The prick by prick test is safe and reliable in 58 children with atopic dermatitis and food allergy.

The initial diagnostic approach of food allergy (FA) is to take a detailed history and to perform a careful physical examination in the gastrointestinal, cutaneous and respiratory systems. Subsequently, verification of the relationship between the symptom(s) and the ingestion of the offending food(s) is mandatory, and finally determination of the immunologic mechanisms involved with in vivo and in vitro tests should be performed. The diagnosis of FA in infancy and in childhood is a challenge both for the pediatrician and allergist because it can be easily accomplished only when there is a correlation between the ingestion of the offending food(s) and the onset of the symptoms, and when it can be demonstrated that these symptoms are the consequence of an immunological reaction. However the underlying immunologic mechanisms may be difficult to document, and the only immunologic mechanism easily to prove in current practice is the IgE-mediated one. In this paper on 58 food-allergic children and 60 nonatopic controls we demonstrate that the prick + prick (P+P) tests are very effective and easy to perform. In addition we stress that FA cannot be excluded only because skin prick tests (SPTs) are negative, as recently suggested.