BEVEL-DOWN SUPERIOR TO BEVEL-UP IN INTRADERMAL SKIN TESTING

Background: Intradermal skin testing is one of the most widely used pr ocedures in the diagnosis of hypersensitivity diseases, in vivo. It is critical to perform the rest accurately and expediently. Yet, there a re Few articles describing its detailed technique or proficiency avail able. Objectives: To identify the better method for intradermal testin g between the bevel-up and bevel-down techniques. Methods: Three inexp erienced testers performed intradermal injections using both methods. Four sets of paired trials each consisting of ten injections were appl ied randomly, alternating between the same volunteer subject's contral ateral arms. Duration to complete ten injections was measured. Numbers of injection sites that bled, that squirted into the air. and failed to form a bleb were counted. The overall comfort level was determined. Results: The times to complete the injections by bevel-up and by beve l-down methods were 165.5 +/- 31.3 and 152.5 +/- 27.4 seconds, respect ively (P < .015). The number of injection sites that bled was higher i n the bevel-up method, particularily on trial one (P < .001). Completi on rate of successful bleb formation in bevel-down was 27.3 as compare d with 23.3 in bevel-up method (P = .013). The comfort level was highe r with the bevel-down than the bevel-up method (P = .0001). Conclusion : The bevel-down method of intradermal testing is superior to the beve l-up method.