Explain a food allergy diagnostic plan and challenge to an anxious parent — OSCE

Candidate instructions (2 minutes reading time)

You are the paediatric registrar in the allergy clinic. Mrs Chen has brought her 2-year-old daughter, Sophie, for review of a positive peanut allergy test. The GP ordered a food allergy panel because Sophie has moderate eczema. The SPT to peanut was 6 mm; all other foods were negative. Sophie has never eaten peanut. Mrs Chen has read online that a 6 mm wheal means a "severe allergy" and is anxious. [1]

Your task: explain what the SPT result means (sensitisation versus clinical allergy), outline the diagnostic pathway, address safety concerns, and agree on a plan. You have 8 minutes. [3]