Age-Stratified Sensitization Patterns in Children Undergoing Skin Prick Testing: A 1-Year Retrospective Single-Center Cohort.

Pediatric allergen sensitization varies by age, exposure context, and clinical presentation, yet routine outpatient skin-prick testing data are often interpreted without an integrated age-stratified framework. This study tested the hypothesis that standardized skin-prick testing data could identify age-associated differences in allergen category distribution, polysensitization burden, wheal-response intensity (defined as the size of the raised skin reaction measured after allergen exposure during skin-prick testing), and clinically interpretable sensitization phenotypes in children with suspected allergic diseases.This one-year, retrospective single-center cohort included 647 children who underwent standardized skin-prick testing between March 2024 and February 2025.  Age-stratified analyses were used to compare airborne and food allergen sensitization, polysensitization burden, and wheal-response intensity. Hierarchical clustering was applied to identify sensitization phenotypes, and multivariable logistic regression was used to examine factors associated with polysensitization and dominant airborne sensitization. Older age groups showed higher prevalence of airborne sensitization, mixed airborne-food sensitization, polysensitization, and larger wheal responses, whereas food-only sensitization was more frequent in younger children. Clustering identified four clinically interpretable phenotypes: skin prick test-negative, airborne-only sensitization, food-only sensitization, and mixed sensitization. Polysensitization was associated with older age, atopic family history, allergic comorbidities, higher allergic inflammatory markers, and selected indoor environmental exposures. These findings indicate that routine skin prick testing data can be organized into a structured age-stratified interpretation framework. Such a framework may support allergen panel refinement, risk stratification, follow-up planning, and individualized management in pediatric allergy clinics, while requiring external validation in multicenter and longitudinal cohorts.