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This article is part of the supplement: Canadian Society of Allergy and Clinical Immunology Annual Scientific Meeting 2012

Open Access Open Badges Meeting abstract

Measured depth of subcutaneous tissue on posterolateral arm of aeroallergen immunotherapy patients

Laura Kim1, Ryan Potts2, Clark Eeuwes3, Arunmozhi Dominic3, Immaculate Nevis4 and Harold L Kim34*

Author Affiliations

1 McGill University, Montréal, Québec, Canada

2 University of Waterloo, Waterloo, Ontario, Canada

3 University of Western Ontario, London, Ontario, Canada

4 McMaster University, Hamilton, Ontario, Canada

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Allergy, Asthma & Clinical Immunology 2012, 8(Suppl 1):A7  doi:10.1186/1710-1492-8-S1-A7

The electronic version of this article is the complete one and can be found online at:

Published:2 November 2012

© 2012 Kim et al; licensee BioMed Central Ltd.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Subcutaneous immunotherapy (SIT) injections for aeroallergens are often utilized in patients. SIT should be injected into the subcutaneous space in the mid-posterolateral upper arm. If the injections are given intramuscularly (IM), there may be an increased risk of anaphylaxis. In our allergy clinic, SIT is given with BD Safety Glide™ Allergy syringes with needle length 13 mm. There is a risk of the SIT being injected IM if patients have a skin to muscle depth (STMD) less than 13 mm.


Charts were reviewed in an allergy clinic for patients on SIT where an ultrasound of the left posterolateral arm was done to measure STMD. Baseline characteristics of the two groups of patients with STMD greater than, and less than or equal to 13 mm were compared. The proportions of patients with STMD greater than 4mm, 6 mm, 8 mm, and 10 mm were calculated. Multivariable logistic regression was performed with age, sex, BMI and race.


Ultrasounds had been completed on 186 patients on SIT. There were 149 (80%) with STMD less than 13mm. Baseline characteristics including age, sex and BMI differed among the two groups (p < 0.05). Based on the logistic regression analysis, BMI was significantly associated with STMD. There were 168 (90%) patients with more than 4mm STMD.


With standard allergy syringes, most patients on SIT are at risk of receiving the injections IM. A needle length of 4 mm would significantly decrease the risk of SIT being given IM.