Primary Immune Deficiency

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Asthma is a chronic, inflammatory lung disease characterized by recurrent breathing problems. People with asthma have acute episodes or when the air passages in their lungs get narrower, and breathing becomes more difficult. Sometimes episodes of asthma are triggered by allergens, although infection, exercise, cold air and other factors are also important triggers.

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Spirometry is type of pulmonary function test (PFT) that captures a “snapshot” of a patient’s lung volumes and can help determine whether he or she has asthma. The test consists of the patient forcefully exhaling into a  tube connected to a computer with the PFT software.

Biologic Injections are a specialized treatment option for severe allergic asthmatics who remain symptomatic despite high doses of inhaled or oral steroids.  The physician will determine whether a patient is a candidate for Xolair, Fasenra, Nucala, Dupixent or Cinqiar through lab tests, skin testing, and spirometry.

Rhinitis is an inflammation of the mucous membrane that lines the nose, often due to an allergy to pollen, dust or other airborne substances. Seasonal allergic rhinitis also is known as “hay fever,” a disorder which causes sneezing, itching, a runny nose and nasal congestion.

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Skin Prick and Intradermal Testing
Commonly referred to as “allergy skin testing,” this diagnostic test evaluates for the presence of allergy to common indoor and outdoor allergens such as dust mites, cat/dog dander, mold spores, tree, grass, and weed pollen.  The skin prick test is performed on the patient’s back and consists of gently scratching the surface of the skin with toothpick-like plastic applicators containing small amounts of the allergen.  For those patients who do not react to this type of skin test, intradermal testing may be performed; this procedure consists of injecting a small amount of the allergen underneath the skin.

Allergen Immunotherapy (“Allergy Shots”)

Immunotherapy (“allergy shots”) is a form of preventive and anti-inflammatory treatment of allergy to substances such as pollens, house dust mites, fungi, and stinging insect venom. Immunotherapy involves giving gradually increasing doses of the substance, or allergen, to which the person is allergic. The incremental increases of the allergen cause the immune system to become less sensitive to the substance, perhaps by causing production of a particular “blocking” antibody, which reduces the symptoms of allergy when the substances is encountered in the future. Typically, a complete desensitization takes 3-5 years and involves initial weekly injections building up to stronger monthly injections

Cluster Allergen Immunotherapy

This treatment option is based on the same principle as traditional allergen immunotherapy, but involves a significantly shorter period for the initial weekly injections.  Therefore patients can reach the stronger monthly injections sooner, which allows them to feel relief sooner.

 Eczema refers to an  inflammation of the skin, usually causing itching and sometimes accompanied by crusting, scaling or blisters. A type of eczema often made worse by allergen exposure is termed “atopic dermatitis”.

Urticaria is a skin condition, common known as hives, characterized by the development of itchy, raised white lumps surrounded by an area of red inflammation.

Contact dermatitis is an inflammation of the skin or a rash caused by contact with various substances of a chemical, animal or vegetable nature. The reaction may be an immunologic response or a direct toxic effect of the substance. Among the more common causes of a contact dermatitis reaction are detergents left on washed clothes, nickel (in watch straps, bracelets and necklaces, and the fastenings on underclothes), chemicals in rubber gloves and condoms, certain cosmetics, plants such as poison ivy, and topical medications.

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Skin prick testing can be used to determine whether the cause of a specific skin reaction are due to immediate-type hypersensitivity from common food or environmental allergens.

Patch testing typically evaluates delayed-type hypersensitivity and whether a reaction on the skin is due to a contact allergy from a metal, cosmetic, fabric etc or whether it is simply due to an irritant effect.

Adverse reactions to food can have a wide spectrum of symptoms among patients.  Therefore, a thorough history is imperative to determining what type of testing and treatment options are appropriate.

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Skin prick testing or ImmunoCAP (blood test) can be used to determine the presence of a food allergen.

Oral food challenges are a type of procedure that involves gradually introducing portions of food to a patient who has not previously tolerated the food, but diagnostic evaluations suggest that it may be safe to re-introduce in the diet.

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Penicillin testing

Unfortunately, several patients avoid penicillin for years due to history of an adverse reaction –which many times they cannot even recall.  Penicillin testing can reliably diagnose immediate type hypersensitivity to penicillin and its various components. It involves a series of skin prick tests and intradermal tests, followed by an oral challenge of Amoxacillin, observed in the office.

Local anesthetic testing

For patients who have experienced adverse reactions to local anesthetics during a medical or dental procedure, it is now possible to attempt to identify which anesthetic was the most likely culprit via skin and intradermal testing.

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Venom skin testing

This procedure is offered to patients who have reported a serious, near-fatal reaction to a stinging insect such as  honeybees, yellow jackets, wasps, and hornets. It involves a series of skin prick tests and intradermal tests with small amounts of the insect venom.

Venom Immunotherapy (VIT)

This treatment option is offered to patients who are positive on their venom skin testing and require desensitization to reduce a patient’s risk of a severe systemic reaction on a future sting. A complete densensitization takes 3-5 years.