Controversies in Skin Testing for Allergic Rhinitis

This article will review different methods of skin testing available for allergic rhinitis, emphasizing controversies and challenges associated with these techniques. The utility of quantitative skin testing has been debated in current literature, as has the accuracy of skin versus in vitro testing. Single- and pauci-allergen immunotherapy (AIT) have also shown good outcomes, thus questioning the use of large testing panels. Recent studies further support the use of standardized and recombinant antigens. Skin testing remains a safe and dependable tool in the diagnosis and management of allergic rhinitis. Newer techniques such as component-resolved diagnostics (CRD), recombinant antigens, and enhanced skin evaluation are being studied, but are still expensive and not widely available. Areas that require more research include designing standardized and recombinant allergens, the real utility of quantitative skin testing, the number of aeroallergens to test and treat, skin testing for molds as well as when to repeat skin testing.