involving common allergens, as detailed in Table17.1 [7]. A minimal amount of an allergen extract containing particular components, both genuine and cross-reacting, is required for the test [9]. The allergen panel selection can be determined according to patients’ age, clinic, and geographic area, typically encompassing 8–12 allergens, which is usually adequate [10, 11]. The allergen extracts must possess high potency and stability, while also considering their shelf life. The pricking device should be sterile and only be used once for each allergen. They are available in a variety of sizes (single or multiple puncture devices), shapes (lancet, needle, bifurcated lancet, with or without guard), materials (plastic or metal), and preparations (precoated with the allergen extract, or not) [9]. The examples of pricking devices are depicted in Fig.17.1. No SPT device has been established as the gold standard in the litera­ture [9]. SPT is conducted on the anterior arm or back and is limited to healthy skin [12]. To prevent cross-contamination, a minimum of 2cm spacing between prick tests is recommended. The most commonly used SPT method involves applying a drop of the allergen extract to a marked area of the skin and then inserting the device through the drop at a 45–60° angle, ensuring it does not penetrate beyond the epi­dermis. If the device is inserted at a 90° angle, it is referred to as a skin puncture test, skin test methods are illustrated in Fig.17.2 [12]. A different SPT technique was used, in which submerge the device into the allergen, then drop to the test area, and apply vertical pressure. Comparable results were found with less effort and expense [13]. It’s important to note that performing the SPT should not cause bleeding [12]. The best outcomes can be anticipated by selecting a single prick/puncture tool and effectively training skin technicians in its use. Skin test prociency protocols should be used to establish consistency in skin test performance among technicians in order to achieve quality assurance. Post-histamine control applications have been advised to adhere to proposed standards, such as a coefcient variation of less than 20% (as per EAACI) and less than 30% (as per Childhood Asthma Management Program— CAMP) [14, 15]. The peak reactivity of prick/puncture tests occurs between 15 and 20min, then the diameters of the erythema and wheal should be measured in mil­limeters (mm) and compared with positive and negative controls. An example of the SPT is exhibited in Fig.17.3. The wheal diameter is determinative while interpret­ing the test result. In clinical studies, wheal diameters ≥3mm are considered posi­tive in SPTs whereas less than 3mm may be accepted positive in epidemiologic studies [16]. Although the severity of clinical symptoms is not always predicted by wheal size, larger wheal sizes may indicate a favorable positive response to nasal provocation. The correlation between wheal size and clinical symptoms may be