The authors provide a concise and pragmatic overview of the management of suspected penicillin allergy. They correctly refer to the importance of skin testing but omit to specify that this usually means prick and intradermal skin testing.
The confusion is compounded by the BMJ publishing a large colour picture of a patch test: an investigation performed by dermatologists for suspected contact dermatitis to external allergens and singularly useless in the investigation of penicillin allergy.
In the interest of getting the right patient to the right specialist first time apply this broad rule of thumb to allergy referrals. If a reaction to an inhaled, ingested or injected agent is suspected then refer to an allergist. If dermatitis or eczema occurs with an agent applied directly to the skin then refer to a dermatologist for patch testing.
Competing interests:
No competing interests
21 August 2017
Graham A Johnston
Consultant Dermatologist and Honorary Associate Professor
LEICESTER ROYAL INFIRMARY
DEPARTMENT OF DERMATOLOGY, LEICESTER ROYAL INFIRMARY
Rapid Response:
Re: Penicillin allergy—getting the label right
The authors provide a concise and pragmatic overview of the management of suspected penicillin allergy. They correctly refer to the importance of skin testing but omit to specify that this usually means prick and intradermal skin testing.
The confusion is compounded by the BMJ publishing a large colour picture of a patch test: an investigation performed by dermatologists for suspected contact dermatitis to external allergens and singularly useless in the investigation of penicillin allergy.
In the interest of getting the right patient to the right specialist first time apply this broad rule of thumb to allergy referrals. If a reaction to an inhaled, ingested or injected agent is suspected then refer to an allergist. If dermatitis or eczema occurs with an agent applied directly to the skin then refer to a dermatologist for patch testing.
Competing interests: No competing interests