Our Services

We are a group of Allergy/Immunology specialists who treat disorders of the immune system. We concentrate on allergy, where the body overreacts to a usually harmless substance. We also deal with immune deficiency, where the body is unable to properly fight off infections, resulting in more frequent and more severe infections. Examples of these disorders or symptoms are:

• Allergic Rhinitis (“Hay fever”)                  • Asthma
• Sinusitis                                                     • Food Allergy
• Urticaria (Hives, welts)                            • Atopic Dermatitis (Eczema)
• Chronic Cough                                         • Anaphylaxis
• Drug Allergy                                               • Recurrent infections
• Insect Allergy                                             • Contact Dermatitis

We perform a special variety of diagnostic tests and treatments to deal with allergic disorders.

Skin Testing for Allergies

Skin testing is the most reliable form of allergy testing. Because histamine-containing cells are located in high numbers just under the skin, results of skin testing have proven to be more accurate than blood testing in diagnosing allergies. Because we are looking for histamine in the skin, we ask you to stop all antihistamine-type medications for a few days prior to your visit. You will find a list of these medications here.

Skin testing is ideal for diagnosing allergies to airborne allergens that can lead to allergic rhinitis and asthma, and can be helpful in diagnosing most types of food allergy. Skin testing is also commonly used to diagnose insect allergy and occasionally drug allergy (see below).

The allergen extracts used to diagnose respiratory allergens include dust mite, animal dander, molds, cockroach and pollen (trees, grasses, and weeds). The battery of food extracts we use include the common (milk, egg, wheat, soy, wheat, peanuts, tree nuts, fish, shellfish) and not-so-common causes of food-related allergic conditions. In the case of insects, we mostly use venom extracts.

The Skin Test Procedure

The surface of your skin is injected or "scratched" with tiny amounts of a number of specific allergens. If the results are positive, a small reaction on the skin occurs, usually within 20 minutes. This reaction usually causes some itchiness and is very similar to a mosquito bite. This indicates that you are very allergic to that specific trigger. If no bump appears, we may do a follow up test to that specific allergen with another small injection of extract. Depending on the results of your skin test, your allergist will determine the best way to treat your allergy symptoms.

Allergen Immunotherapy (“Allergy Shots”)

Allergen Immunotherapy is a treatment program designed to reduce allergic sensitivity to environmental substances (allergens like dust mite, mold, animal dander and pollens). Extracts of these substances are injected over a period of time. These extract mixtures are basically vaccines that teach your immune system to ignore these normally harmless substances. They do not contain any drugs. They are just a combination of proteins that make up the allergens and are safe for children and adults. Please see our Frequently Asked Questions (FAQ’s) about Allergen Immunotherapy here.

There have been reports in the news about sublingual immunotherapy. We currently do not offer this treatment since it is not approved for use in the United States. Studies from Europe have generally shown them to be not as effective as standard allergy shots.

Pulmonary Function Testing

We use state-of-the-art spirometry equipment to test lung function. These tests are performed when a patient has difficulty breathing or is chronically coughing. By determining the amount (volume) and/or speed (flow) of air that can be exhaled, we can measure bronchial obstruction. It is used to diagnose asthma or determine the severity of the disease.

To perform the test, the patient is asked to take the deepest breath they can, and then exhale into the device as hard as possible, for as long as possible. Then the patient is asked to rapidly inhale, in particular when assessing possible upper airway obstruction. Then the test is repeated after a bronchodilator treatment to determine if there is an improvement typically seen in asthma.

Food Testing

We have excellent skin testing materials for food allergy. They have proven to be a more sensitive type of test than blood allergy tests (RAST’s). With skin tests, we are looking for the allergic protein IgE that is specific to a certain food. IgE is responsible for the most serious type of food allergy that lead to hive or welts (urticaria), swelling (angioedema), and anaphylaxis – the most severe form of food allergy reactions. If a food allergy exists, we teach the patient and their caregivers how to avoid these foods and how to prepare for accidental ingestion.

If there is a questionable food allergy, we may have the patient carefully eat small amounts of the food under close supervision to determine if they are truly allergic. In this way, we are often able to free the patient from the fear, stigma and hassle of being labeled as allergic to a food. The patients are then able to expand their diet and enjoy life a bit more. See our detailed article about food allergy here.

Allergen Avoidance Counseling

As Allergy/Immunology specialists, we are the medical experts when it comes to helping our patients avoid things which cause their allergic symptoms. While there is a huge amount of information on this site and elsewhere on this subject, each person’s home, school, or workplace presents special challenges. We will provide each patient with specific advice for their special situation.

Drug Testing and Challenges

For drug allergies, we are generally able to work these out by taking a long, detailed history of reactions. When true drug allergies exist, we are almost always able to give the patient and their doctor guidance on what medications can be used safely. We do skin testing for some drug allergies (e.g. local anesthetics like lidocaine), but there are a limited amount of drugs for which there are effective and safe testing materials. In some cases, we are able to do a very careful challenge with a drug (giving the patient tiny amounts by mouth) to determine sensitivity.

Patch Testing for Contact Dermatitis

We offer the most accurate and extensive methods of testing for substances that touch the skin and cause dermatitis (a poison-ivy type of rash). Examples of these substances would be metals like nickel, perfumes, hair dye ingredients, and antibiotic ointments. In addition to treating the rash with appropriate medications, we give the patient extensive information on how to avoid these allergic triggers.

Insect Allergy Testing and Immunotherapy

We also have excellent skin testing methods for insect allergies (e.g. bees, yellow jackets, and fire ants). If a patient is allergic, we teach them how to avoid being stung and how to prepare for stings at the park, for instance. For those who are very allergic, we often suggest insect venom allergy shots. Venom immunotherapy is almost 100% effective in preventing serious reactions to insect stings. See our article on allergic reactions to insect stings here.