Skin prick test is useful for allergens avoidance & can differentiate between allergic rhinitis & non-allergic rhinitis of eosinophilic syndrome (NARES). 

Nasal polyposis, chronic rhinosinusitis and allergic rhinitis are medical conditions that are often parallelly found. Although there are not enough evidence based data that allergic rhinitis is the cause of chronic rhinosinusitis and nasal polyposis sensitization to inhalant allergens worsens the former. In regard to that it is worthwhile  to do SPT in such patients and consider allergy treatment in order to achieve better therapeutic results.

As nasal polyposis is essentially a medical condition patients will receive anti allergy medication whether SPT is positive or not.

Perhaps if SPT is strongly positive for a particular Allergan consideration can be given for immunotherapy.

There no documented evidence to suggest immunotherapy in itself will cause regression of the polypi.

I think it is important to make a skin test in order to differantiate allergic rhinitis from chronic rhinosinusitis. also for deciding an immunotherapy it should be made. If the patient has alllergic rhinitis and receives immunotherapy sypmtoms may decrease.

Kevser does not answer the original question posted by Mustafa. Certainly if SPT is positive in allergic rhinitis immunotherapy will help. Question is in what percentage of patients with nasal polyposis immunotherapy is beneficial.

Kevser , I wonder  that  skin prick test is useful in patient with nasal poliposis? Because of that information of 2/3 of in patient with nasal poliposis together with alergic rhinitis. 

SPT in nasal polyps are usefull to determine if a patient is allergic. I would not call it allergic rhinitis if patients have nasal polyps. There is no evidence that allergy is causing  nasal polyps, however it will worsen the symptoms. On the other hand local IgE in nasal polyps can be sky high independent of allergy. So even in non allergic patients IgE is involved. We recently have demonstrated that anti-IgE treatment is effective in alleric and non-allergic patients with nasal polyps and asthma. 

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we had a  meta-analysis study on this subject in our department It showed that skin prick test & immunotherapy (previously called desnsitization)  is only effective after radical surgery and removal of the polypi . It has no role in management as a single therapy or preoperative therapy it delays or may prevent the recurrence  in the last five years I used it routinely after radical removal of nasal polypi with very low incidence of recurrence except those patients having the tride of asthma - polyposis and asprin sensitivity    a second point in my researches is the role of fungus in polyposis I give routinly in addition local antifungal drops for 2 months and systemic treatment for 10 days after operation  to summerize  1- do radical surgery  2- immunotherapy 3- local antifungal treatment

Dear Mohamed El-Begermy, would you mention from where we i can download your mete-analysis article?

I am not sure whether SPT results mean useful additional information for necessary postsurgical treatment . What is your opinion about  INS and local antifungal treatment  for 4-8 weeks + anti-IgE if  serum IgEtotal is above  2x average value. Based on SPT alone I probably would not suggest  immunotherapy. Am avare of a trial on new biological treatment of nasal polyposis.

I think that there is no complementary test or exam able to “demonstrate allergy”, since "allergy" is a clinical diagnosis. Instead, the complementary tests may suggest “”sensitization” what may help the physician to choose allergens to prove clinical relevance by means of challenge tests. See the texts attached.

and also...

We studied this problem and publish two paper :

Acta Otolaryngol. 2008 Feb;128(2):186-92.

Influence of allergy in patients with nasal polyposis after endoscopic sinus surgery.

Bonfils P1, Malinvaud D.

Author information

Abstract

CONCLUSION:

Allergy does not modify the symptoms and steroid consumption (oral and local) of nasal polyposis (NP) patients after functional endoscopic sinus surgery (FESS).

OBJECTIVES:

To assess the role of allergy in the evolution after FESS of patients presenting with the diagnosis of NP.

PATIENTS AND METHODS:

This was a prospective study of 63 consecutive patients with NP (57% males, mean age 45.8 years), who were analyzed to detect whether the results of a surgical treatment of NP were influenced by the presence of positive allergic tests (Phadiatop). Three nasal criteria were scored: nasal obstruction, posterior rhinorrhea, and the loss of smell. The frequency of asthma was evaluated. Medical treatment of NP after FESS consisted of washing of the nasal cavities, steroid spray, and oral steroid administration. The amount of consumption of steroids (prednisolone and beclomethasone) was studied.

RESULTS:

Decrease of all nasal symptoms was not statistically different in the two groups of patients with and without allergy. Cumulative consumption of prednisolone and beclomethasone after surgery was similar in the two groups.

AND

Acta Otolaryngol. 2006 Aug;126(8):839-44.

Influence of allergy on the symptoms and treatment of nasal polyposis.

Bonfils P1, Avan P, Malinvaud D.

Author information

Abstract

CONCLUSION:

Allergy does not modify the symptoms of nasal polyposis, either initially or after a 1-year medical treatment.

OBJECTIVES:

To assess the role of allergy in the symptoms and treatment of patients presenting with the diagnosis of nasal polyposis.

PATIENTS AND METHODS:

Two simultaneous studies were carried out. In the first study, 180 consecutive patients with nasal polyposis (60% males, mean age = 48.4 years) were analyzed to detect whether the severity of their symptoms correlated with the presence of positive allergic tests. In the second study, 74 consecutive patients (57.5% males, mean age = 48.3 years) were analyzed to detect whether the results of a 1-year medical treatment of nasal polyposis were influenced by the presence of positive allergic tests (Phadiatop). Five nasal criteria were scored: nasal obstruction, anterior and posterior rhinorrhea, facial pain, and the loss of sense of smell. The frequency of asthma was evaluated. Treatment of nasal polyposis consisted of washing of the nasal cavities, steroid spray, and oral steroid administration. The amount of steroid consumption (prednisolone and beclomethasone) was studied.

RESULTS:

In the first study, mean scores of nasal symptoms did not differ between the two groups of patients with and without allergy. The prevalence of asthma (p = 0.03) was higher in the group with than without allergy. In the second study, decrease of all nasal symptoms was not statistically different in the two groups. Cumulative consumption of prednisolone and beclomethasone between baseline and year 1 were similar in the two groups.

I have not found prick test is of much value in the diagnosis or management of nasal polyposis. Traditional medical and surgical treatment is the best option,

Perhaps thee is a place for prick tests in recurrent and recalcitrant cases if immunotherapy is contemplated.

Nasal polyposis is a chronic recurrent condition with unclear cause and difficult to treat. It coincides often with allergic rhinitis which can in its turn worsen nasal symptoms. In regard to that it makes sense to diagnose AR and take every possibility to cope with it. There some data that treating allergy in patients with nasal polyps  can have beneficial effect on the course of the disease. And here is the role of SPT.

Contingent on your comments, this topic is unclear in otolaryngology field. May be further studies can explain this question.Thanks for your comments.