The allergy/immunology specialist will work with you to make the correct diagnosis and after that to find the right medic action and to answer any concern about side effects. As well to develop a personalized asthma action plan.
Most people will need two kinds of medications:
- Quick relief: A) Short acting beta agonists (Albuterol) and B) anticholinergics (phlegm). Both of them open your windpipes, allowing more air in and out. Taken on as needed basis.
- Long term controller. Help to control the inflammation that causes the difficulty for breathing. These are to be taken on daily basis.
Atopic dermatitis (also known as, Eczema*) is a chronic or recurrent inflammatory skin disease. The word “atopic” means that there is typically a genetic tendency toward allergic disease. Atopic dermatitis usually begins in the first few years of life and is often the initial indication that a child may later develop asthma and/or allergic rhinitis (hay fever). In infants, eczema usually appears as tiny bumps on the cheeks. Older children and adults often experience rashes on the knees or elbows (often in the folds of the joints), on the backs of hands or on the scalp.
Symptoms of atopic dermatitis include:
* Patches of skin that are red or brownish
* Itchy skin, especially at night
* Dry cracked or scaly skin
Contact dermatitis is a disorder caused by contact with an external substance that triggers an allergic response. The history taken by the allergy/immunology specialist is important for the diagnosis and management of the disease. Common triggers include: sunscreen; Fragrant soaps; Shaving lotions; Rubber; Certain deodorants and perfumes; Bleach; Hand sanitizers; home fragrance diffusers, preservatives and emulsifiers, hair dye, shampoos.
A special test called patch test is indicated in any patient with acute or chronic dermatitis. Patients are typically asked to wear the patch for 48 hours, keeping it dry for that period. The allergist will then ask to return twice to check on the reaction. The patch test conducted by an allergist will determine what caused the reaction so that the allergen or irritant can be avoided in the future. The patient will receive a list of what they are allergic and also a list of products that they can use.
Cough is usually described as chronic if it is present for eight weeks or more. The most common causes of chronic cough are postnasal drainage, asthma and gastro esophageal reflux disease (GERD), or heartburn. Any or all of these may be the cause of chronic cough, in addition to a number of other less common causes. An allergist can help diagnose the cause(s) of your chronic cough.
Allergists have particular expertise in allergic rhinitis (or hay fever) and sinus infections, which may contribute to postnasal drainage, a common cause of chronic cough. Allergists are also experts at diagnosing and treating asthma, which may be present in 25% of patients with chronic cough. Cough from asthma may be associated with wheeze, shortness of breath or chest tightness and may be worsened by colds, exercise, smoke exposure and laughter, among other things. When to see an allergist*:
* If you have a cough that lasts more than eight weeks.
* If your cough is associated with symptoms of asthma.
* If your cough is associated with nasal symptoms or tobacco use.
* If your cough is severe and affecting your quality of life.
Contact Dermatitis refers to an inflammation of the skin resulting from direct contact of a substance with the surface of the skin. Unlike atopic dermatitis*, there is not necessarily a pre-disposition to allergic disease.
Symptoms of Contact Dermatitis include:
* Red rash, bumps or a burn-like rash on the skin
* Itchy, painful or burning skin
* Blisters and draining fluid
There are two types of contact dermatitis:
* Irritant Contact Dermatitis is the most common form and is caused when substances such as solvents or other chemicals irritate the skin. The exposure produces red, often more painful than itchy, patches on the involved skin areas.
* Allergic Contact Dermatitis occurs when a substance triggers an immune response. Nickel, perfumes, dyes, rubber (latex) products, topical medications and cosmetics frequently cause allergic contact dermatitis.
People with drug allergy may experience diverse symptoms with a spectrum from rashes, itching, breathing difficulties, swelling to a severe life threatening reaction called anaphylaxis.
Common drug allergies include:
- Penicillin and related antibiotics
- Antibiotics containing sulfonamides (Sulfa Drugs)
- Anticonvulsants
- Aspirin, and non-steroidal anti-inflammatory drugs (Nsaids)
- Chemotherapy drugs
- Biological: Monoclonal antibodies
If you have eczema (atopic dermatitis*), taking care of your skin is important for maintenance and treatment of the condition. Eczema is an allergic skin reaction resulting in a red, scaly, itchy rash. The rash often appears on the face, elbows, knees, hands or scalp. Triggers include allergens, overheating or sweating, emotional stress, food and contact with wool, pets or soaps.
If you have eczema, avoid drying soaps or harsh detergents. The average pH level (acidity or alkaline) of soap is 9 to 10. The skin’s normal pH level is 4 to 5. Because of this difference, soap increases the skin’s pH to an undesirable level and can worsen eczema symptoms. It is best to use a non-soap cleanser because they are usually free of sodium lauryl sulfate. This chemical creates soap’s foaming action and can irritate skin.
Examples of non-soap cleansers:
- Dove® Sensitive Skin Unscented Beauty Bar
- Aquaphor® Gentle Wash
- AVEENO® Advanced Care Wash
- Basis® Sensitive Skin Bar
- CeraVe™ Hydrating Cleanser
- Cetaphil® Gentle Cleansing Bar
Other Eczema tips:
- When bathing or showering, avoid using anything that will scrape the skin, such as a washcloth, sponge, or loofah.
- Do not use bubble bath.
- Pat skin dry rather than rub.
Moisturize immediately after bathing/showering to seal in moisture.
Epinephrine is an injection-based medication used to treat life-threatening allergic reactions called anaphylaxis* (an-a-fi-LAK-sis). These very serious reactions are most commonly caused by foods, drugs and stinging insects. People with severe allergy or a history of anaphylaxis should carry (2) auto injectable epinephrine with them at all times. Epinephrine typically comes as a single-dose pre-filled automatic injection device to be injected into the thigh. In some very severe cases, patients may require a second dose of epinephrine after a few minutes to stop the anaphylactic shock and avoid death. After you use the automatic injection device, go the closest emergency room immediately. Later, check back with your allergist.
Food allergy is an adverse reaction caused by an abdominal response of the immune system to food allergens. Behaving like recognizing an invader and sending out chemicals to defend against it.
A specialist in allergy and immunology would take a comprehensive clinical history (such as; reaction to the culprit food, diet history, etc.) to guide the selection and tests to perform and interpret the results. The ultimate goal of the allergy test result is to determine the probability of clinical relevant allergy.
Eight types of food can cause 90% of all reactions: egg, milk, peanuts, tree nuts, fish, shellfish, wheat, soy.
Skin prick test provide results in 20 minutes.
Serum testing allows evaluation of patients who cannot stop the routine antihistamines therapy prior to testing. Serum specific IGE techniques are less efficient (results available in about a week) and are more expensive than skin testing.
Once the food allergy is diagnosed the most effective treatment is to avoid the food. Once you have been diagnosed with food allergy, your allergist/immunologist should prescribe an epinephrine auto-injector.
Oral food challenge is the most accurate test to diagnose food allergy. But requires expensive resources, highly trained personnel, and carries the risk of causing an acute allergic reaction.
A food intolerance, or a food sensitivity occurs when a person has difficulty digesting a particular food. This can lead to symptoms such as intestinal gas, abdominal pain or diarrhea. A food intolerance is sometimes confused with or mislabeled as a food allergy*. Food intolerances involve the digestive system. Food allergies involve the immune system. With a food allergy, even a microscopic amount of the food has the potential to lead to a serious or life-threatening reaction called anaphylaxis.
