reactivity that is all that it counts.

Groups: None
By Momcat on Fri, 05-25-07, 01:22

It seems to me that anything that provokes a reaction in the body, whether local or systemic must be an "exposure".

Whether this type of exposure will be a problem for a particular individual, you just don't know. Our allergist says, "Skin testing is generally well tolerated." His feeling is that the risk of adverse effects is low (but not zero.)

Cathy

------------------
Mom to 8 yr old PA/TNA daughter and 4 yr old son who is allergic to eggs.

__________________

[url="http//allergy.hyperboards.com"]http//allergy.hyperboards.com[/url]

Groups: None
By Scooby on Fri, 05-25-07, 01:24

Quote:Originally posted by Carefulmom:
[b]Interesting...but for my dd if the real world sensitized her (not in a bubble), then the skin test would have come out positive. But since the skin test was negative, it would seem that the skin test was her first exposure. All those non-bubble experiences did not sensitize her; it was the skin test that did. So it would be hard to say that the skin test was not an exposure. [/b]

My DS age 9 had a negative SPT to egg. He had several contact reactions prior but we weren't sure of the cause. It wasn't until he had a Rast test that came up Class 4 that we realized he was reacting to egg. He is MEP allergic.

Unless you never ate eggs while pregant or breastfeeding, I just don;t see how you can be 100% positive that your DD's SPT was the cause of the egg allergy.

JMHO, but I think your DD is in the small minority of false negatives, just like my DS.

[This message has been edited by Scooby (edited May 24, 2007).]

Groups: None
By Carefulmom on Fri, 05-25-07, 02:13

The reason he determined that she was sensitized by the skin test was that she was skin tested after the ana reaction and it was very positive. The false negative rate is actually 3% not 5% (responding to the post a few posts up). The allergist said the fact that it went so quickly from negative to positive with the ana reaction in between meant it was probably not a false negative, but rather due to the fact that she got sensitized from skin test #1. He said that if she were in the 3% that was a false negative, it would have stayed negative after the reaction. Also, they used the same lot for the two skin tests, the negative one and the strongly positive one.

As far as why she was skin tested after the ana reaction (skin test #2), it was to rule out a soy allergy. She had a scrambled egg and soy milk and went into anaphylaxis, had to use the epi. So he wanted to be sure the ana reaction was from egg and not soy. They did not have cap rasts back then.

[This message has been edited by Carefulmom (edited May 24, 2007).]

Groups: None
By Corvallis Mom on Fri, 05-25-07, 02:24

Quote:Originally posted by Carefulmom:
[b]Interesting...but for my dd if the real world sensitized her (not in a bubble), then the skin test would have come out positive. But since the skin test was negative, it would seem that the skin test was her first exposure. All those non-bubble experiences did not sensitize her; it was the skin test that did. So it would be hard to say that the skin test was not an exposure. [/b]

I didn't say it wasn't.

Just that (evidently in the opinion of [i]most[/i] allergists... ) she's in the minority.

For some people, it's an "exposure" of sufficient magnitude to induce sensitization. For others, not. (In [i]either[/i] case, a SPT is totally invalid in a person who has never had any exposure to the antigen.)

In other words, there isn't a test that [i]is[/i] useful in someone who is [i]destined[/i] for sensitization but isn't there yet. (So one person might skin test negative, negative, positive.... and another negative, negative, negative.... but both could react after an egg ingestion.)

One size fits most... [i]generally[/i] well-tolerated. Not [i]universally[/i] so.

It's frustrating, but there isn't any one answer.

Groups: None
By the momma on Fri, 05-25-07, 03:23

If they are pricking allergens into you skin then the answer is [b]YES[/b] It is what you are allergic to that they are putting into your body.

It is what allergy shots are too. THey are the allergens that you are allergic to (non food that is).

That is why my allergist does only rast tests for foods. She will not skin prick.

I just recently went through the skin prick test.

__________________

Renee

We are all united together for the villigance of keeping our children safe.

