Allergy Skin Testing

Allergy

Allergy Skin Testing Allergy testing allows us to determine how likely it is that inhaled allergens play a role in your symptoms. Some conditions like non-allergic rhinitis, food allergy, infection or gastric reflux may produce symptoms identical to allergic rhinitis and can be difficult to distinguish without testing. Another important reason for testing is identification of your specific allergic triggers. Identifying your triggers is critical for serious allergy sufferers since one of the keys to effective treatment is AVOIDANCE. Testing is also the first step in formulating an alternative therapy to traditional allergy medications called immunotherapy, which may offer effective long-term suppression of allergic disease. How is Skin Testing Performed? Skin testing is done in two steps and each step uses different techniques. The first step is called the extended skin prick test and involves the application of four Multi-Test devices to the arm. The devices have no needles and do not break the skin. Allergens are placed on the skin as well as a small amount of histamine to make sure your skin is capable of producing a normal, visible skin reaction. Skin reactions are measured after 20 minutes. Itching, redness and wheals (small, itchy lumps) indicate sensitivity to a particular allergen or a normal response to histamine. The most common reason for lack of histamine response is use of antihistamines or medications that block the normal histamine response. Prior to your visit, you will be given a list of medications that may interfere with testing. Be sure to alert us if you are taking one of these and cease taking them prior to your testing according to your physician’s direction. The second step in skin testing is called intradermal testing. This allows us to figure out precisely your degree of sensitivity to an allergen that produced a skin reaction on the prick test. It is also a more sensitive test that can tell us if you really are sensitive to an allergen that had little or no reaction on the prick test. Intradermal testing involves injection of a very small volume of each of the allergens into the skin to make a tiny lump. This is similar to the skin test for Tuberculosis, called a PPD test. We then measure the skin reaction to each of the allergens in 15 to 20 minutes. Are there Any Side Affects to Skin Testing? Skin testing is not painful and usually well tolerated other than itching and redness. We will provide a soothing cream for your arm after the test. Occasionally large responses may take a few hours to clear. Rarely, they may take a couple of days to clear. Let us know if a delayed reaction occurs (a wheal that develops after 2-3 days where one was not seen before). Wheezing, cough and flaring of allergy symptoms are possible with testing, especially if large skin reactions were seen. People taking beta-blockers or asthmatics are more likely to have these severe reactions. Who Should Not Have Allergy Skin Testing? If you are taking beta-blockers (like Toprol, Metoprolol, Inderal, Atenolol) for blood pressure control or a heart condition or have asthma that is difficult to control (frequent wheezing, shortness of breath or frequent inhaler usage) you should not undergo skin testing because of the increased risk for a severe allergic reaction called anaphylaxis. Blood tests should be done instead. Please feel free to fill out our allergy testing paperwork prior to your appointment. Common Allergens
White Oak: • Located in eastern North America • Usually ashen gray in color • 65-85 feet tall at maturity • Tolerant to a variety of habitats – found on ridges and in valleys • Can survive in dry and moist habitats • Oak pollen season extends from March to May/June
Short Ragweed: • The “king” of all allergenic plants • Native species aggressively flourish along roadsides and in disturbed soil • Produces an enormous number of pollen grains that remain air born • Blooms in late summer and early autumn • Plant may grow to be four feet tall but is usually smaller • Blooms from mid-August through October
Timothy Grass: • Commonly grown for cattle feed and hay for horses • Grows by roadsides and abandoned fields but requires nutrient rich soil • Its pollen is a common allergen and the plants persist through the winter • All grass pollen is in season from February through November
Alternaria Mold: • Dark colored mold which when exposed to can provoke respiratory and asthmatic symptoms in a susceptible person • Located in damp areas in households
