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Educational draft · awaiting clinical reviewUse Rapid for revision, not patient-care decisions. Check current national and local guidance and the BNF or BNFC before acting.
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Patch testing and prick testing distinctions

Essential points for quick revision.

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Escalate

Escalate urgently when assessment for Patch testing and prick testing distinctions reveals systemic toxicity, airway or eye involvement, extensive skin failure, a non-blanching eruption in an unwell patient, or a rapidly changing lesion suspicious for aggressive malignancy.

Synopsis

Distinguish delayed contact-allergy patch testing from immediate hypersensitivity skin-prick testing, prepare patients safely, and interpret sensitisation only within a compatible history.

  • Patch testing evaluates delayed type IV allergic contact dermatitis by applying allergens under occlusion and reading reactions after defined intervals.
  • Skin-prick testing evaluates immediate IgE sensitisation within minutes using positive and negative controls in a setting equipped for systemic reactions.
  • A positive result shows sensitisation, not automatically clinical allergy; relevance depends on exposure, timing, distribution and symptoms.

Key red flags

Airway swelling, breathing difficulty, hypotension or rapidly progressive multisystem allergy requires emergency treatment; neither patch nor prick testing belongs in acute resuscitation.

Anaphylaxis history

Previous severe immediate reactions require specialist planning and resuscitation readiness before any provocation or skin test.

Investigation priorities

01
Patch testing with delayed readingsFirst step

Identify contact sensitisation relevant to chronic eczematous disease.

Management branches

Planned assessmentUse allergy test selection systematically

The patient is stable and the result will alter diagnosis, referral or follow-up.

  1. Define the question for Patch testing and prick testing distinctions, explain the process and obtain valid consent before exposing, touching, photographing or sampling skin.
  2. Choose representative anatomy, optimise lighting or specimen technique, and document site, morphology, symptoms and relevant previous treatment. Apply that step specifically within the patch testing and prick testing distinctions assessment and its recorded clinical context.
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Sources and review status3 sources · checked 27 Aug 2026 · clinical review pending
Sources

Sources and review status

National guidance is shown before implementation-dependent detail. Typical adult dose examples remain subject to patient factors, contraindications and the live BNF or specialist protocol. Source check completed 27 Aug 2026; clinical approval remains outstanding.

Authoring stateRapid draftClinical stateAwaiting reviewJurisdictionUnited Kingdom