Regarding allergen testing, such as blood draws and punctures, is there anything that can really confirm its accuracy. I read a report some time ago that the allergens measured by an institution in the UK were not reproducible, and I also feel that allergen testing is not very reliable in my own clinical practice. Allergic diseases account for a large proportion of dermatology, and allergen testing sounds so good that doctors who can’t treat the disease will say to their patients that you’d better have an allergen test. Opinion 1: Having applied the Biocon Bioresonance method for allergen detection, I think it is not very meaningful, and also allergies are often multiple, that is, patients are allergic to many kinds of things and cannot avoid exposure. However, if there is a high suspicion of allergy to a certain substance, I think the patch test is more reliable, because there are too many substances in nature, and what we can detect is limited. Opinion 2: Allergen testing is very important for allergic diseases. The main reason for allergic patients to visit the doctor is to identify the allergen. The main reason for allergic diseases is to identify the allergen. If the allergen is found and the re-exposure is avoided, some cases can be cured; the doctor should also help the patient to find the allergen. Secondly, the specificity and sensitivity of allergen testing varies from method to method, and there is no shortage of both, such as the patch test. There are also some that are more difficult to accept rationally, such as bioresonance and food intolerance. As for “irreducible”, I have no experience, but I believe that more scientific methods can be repeated. Finally, the pathogenesis of allergic diseases is complex, and there are countless allergens that we come into contact with on a daily basis, so the current limited allergen reagents are far from meeting clinical needs. Point 3: There are many reasons for positive and negative allergen tests, and normal testing is still necessary. There was a patient who suffered from chronic eczema for nearly a decade, and had used antihistamine, herbal and hormonal treatments, with recurrent episodes of the disease. Later, he did a skin patch test and found that the allergen was rosin. The patient often played erhu before and after the disease and was exposed to more rosin. Opinion 4: Allergen testing (the concept here includes patch test), patch test has better reliability, sensitivity and specificity. The sensitivity and specificity of the needle allergen test is not high, the reason: some doctors prescribe needle allergen test for patients with eczema and itchy rash, that may not be allowed, because the disease the patient suffers from is a type 4 allergic reaction, needle monitoring is mostly a type 1 allergic reaction, even if the test belongs to the type 1 allergic reaction of urticaria (some chronic urticaria is also not type 1), there are problems: is the purified reagent the same as the chemical that causes the patient’s allergic reaction? the same chemical that caused the patient’s allergic reaction? For example, if someone is allergic to fish, there must be hundreds of chemicals in the fish body that can act as allergens, right? Can all of them be purified? Under normal circumstances, fish enters the body after digestion in the gastrointestinal tract, can the reagent purification process be the same as digestion? So the reagent “fish” can not represent the real “fish”? Therefore, even if it is used to check type 1 allergic reactions, it is not accurate. On the contrary, the reason why the patch test is accurate is that it simulates the disease process to the greatest extent. In summary: the reasons for inaccurate allergen testing: 1. wrong indications 2. the test itself is inaccurate allergen testing is only valid when there is a suspected allergen. If the allergic disease is caused by anxiety, fatigue, indigestion, etc., often no clear allergen can be detected, or there is a “hypersensitivity state”, that is, there is an allergy to a variety of substances. At this time, it is not very meaningful to check the allergen. Because the hypersensitivity status will improve as the primary disease is corrected, allergen testing is not the first choice at this time. The indications for allergen testing are: 1. long duration, recurrent atopic dermatitis, moderate to severe dermatitis, or the tendency to have other systemic complications 2. stubborn chronic eczema or dermatitis 3. chronic contact dermatitis, the cause of which is not well determined 4. severe allergic reactions, seriously affecting health (such as AD infants with severe diarrhea or even blood in the stool, need to detect milk allergens) 5. heavy psychological burden Patients with urticaria are less suitable for allergen testing. Acute urticaria can usually resolve on its own, while chronic urticaria often has complex causes, and no clear cause can be found. If I had to do it, I would choose to test chronic urticaria patients for allergens during remission, but the positive rate is actually very low (UniCap sIgE in our case). And even if the allergen is found, the avoidance treatment is very ineffective. It is said that the accuracy of the serological sIgE test is not affected by medication, is this true? But the sIgE test is not affected by the systemic application of glucocorticoids? I have been doing allergen testing on patients with chronic urticaria for more than 3 years with the Bacone electronic biofeedback therapy instrument, and I have done more than 1000 cases. How can I avoid dust mites and other things in the current environment? No test is 100% accurate and is for reference only. Besides, testing for allergens, for example, is done on a limited number of common substances, which is similar to guessing riddles. Besides, the patient may be in a non-acute phase of allergy when he/she undergoes the test, plus the patient has great expectations of the method, which may lead to a series of neurological changes, and may not be able to detect the substance that he/she is allergic to, or the substance that causes allergy is not included in the method. For example, if a young patient is allergic to fish, shrimp, beef or mutton, he may not be allergic anymore as he grows older and his immune system and various functions are well developed. I personally feel that allergen testing is not very meaningful, because there are too many variables, both horizontally and vertically. Whether allergen testing is reasonable and accurate, the premise is to clarify which type of allergic reaction the patient’s allergy belongs to, because whether the allergen test is specific IgE or patch test, the first thing to figure out is which type of allergen test is for which type of allergic reaction, for example: urticaria is a type I allergic reaction, which should be checked by blood sampling specific IgE; eczema, contact dermatitis is a type IV allergic reaction, which should be checked by patch test. For example, urticaria is a type I allergic reaction and should be checked by blood sampling for specific IgE; eczema and contact dermatitis are type IV allergic reactions and should be checked by patch test for allergens. We have just recently done a retrospective analysis of allergen testing and found that there are many shortcomings in domestic allergen testing, especially the testing methods are confusing and unreasonable. By consulting authoritative databases, there is no foreign literature indicating that bioresonance can be used to detect allergens. The UniCap system is currently used to detect allergens with higher sensitivity and specificity, but the reagents are more expensive and the variety is limited. There is also the German Allergy Screening System, which is also more accurate. The immunostaining method of dot prick and blood screening has IG-E involved, and the spot patch method has IG-G involved. Five elements meridians, electromagnetic waves, pseudoscience one. Allergic reactions have four elements: allergen, susceptible person, mechanism of allergic reaction and allergic result. In many clinical cases, the test result is positive, but the patient has no clinical symptoms, such as some people milk or lamb and other specific IgE antibodies, but usually drink milk or eat lamb without symptoms, no inflammatory reaction or organ loss can not form a complete allergic reaction.