For future, or potential future patients of the Asthma and Allergy Center of Whatcom County who have any questions about what an evaluation entails, please do not hesitate to contact our office for information.
Allergy skin testing is helpful in confirming allergy and directing care, but is not required in order to be evaluated and treated by an allergist.
A new patient evaluation may take up to 2 to 3 hours, if skin testing is desired. After filling out important basic information about you or your child, a nurse will escort you to an exam room and obtain some basic information about your medical concerns you would like us to evaluate. Vital signs will be obtained, and if indicated, pulmonary function tests will be performed. Then, Dr. Anderson will meet you, and begin his evaluation. This starts with a thorough review of your medical concerns as well as your general health status and history. If your problem has been a significant puzzle for your primary care provider and other physicians, many very specific questions may be asked of you about the problem to help assist you and your health providers. An examination is then performed, concentrating on the upper and lower airway, and if indicated, the skin. Then skin testing may be performed, if indicated.
For older children, adolescents and adults, percutaneous skin testing is initially performed on the back, usually. It may also be performed on the arm. This consists of dipping a plastic stick like device with a few sharp points into allergenic extract, and then pricking the skin. This introduces a very small quantity of allergen into the skin. If one is allergic, ( has allergic antibody to the substance or allergen) then within 20 minutes, often within a few minutes, a hive or itchy spot will appear at the site. It will not last long, resolving over about an hour or two. If there are negative reactions to some allergens, such as dust mites, mold or animal dander, then an intradermal test may be performed. In this test, a very small needle is used to place a drop of more dilute allergen just under the skin on the forearm. This is a more sensitive test to detect allergy, if there is a negative test by the percutaneous evaluation.
For younger children, down to about 12 months of age (1 to 7-8 year old children), we perform another type of skin test where we evaluate a number of different allergens all together using a device called a Multi-Test instrument. After 6 allergens and the two controls are dropped onto the small wells of this device, it is pushed gently onto the back of the infant or young child and lifted off. It is very well tolerated by young children and infants, as we are able to "bypass" the scratch or prick skin tests used for evaluating older patients.
Skin testing is the most accurate and efficient evaluation to determine if one has allergic antibody (IgE) to a potential allergen including aeroallergens such as pollens, dust mites, animal dander, mold, or food allergens such as peanut, milk, egg, wheat, soy, fish, shellfish, tree nuts or other foods, and to bee venom and some antibiotics such as penicillin. See the page Allergic Disorders to learn more about IgE antibody.
After a thorough history and exam, and selected evaluations, a diagnostic impression will be provided along with a treatment plan. A diagnosis cannot be confirmed unless there is a definite positive response to therapy, as expected, based on an individualized evaluation, diagnostic impression and treatment. If therapy provided does not lead to desired results, then it is expected that further evaluation will be considered, along with an adjustment in the treatment plan.
"Improving the quality of life of children and adults through the art and science
of asthma and allergy care"
Asthma & Allergy Center of Whatcom County