EXTENDED EVALUATION OF DIAGNOSTIC SKIN TESTING PRACTICES IN ORANGE-COUNTY, CALIFORNIA

In an effort to evaluate conformity with published guidelines for diag nostic allergy skin testing in their locality, a committee of members of the Orange County (California) Society of Allergy and Clinical Immu nology surveyed their membership for the number, identity, and rates o f sensitization of aeroallergens in a selected patient population. Tes t data were analyzed on patients who were judged appropriate to underg o immunotherapy. Complete test results of 271 patients were obtained f rom one third of local allergy specialists. A total of 115 different a eroallergen extracts were identified. By category, tree pollen allerge ns (32) were followed in declining order by weed pollens (28), molds ( 22), environmentals (18), and grass pollen extracts (15), for the tota l of 115. The average number of aeroallergens used by a practice in a comprehensive evaluation was 77 (range, 47-114). When only unequivocal ly positive reactions were considered (3+ equivalent or greater), Berm uda grass pollen extracts elicited the highest rate, 85%, and the envi ronmental, rat dander, was the lowest at 1.8%. At least 20% of the pat ients reacted strongly on skin tests to 97% of the extracts. The dispa rity between the recommendations of a maximum of 30 aeroallergens for a comprehensive evaluation and actual practice procedures merits effor ts at resolution.