D.Farinae Mite or D. Pteryonsysimus: • Dust mites are microscopic creatures related to ticks and spiders that live in house dust • Dust mite body parts and feces cause allergic reactions in people who have become sensitized to dust mite proteins • Dust mite allergens also trigger asthma attacks • All homes contain some dust mites, amount varies depending on the moisture and temperature in the home • Dust mites thrive in humid, warm environments, feed on dead human skin and are concentrated in mattresses, bedding, upholstered furniture, carpets and are common in stuffed animals
Pet Allergies: • Proteins from hair, saliva and or urine of household pets can cause an allergic reaction that attacks the eyes and airways like hay fever and can result in asthmatic symptoms • Atopic dermatitis (red, swollen and itchy skin) and/or a nettle rash (stinging, itching sensation that can last several hours) are also common
Red Birch: • Birch trees are usually small to medium sized trees or shrubs mostly of northern temperate climates • In northern latitudes Birch is considered to be the most important allergenic tree pollen causing hay fever symptoms • Allergies to Red Birch are most common between March and June but are weather dependant
E. Cottonwood: • One of the largest North American hardwood trees • Common throughout eastern United States and just into southern Canada • Leaves are alternate and simple with coarsely-toothed edges • Leaf shape is triangular • Allergies to E. Cottonwood are most common between March and June but are weather dependant
American Elm: • Species native to eastern North America, from Nova Scotia west as far as British Columbia, from Northern Alberta to Florida and central Texas • Can withstand temperatures as low as – 42 degrees Celsius and can live for several hundred years • Allergies to American Elm are most common between March and June but are weather dependant
Box Elder Maple: • A species of maple native to North America that is usually fast growing and short-lived tree • Can grow up to 10-25m tall • Often has several trunks and can form impenetrable thickets • Often grows on flood plains and around houses and hedges, areas with ample water supply • Able to endure big city environment and has been extensively planted as a shade tree • Allergies to Box Elder Maple are most common between March and June but are weather dependant
White Ash: • Native to North America from Nova Scotia west to Minnesota, south to northern Florida and southwest to eastern Texas • Large deciduous tree growing 20-30m tall, exceptionally to 50m • Bark is smooth and gray on young trees and becomes fissured with age • Natural lifespan is up to a maximum of about 300 years • While allergies to White Ash are most common in April and May, they can start as early as January
American Sycamore: • Native to North America easily recognized by its mottled exfoliating bark • Can grow up to 30-40m and is often divided near the ground into several secondary trunks • Bark is dark reddish brown and broken into oblong plate-like scales • Allergies to American Sycamore are most common between March and June but are weather dependant
Shagbark Hickory: • Common hickory in the eastern US and southeast Canada • Large deciduous tree growing up to 27m and living up to 200 years • Shaggy bark is found on mature trees and younger trees have smooth bark • Hickory pollen season extends from April to June but is weather dependant
Bermuda Grass: • Grown as lawn grasses in warm temperature regions such as the Sunbelt area of the US where they are valued for their drought tolerance compared to most other lawn grasses • In some cases it is considered to be a weed spreading through lawns and flower beds • All grass pollen is in season from February through November but are weather dependant
Lamb’s Quarters: • Fast growing weedy annual plant • Other names include: white goosefoot, pigweed or dungweed • Its native range is obscure due to extensive cultivation • Tends to grow upright at first reaching heights of 10-150cm but typically becomes recumbent after flowering • Allergies to Lamb’s Quarters are most common between March and June but are weather dependant
Rough Pigweed: • Summer annual about 1-3 feet tall that is either sparingly branched or unbranched • Central stem is stout, round and light green and more or less covered with white hairs • Habitats include dry areas of disturbed prairies, disturbed hill prairies, farm lots, gravelly roadside areas and waste areas • Allergies to rough pigweed are most common between June and September but are weather dependant
