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Skin Testing and Food Challenges for the
Evaluation of Food Allergy
Larry W. Williams, MD
Address (milk, egg, peanut, tree nuts, and seafood) in children
Division of Allergy and Immunology, Duke University Medical Center, and foods that are only slightly less commonly associ-
Box 3559, Durham, NC 27710, USA. ated with these reactions (wheat and soy). Work with
E-mail: larry.williams@duke.edu
other forms of adverse food reactions, such as protein-
Current Allergy Reports 2001, 1:61–66 induced enteropathy and oral allergy syndrome, has fol-
Current Science Inc. ISSN 1529-7322
Copyright © 2001 by Current Science Inc. lowed more recently.
These early studies also demonstrated that IgE to a food
is necessary for an immediate hypersensitivity reaction, but
Skin testing by prick technique has an excellent safety record it is not sufficient in isolation for a reaction. Thus, an
in the evaluation of food hypersensitivity. Skin prick tests for
unequivocally positive skin test or radioallergosorbent test
the common food allergens are excellent tools for identifying
(RAST) may be seen in a patient who tolerates ingestion of
those at very low risk of reaction on eating the food but are the tested food. In addition, for foods to which infants
of variable value in identifying patients who will be
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