Human vs Machine in Bioengineering Allergology: A Comparative Analysis of Conventional vs Innovative Methods for Quantifying Allergological Skin Prick Tests

Purpose: Immediate hypersensitivity reactions, commonly triggered by allergens, play a crucial role in clinical allergies. The skin prick test is the primary diagnostic tool for allergy, involving the application of an allergen drop on the forearm's volar surface. A sterile lancet is then used to cross the drop, observing the formation of a wheal if sensitized. In allergy practice, wheals are quantified using an arbitrary visual scale or methods such as the Dermographic Pen Method, involving a dermographic pen and graph paper, or a centimeter ruler. These methodologies are semi-quantitative, time-consuming, and operator-dependent. This study addresses the need for accurate and standardized quantification of SPT responses. We developed a Semi-Automated Method (SAM) for wheal detection to achieve this. Methods: A cohort of 26 patients with respiratory allergies underwent SPTs with various allergens. Wheals were quantified using three methods: Arbitrary Visual Scale (AVSM), DPMM (Dermographic Pen Measurement Method), and the newly developed SAM. SAM utilized photographic detection and image analysis, and calculated major and minor diameters, mean diameter, wheal surface area, and skin index. Results: Comparative analysis revealed SAM's superior performance in precision and efficiency compared to AVSM and DPMM. Mean surface measurements of histamine-generated wheals using SAM were significantly lower than those obtained with DPMM. Interestingly, SAM consistently demonstrated better performance across all tested allergens. Conclusion: The introduction of SAM represents a significant advancement in allergy diagnostics. Its semi-automated approach enhances precision and facilitates long-term monitoring of SPT results. Through automation, SAM achieves accuracy in results and ease of use, notably improving allergy diagnostics.