Skin tests and RASTs are important tools but do not by themselves make or exclude the diagnosis of allergy. Positive results require a confirmatory medical history, whereas negative results exclude IgE-mediated allergy with a high degree of reliability. Skins tests are preferred for routine use, because with appropriate procedural controls they are simpler, give rapid results and are cost-effective. RASTs are an excellent alternative when skin tests are precluded. Disorders such as asthma and allergic rhinitis may be provoked by irritants (e.g., cigarette smoke), physical factors (e.g., cold, dry air) and chemical substances (e.g., acetylsalicylic acid) and metabisulfite), none of which involve an IgE-antibody-mediated mechanism.
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