Stinging insect allergy: changing concepts.

Immunologic advances promise changes in the approach to diagnosis and treatment of Hymenoptera stings. Results of skin tests with venom show good correlation with those of in vitro tests (histamine release and radio-allergosorbent test [RAST]). Similar comparisons of whole-body extract (WBE) skin tests with in vitro tests show poor correlation. Treatment emphasis must currently be placed on sting prevention and on medical treatment. The only material now available commercially for immunotherapy is WBE. Circumstantial evidence suggests some benefit from immunotherapy with WBE, but immunologic data do not support this observation.