Ezgi TOPYILDIZ, Handan DUMAN ŞENOL, Ayşe PAKEL, Mehmet GEYİK, Figen GÜLEN, Esen DEMİR
The Journal of Pediatric Research - 2026;13(2):150-157
Aim: Skin prick testing (SPT) provides a rapid, inexpensive, and reliable means of confirming IgE-mediated sensitization in the context of clinical history. This study aimed to evaluate whether baseline SPT reactivity, particularly minimal reactions, predicts the development of new aeroallergen sensitizations during long-term follow-up. Materials and Methods: In this longitudinal observational study, 121 children who underwent repeat SPT after an interval of at least three years were included. The patients were stratified into four groups based on their baseline maximum wheal diameter and subcutaneous immunotherapy (SCIT) status: Group 1 (0 mm), Group 2 (1-2 mm), Group 3 (>=3 mm), and Group 4 (>=3 mm with SCIT). The primary outcome was new sensitization, defined as a wheal diameter >=3 mm to an allergen which was previously negative. Results: A total of 121 patients were included in this study. The rates of new sensitization were significantly higher in Groups 2, 3, and 4 compared with Group 1 (p<0.001). New house dust mite sensitization was strikingly more frequent in Group 2 (53.3%) than in all other groups (p<0.001). An increase in wheal diameter to the same allergen was most prominent in Group 2 (66.7%). Sensitization to pollens and cat epithelium increased significantly after 10 years of age (p<0.05). A history of coronavirus disease-2019 was associated with new sensitizations (odds ratio: 2.97, p=0.034). Conclusion: Minimal SPT reactions (1-2 mm) in symptomatic children are clinically relevant and predict a high risk of developing frank aeroallergen sensitization during follow-up. Repeat SPT should be considered in this population in order to guide timely interventions.
