Appreciation of many a valuable diagnostic procedure may be lost through its injudicious use. As pointed out by Peshkin in this issue (page 820) skin testing with allergens is no exception. Skin tests with food allergens are of especially limited value. Matheson1 says emphatically that skin tests should not be done routinely without first obtaining a history and physical examination if for no other reason than to determine what allergens to use in making the tests. Skin tests are of diagnostic value only if interpreted in the light of the clinical findings.
Even in a person with a known clinical sensitivity to an antigen the skin test may be negative. This sometimes leads the physician to conclude wrongly that the allergen is no longer potent or that the patient has nonreactive skin. Peshkin points out the need for standardization of antigens, as at present those produced by different laboratories
DIAGNOSTIC VALUE OF SKIN TESTING. JAMA. 1955;157(10):825. doi:10.1001/jama.1955.02950270043012