Cutaneous allergometric tests, if possible, should be preferred and considered as the first diagnostic level in case of patients with clinical history of suspect allergic reactions, as they are more rapid, less invasive and cheaper than serological tests. Exceptions from this recommendation are: situations in which it’s impossible to perform cutaneous tests, such as hypo- or hyper- reactive skin status (i.e: chronic intake of anti-histamines or corticosteroids, or dermographism); the unavailability of adequate allergen extracts.Total serum IgE assessment is scarcey useful as it is not indicative of a current allergic sensitization: allergic patients may have low or normal IgE levels, while patients with high levels of total IgE may be not atopic or allergic.
Moreover, all allergometric tests should be interpreted by specialists in Allergy and Clinical Immunology, as an erroneous interpretation may lead ab unexpert doctor to propose therapeutical behaviours potentially harmful for the patient.