Groups: None
By LuvMyKids on Fri, 05-25-07, 11:01

It seems like it should be, but my child had a peanut skin prick twice (6 months and 13 months) and doesn't have a peanut allergy. He is however a very allergic child w/ milk, soy, and wheat allergies. So, it doesn't seem to have sensitized him even though he is high risk.

__________________

Allergic to Milk, Wheat, Eggs, and Peanuts

Groups: None
By Scooby on Fri, 05-25-07, 16:27

Quote:Originally posted by Carefulmom:
[b]The reason he determined that she was sensitized by the skin test was that she was skin tested after the ana reaction and it was very positive. [/b]

Thanks for the explaination Carefulmom, it makes more sense now.

Groups: None
By TeddyAlly on Fri, 05-25-07, 20:29

I say YES. My dd had to be EpiPen'ed in the allergist's office after her last skin test. She started having severe reactions (uncontrolable sneezing, coughing, face flushing, etc...) about 10 mins after the skin test. So they EpiPen'ed her twice, gave her Zertec, and something else (dont remember what it was). Dd is only allowed blood tests now.

__________________

Ally (nickname )
DD (PA & TNA, age 8)
DS (age 5)

Groups: None
By NoPeanutsPlease.com on Sat, 05-26-07, 05:54

Our daughter's skin prick test was done surface only since we were 99.9% certain of her peanut allergy. She still had a large wheal. The reason the skin was not broken was due to the risk of anaphylaxis ... how could there be a risk of anaphylaxis if there was no exposure? That doesn't make sense.

------------------
[url="http://www.NoPeanutsPlease.com"]www.NoPeanutsPlease.com[/url]

__________________

[url="http//www.NoPeanutsPlease.com"]www.NoPeanutsPlease.com[/url]

Groups: None
By AmberC. on Fri, 12-13-13, 21:12

This is an old thread but I think the skin prick test IS absolutely a source of exposure.

Not only a source of exposure, but the skin prick test could be creating new food allergies.

For example, you go in with a confirmed peanut allergy since your kid ate peanuts and almost died--now let's test for every nut in the world.

Let's also test for dairy, shellfish, sesame because these are common allergies.

***

Consider how people used to be vaccinated: the skin was scratched and the virus placed in the scratch. BINGO: you have antibodies to the virus.

(Well, most of the time, it didn't work 100% of the time.)

Does anyone have a 90 year old grandparent? I do, ask him/her how he/she was "vaccinated." They will confirm what I am telling you.

Likewise, food protein in the tiniest broken blood vessel could create antibody: to the food!

***

And then, you might just be outgrowing the food allergy, but you are given your "booster" by the well-meaning allergist.

***

We know kids get "booster shots" to up their immunity to viruses: what if these skin pricks are actual booster shots for the creation of allergy?

Repeat the shot over and over again until you get 100% immunity.

However, even with shots, 100% immunity is not achieved all the time.

Likewise, some kids could be getting sensitized by the scratch tests, others not.

***

GO BACK AND READ THE NOBEL PRIZE ACCEPTANCE SPEECH FROM CHARLES RICHET.

IT'S ALL THERE.

HE COINED THE TERM "ANAPHYLAXIS."

We have forgotten what we once knew!

PS: We all know it takes only the tiniest bit of peanut protein to kill someone with peanut allergy; so the inverse could be true, the tiniest amount of the food protein in the a tiny, tiny scratch could create the allergy.

Groups: Airlines

Peanut Free and Nut Free Directory

Peanut-Free/Nut-Free Directory

Our directory is intended as a resource for people with peanut and nut allergies. It contains foods, helpful products, and much more.

Close x

Sign up for our newsletter and receive a free peanut-free snack guide.

Stay on top of your allergy with recipes, lifestyle tips and more.

Email

PeanutAllergy.com Social

 

Poll

Where do you get your peanut allergy information?
The internet
29%
My allergist
57%
Friends or family
14%
Other
0%
Total votes: 7