Comparison of five techniques of skin prick tests used routinely in Europe

Background: Skin prick tests represent indispensable tools in allergy, even more than 30 years after their introduction in clinical practice. Objectives: Few recent European studies have focused on this topic and we thus wanted to compare the instruments most often used today. Methods: Four instruments were investigated: the 23G intravenous (IV) needle, the ALK Lancet, the Stallergenes (STG) Prick Lancet and the Stallerpoint (R) (using two different methods). Sensitivity, reproducibility, and acceptability were evaluated. In 22 subjects, we calculated the sensitivity and reproducibility (both intra-and interpatient) of these methods by testing the positive control five times. In 50 subjects, we tested the single-blind acceptability of these same five techniques. Results: In terms of sensitivity, the IV needle (100%) and metal lancets (96% for the ALK Lancet and 98% for the STG Prick Lancet) were superior (P < 0.01) to the two Stallerpoint (R) methods (20% and 57%). Intrapatient reproducibility was 16.2%, 14.6%, 15.0%, 97.1% and 18.1%, respectively. The instruments that were best tolerated by the patients were the IV needle and the two metal lancets. Conclusion: Metal needles and/or lancets are the tools of choice for skin prick testing.