Mugwort Sage: • Aromatic plant that may be over three feet tall • Stems and leaves are usually white from the presence of fine hairs • Hundreds of tiny yellowish flower heads form on the upper branches • Fruits are tiny with no bristles • Thrives in cool moist soil • Allergies to mugwort sage are most common between July and September but are weather dependant
English Plantain: • Perennial plant consisting of a rosette of basal leaves and one or more flowering stalks • Blooming occurs intermittently from April to October and can last several months for a population of plants in a given locale • Typical growing conditions are partial to full sunlight in a dry soil • Prefers disturbed areas, lawns, cracks in pavement, vacant lots and roadsides • Allergies to English Plantain are most common between June and September but are weather dependant
Sheep Sorrel: • Common perennial weed with arrowhead-shaped leaves and red-tinted deeply ridged stems • In North America it is a common weed in fields, grasslands and woodlands • It favors moist soil and disturbed areas • Allergies to Sheep Sorrel are most common between June and September but are weather dependant
Cocklebur: • This is an erect much branched annual that grows up to three feet high • The leaves are shiny dark green and hairy on the upper surface and downy beneath • It can adapt to a variety of different climates and is widely distributed • May grow in cultivated fields, wastelands, farm yards, flood plains and along waterways • Allergies to Cocklebur can be active anytime between February and November but are weather dependant
MOLD SYMPTOMS CAN INCLUDE HEADACHES, TROUBLE SLEEPING, ITCHING, RASHES, FATIGUE, AND OTHER NEUROLOGICAL COMPLAINTS AND RESPIRATORY AND ASTHMATIC SYMPTOMS.
Rhizopus Stolonifer: • This mold has a cosmopolitan distribution capable of causing opportunistic infections in humans • It is commonly found growing on bread and soft fruits such as bananas and grapes • Its spores are common in the air
Penicillium Notatum: • A green bread mold that can also grow in areas such as an air conditioning system, moist areas, flooded areas where moisture has been sitting for an extended time, on shoes and furniture
Helminthosporium: • A widespread fungus that is most frequently associated with grasses, plant material, decaying food, and soil • Commonly found on celery and rooted vegetables • The fungus produces large spores, which are deposited in the upper respiratory tract • These spores can be dangerous to human health causing asthma and other respiratory problems
Hormodendrum Clodosporium: • A black mold, though not the “toxic black mold” • Commonly grows on insulation in air conditioning systems, on bathroom ceilings where there is not enough ventilation, sometimes on walls and wallpaper in rooms where insulation is lacking, on foundation walls, sub flooring, basements and crawlspaces
Mucor Racemosis: • Primarily a soil fungus but has been found elsewhere such as in horse manure, plant remains, grains, vegetables and nuts • Often seen on soft fruit, fruit juice and marmalade • Mucor is also the dominating mold found in floor dust in houses and is considered an indoor mold • It has a worldwide distribution, reported frequently all over Europe and in the Americas from Alaska to Brazil
Phoma Destructiva: • Also known as Phoma rot begins at the blossom end of fruit as sunken black spots with water-soaked edges and dark-centered rings, similar in appearance to buckeye rot
Fusarium Oxysporum: • Also referred to as Panama Disease or Agent Green • It is a fungus that causes disease in more than one hundred species of plants including many indoor plants
Aspergillus Fumigatus: • Very common indoor mold that can be found on basement ceilings, on air conditioning coils, at leak areas, lower parts of foundation walls, basement steps, leaky roofs and high humidity areas
Feathers: • Alleries are a reactions to feather dander or feather dust • Symptoms include allergic rhinitis, coughing and breathing difficulties • Feathers carry dust mites and mold, which cause allergic responses. Feather allergens are airborne
Cockroaches: • Allergen is believed to derive from waste, saliva and the bodies of these insects • The amount of roach allergen in house dust or air can be measured. In dwellings where the amount is high, exposure is high and the rate of hospitalization for asthma goes up • Allergen particles are large and settle rapidly on surfaces. They become airborne when the air is stirred by people moving around or by children at play • People with chronic severe bronchial asthma, chronic stuffy nose, skin rash, constant sinus infection, repeat ear infection and asthma are most likely to have cockroach allergy • People with cockroach allergies can also have reactions to some pre ground coffee and chocolate products