What role do skin tests and specific IgE testing play in the diagnosis of hypersensitivity reactions in primary care?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 22 August 2025Updated: 22 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Role of skin tests and specific immunoglobulin E (IgE) testing in primary care diagnosis of hypersensitivity reactions:

Skin prick tests and specific IgE antibody blood tests are used in primary care to support the diagnosis of IgE-mediated hypersensitivity reactions, particularly food allergies, based on a thorough allergy-focused clinical history.

These tests should only be performed by healthcare professionals with the appropriate competencies to select, conduct, and interpret them safely and effectively.

Skin prick tests must be done where facilities to manage anaphylaxis are available, ensuring patient safety.

Testing is not recommended without first taking a detailed allergy-focused clinical history, and test results must be interpreted in the context of this history to avoid misdiagnosis.

For suspected IgE-mediated food allergy, either or both tests may be offered depending on clinical judgment, patient suitability, and acceptability.

However, specific IgE testing is not recommended for diagnosing drug allergy in non-specialist primary care settings.

Educational content only. Always verify information and use clinical judgement.