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Wise et al.

Page 335

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Topical (cutaneous) corticosteroids Aggregate Grade of Evidence: A (Level 1b: 2 studies, Level 2b: one study) • Skin tests should not be placed at sites of chronic topical steroid treatment . Systemic corticosteroids Aggregate Grade of Evidence: C (No effect – Level 1b: 1 study, Level 2b: 1 study; Suppression – Level 3b: 1 study, Level 4: 1 study) • Systemic corticosteroid treatment does not significantly impair skin test responses . Selective serotonin reuptake inhibitors (SSRIs) Aggregate Grade of Evidence: B (Level 2b: 1 study, Level 4: 1 study) • Does not suppress allergy skin test response . Benzodiazepines Aggregate Grade of Evidence: C (Level 4: 1 study, Level 5: 1 case report) • May suppress skin test responses . • Conflicting results regarding skin test suppression .

Aggregate grades of evidence: medications that affect allergy skin testing H1 antihistamines Aggregate Grade of Evidence: A (Level 1b: 2 studies, Level 2b: 3 studies) • Should be discontinued 2-7 days prior to testing . H2 antihistamines Aggregate Grade of Evidence: B (Level 1b: 2 studies) • Ranitidine suppresses skin whealing response, may result in false negatives . Topical antihistamines (nasal, ocular) Aggregate Grade of Evidence: Unable to determine from one Level 1b study. • Should be discontinued 2 days prior to testing . Anti-IgE (omalizumab) Aggregate Grade of Evidence: A (Level 1b: 2 studies) • Results in negative allergy skin test results .

Leukotriene receptor antagonists Aggregate Grade of Evidence: A (Level 1b: 2 studies, Level 2b: 1 study) • May be continued during testing . Tricyclic antidepressants Aggregate Grade of Evidence: Unable to determine from one Level 2b study. • Agents with antihistaminic properties suppress allergy skin test responses .

TABLE VIII.E.4.a-2.

Topical calcineurin inhibitors (ie. tacrolimus, picrolimus) Aggregate Grade of Evidence: D (Level 1b: 1 study, Level 2b: 1 study – results conflicting)

Int Forum Allergy Rhinol . Author manuscript; available in PMC 2020 June 10.