Allergy Skin Testing
Allergy skin testing, usually performed by pricking the skin, is performed in order to aid in the diagnosis of allergies to certain substances. During a skin test, a specialized tool is used to puncture a dilute allergen into the surface of your skin. The patient is then observed for approximately 15-20 minutes to see how the skin reacts to the substance. Redness, swelling, or itchiness of the skin are signs of an allergic reaction. Allergy skin testing can be used to identify allergies to airborne allergens, such as animal hair or dander, dust mites, molds, and pollens. In order to obtain accurate results, it is important to eliminate use of antihistamines for several days prior to the appointment date, since these medications can interfere with skin tests.
Patch testing is a method used to aid in the diagnosis of allergic contact dermatitis. Patch testing involves the application of suspected allergens to the patient's skin, including ingredients in hair dyes, cosmetics, fragrances, and other commonly used products. Since the substances that are being tested in patch testing cause delayed reactions, results of the patch test are typically read 48 hours after initial placement of the patches. Patients who undergo patch testing must visit the office three times in a week - they typically come on a Monday, Wednesday, and Thursday. Occasionally patch testing is used to identify food allergens in patients with gastrointestinal disorders.
Immunotherapy injections involve administering the substance that a person is allergic to in order to build up immunity and reduce allergic symptoms. Unlike typical medications such as antihistamines, immunotherapy helps to cure the underlying allergic condition. In immunotherapy, the allergenic substance is typically administered once per week, and the dose is slowly and steadily increased until a "maintenance" dose is reached. The patient typically reaches this point after about 5-6 months of immunotherapy, and receives the greatest benefit at this point. Cluster immunotherapy follows the same general principle, but is administered over a much more rapid time frame. Shots are given in “clusters” of 2 to 3 at a time, 2 to 3 times per week. Through cluster immunotherapy, a patient reaches their maintenance dose in as little as 3 to 4 weeks.
Spirometry is a test used to measure the function of your lungs. Spirometry can be used as an important diagnostic aid in determining whether a patient has obstruction of the airways (diseases like asthma) or restriction, which indicates a reduction in the ability of the lungs to expand (diseases like pulmonary fibrosis). During a spirometry test, you will be asked to breathe into a tube which is attached to a spirometer (a machine that measures the volume of air inhaled and exhaled). Often, a medication called a bronchodilator will be administered after the initial test in order to see whether bronchial obstruction can be relieved.
An oral food challenge is a test used to accurately diagnose a specific food allergy. Any food may be used during the challenge but most commonly include milk, eggs, peanuts, tree nuts, wheat and soy. During an oral food challenge, the patient is administered slowly increasing amounts of the suspected allergenic food, and is closely monitored for any symptoms.
Immunotherapy injections involve administering the substance that a person is allergic to in order to reduce allergic symptoms. These injections usually include some combination of animal hair or dander, dust mite, mold or pollens. Unlike typical medications such as antihistamines or nasal steroids, immunotherapy helps to make long-term improvements in a patient's allergic condition. In immunotherapy, the allergenic substance is typically administered once per week, and the dose is slowly and steadily increased until a "maintenance" dose is reached. Cluster immunotherapy follows the same general principle, but is administered over a much more rapid time frame. Shots are given in “clusters” of 2 to 3 at a time, 2 to 3 times per week, enabling a patient to reach their maintenance dose in as little as 3 to 4 weeks.
Penicillin Testing and Desensitization
Many patients have allergic reactions to penicillin, amoxicillin, or related medications, consisting of rashes or serious systemic reactions. A history of penicillin allergy prevents patients from taking this important class of medications for years or even decades. In order to determine whether a patient is still allergic to penicillin or amoxicillin, allergy skin testing to these drugs should be performed. If the results do show an allergy to penicillin or amoxicillin, our practice can perform desensitization, which is a process designed to eliminate sensitivity to the drug. This process consists of administering initially tiny doses of the drug by mouth and then gradually increasing the amount over a period of several hours. Our practice has significant experience with drug desensitization to penicillin, amoxicillin and a large number of other medications.
Aspirin sensitivity is common and may cause acute, severe symptoms of asthma, hives, facial swelling, and possibly throat swelling after taking even small doses of aspirin. Many people require daily doses of aspirin for other medical conditions, such as reduction of coronary artery disease, and are not able to take it because of their history of aspirin sensitivity. A very specialized procedure called aspirin desensitization may be performed, in which very tiny doses of aspirin are administered and gradually increased over 1-2 days, allowing a patient to take this important medication. In addition, aspirin desensitization followed by chronic daily aspirin therapy may significantly improve asthma and sinus symptoms in patients with asthma and aspirin sensitivity. Our practice has been performing this procedure for many decades and is experienced in performing it in the outpatient setting.