John M Kelso1. 1. Allergy Division, Naval Medical Center, San Diego, California, USA. kelso.john@scrippshealth.org
Abstract
BACKGROUND: In many allergy clinics topical corticosteroid cream is applied to sites of positive skin tests in an attempt to alleviate itching. OBJECTIVES: To determine whether or not this practice is effective. METHODS:Patients with 5 or more positive skin test results were randomly assigned to 1 of 3 groups after skin test result reading: application of 2.5% hydrocortisone in moisturizing cream, moisturizing cream alone, or no topical application. Immediately after the skin test results were read (baseline) and at 5, 15, and 30 minutes, patients rated their itching on a 100-mm visual analog scale. RESULTS:Average itch scores for all groups combined were 44, 33, 22, and 12 at 0, 5, 15, and 30 minutes, respectively. No differences were found among the groups at any time point. No correlation was found between the baseline itch scores and age, sex, number of positive skin test results (> or = 3-mm wheals), or number of large positive skin test results (> or = 15-mm wheals). CONCLUSIONS: The application of corticosteroid cream to sites of positive immediate-type allergy skin tests does not provide relief of itching; therefore, this practice should be abandoned. Instead, patients should be informed that any itching they may be experiencing will substantially resolve during the next 30 minutes and that application of such topical treatment will not hasten the relief of itching.
RCT Entities:
BACKGROUND: In many allergy clinics topical corticosteroid cream is applied to sites of positive skin tests in an attempt to alleviate itching. OBJECTIVES: To determine whether or not this practice is effective. METHODS:Patients with 5 or more positive skin test results were randomly assigned to 1 of 3 groups after skin test result reading: application of 2.5% hydrocortisone in moisturizing cream, moisturizing cream alone, or no topical application. Immediately after the skin test results were read (baseline) and at 5, 15, and 30 minutes, patients rated their itching on a 100-mm visual analog scale. RESULTS: Average itch scores for all groups combined were 44, 33, 22, and 12 at 0, 5, 15, and 30 minutes, respectively. No differences were found among the groups at any time point. No correlation was found between the baseline itch scores and age, sex, number of positive skin test results (> or = 3-mm wheals), or number of large positive skin test results (> or = 15-mm wheals). CONCLUSIONS: The application of corticosteroid cream to sites of positive immediate-type allergy skin tests does not provide relief of itching; therefore, this practice should be abandoned. Instead, patients should be informed that any itching they may be experiencing will substantially resolve during the next 30 minutes and that application of such topical treatment will not hasten the relief of itching.