The skin prick test – European standards

Table 2 Potential interference of medications with the skin test reaction (adapted from Demoly (2003) [23]; Rueff (2010) [24]and Position Paper: Allergen standardization and skin tests: The European Academy of Allergy (1993))

Drug	Suppression	Abstinence before testing	Reference
	0: no evidence; (+): possible, +: slight; ++: medium, +++: strong
Antihistamines
1st generation H1-blocker	+++	> 2 days	Dreborg (1989) [25]
Hydroxyzine	+++	> 2 days	Dreborg (1989) [25]
2nd generation H1-blocker	+++	7 days	Devillier (2008) [26]
Cetirizine, Loratadine, etc.	+++	7 days	Devillier (2008) [26]
Ketotifen	+++	> 5 days
H2-blocker	0 - +	Ø
Glucocorticosteroids
Topical (in test area)	+	> 1 week ¹	Hammarlund (1990) [27], Pipkorn (1989) [28], Gradman (2008) [29]
Nasal	0	Ø
Inhaled	0	Ø
Systemic/short term (up to 10 days)	0 / (+)
< 50 mg/d Prednisolone-equivalent	0 / (+)	> 3 days	Hammarlund (1990) [30]
> 50 mg/d Prednisolone-equivalent	(+)	> 1 week ²	Des Roches (1996) [31]
Systemic/long term (more than 10 days)
<10 mg/d Prednisolone-equivalent	0	Ø	Olson (1990) [32]
>10 mg/d Prednisolone-equivalent	0	> 3 weeks ²	Des Roches (1996) [31]
Topical calcineurin inhibitors	+	> 1 week	Gradman (2008) [29]
Other systemic drugs
Omalizumab	++	> 4 weeks	Noga (2003) [33]
Leukotriene receptor antagonist	0	Ø	Cuhadaroglu (2001) [34], Hill (2003) [35]
Cyclosporin A	0	Ø	Munro (1991) [36]
Theophylline	0	Ø	Spector (1979) [37]
Antidepressants
Doxepin	++	7 days	Rao (1988) [38]
Desipramine	++	3 days	Rao (1988) [38]
SSRI: Citalopram, Fluoxetin, Sertralin	0	Ø	Isik (2011) [39]
β-adrenergic agonists	0	Ø	Abramowitz (1980) [40], Spector (1979) [39]
Salbutamol, Salmeterol, Bambuterol, Terbutalin	0		Petersen (2003) [41]

¹ Depends on dosage and length of treatment (> 3 weeks).
² A retrospective study showed no influence of the skin reaction by 10–60 mg prednisone for 2 or more years.

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