Diurnal Variations in Skin Prick Testing

Elisa Ochfeld*, Brian Cheng, Nina Bowsher, Anna Fishbein

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


Background: Prior research suggests that skin prick testing (SPT) might be larger in the afternoon, with unclear clinical significance. Methods: This retrospective chart review analyzed SPT results from patients between June 2008 and June 2017, organized into 4 time groups for analysis (Group 1: 7:00 AM-10:29 AM, Group 2: 10:30 AM-11:59 AM, Group 3: 12:00 PM-2:29 PM, and Group 4: 2:30 PM-8:15 PM). Results: In total, 12,982 (n) patient test results had positive histamine and were included in final analysis. Histamine wheal size was not significantly increased in the PM compared with AM (P = 0.89). Food allergen and aeroallergen wheal sizes were not significantly increased in PM. Histamine erythema size was increased in the PM compared with AM (P ≤ 0.01). Food allergen and aeroallergen erythema sizes trended toward an increase in the PM. Conclusions: There were not significant differences in SPT wheal size based on time of day for histamine, food allergens, or aeroallergens. SPT can be reliably performed at any time of day.

Original languageEnglish (US)
Pages (from-to)125-129
Number of pages5
JournalPediatric, Allergy, Immunology, and Pulmonology
Issue number4
StatePublished - Dec 1 2021


  • circadian rhythm in allergic disease
  • diurnal variation
  • pediatrics
  • skin prick testing

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Pediatrics, Perinatology, and Child Health
  • Immunology and Allergy


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