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• Eczema / Atopic Dermatitis - Adult
• Eczema / Atopic Dermatitis - Pediatric
• Urticaria

• Between 6 and 7 million Americans, or 2 to 2 1/2 percent of the general population, suffer from food allergy.
• 1.1 percent of the population or close to 3 million Americans are believed to be allergic to peanuts or tree nuts (pecans, walnuts, almonds, etc.). Peanuts are the leading cause of severe allergic reactions, followed by shellfish, fish, tree nuts, and eggs.
• Eight foods account for 90 percent of the allergic reactions: peanuts, tree nuts (walnuts, pecans, etc.), fish, shellfish, eggs, milk, soy, and wheat.
• Food allergy is the leading cause of anaphylaxis outside the hospital setting, accounting for an estimated 30,000 ER visits.
• It is estimated that as many as 100 to 200 people die each year from food allergic reactions, approximately 50 people die from insect sting reactions.

1. What happens in the body during a food-allergic reaction?  The immune system mistakenly believes that a harmless substance, in this case a food item, is harmful. In its attempt to protect the body, it creates specific IgE antibodies to that food. The next time the individual eats that food, the immune system releases massive amounts of chemicals and histamines in order to protect the body. These chemicals trigger a cascade of allergic symptoms that can affect the respiratory system, gastrointestinal tract, skin, or cardiovascular system.

2. What are the common symptoms of a reaction?  Symptoms range from mild to severe. The severe or life threatening reactions are called anaphylaxis. Symptoms can include tingling sensation in the mouth, swelling of the tongue and the throat, difficulty breathing, hives, vomiting, abdominal cramps, diarrhea, drop in blood pressure, and loss of consciousness. In rare cases, death occurs. Symptoms typically appear within minutes to two hours after the person has eaten the food to which he or she is allergic.

3. What is the best treatment for food allergy?  Strict avoidance of the allergy-causing food is the only way to avoid a reaction. Reading ingredient labels for all foods is the key to maintaining control over the allergy. If a product doesn't have a label, allergic individuals should not eat that food. If the label contains unfamiliar terms, shoppers must call the manufacturer and ask for a definition or avoid eating that food.

For more information about food allergy & anaphylaxis, visit The Food Allergy Network

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Allergic Dermatitis & Rash

 According to the American College of Dermatology, allergic contact dermatitis occurs from your body's reaction to something that directly contacts the skin. Many substances can cause allergic contact dermatitis. The substances are called 'allergens'. Usually the substances do not cause trouble for most people, and may not even be noticed the first time the person is exposed however, once the skin becomes sensitive or allergic to the substance, any exposure will produce a rash. The rash usually doesn't start until a day or two later, but can start almost immediately or take as long as a week to become obvious.

Allergic contact dermatitis is not usually caused by things like acid, alkali, solvent, strong soap or detergent. These harsh compounds, which can produce a reaction on anyone's skin, are known as 'irritants'. Although some chemicals are both irritants and allergens, allergic contact dermatitis results from brief contact with substances that don't usually provoke a reaction in most people.

The dermatitis usually shows redness, swelling and water blisters, from tiny to large. The blisters may break, forming crusts and scales. Untreated, the skin may darken and become leathery and cracked. Allergic contact dermatitis can be difficult to distinguish from other rashes, especially after it been present for a while. Patch testing is usually the first step in identifying the allergen, although biopsy is sometimes required.

For more information about contact dermatitis, please visit The American Academy of Dermatology.

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Skin Testing for Allergy

The prick method is the most common type of skin test. The back is the best location for this type of testing as the surface area is large and easily visible. This method is safe and causes little discomfort. Many allergens can be tested at the same time and the standard set consists of 110 allergens.

1. The back is cleaned with alcohol and the base marks are applied with a marker pen.
2. A drop of allergen extract is placed on the skin with a small plastic prick.
3. If the patient has IgE antibodies to the allergen, a hive will appear at the site within about 15 minutes. The test is recorded, the back cleansed and a mild steroid cream applied for itching.

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Patch Testing for Allergy

Patch skin testing may be used to find out if a rash is from direct contact with an allergen such as metals, dyes and chemicals. Small amounts of allergens are placed on the skin, usually on the back. The skin is covered with a watertight bandage for several days. The patch test is viewed (read) at intervals during the test period where the patch is removed and the skin reactions are measured to find out if you may have a contact allergy.

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Intradermal Testing for Allergy

Another form of skin testing for allergy is by intradermal skin testing. It is most often used when prick skin testing is negative and there is a strong suspicion of allergy from the history. A small amount of each allergen is placed under the skin with a needle, usually on the upper arm. If you are allergic to an allergen, you will get a bump and redness where the needle has gone under the skin. After about 10 minutes, each skin test reaction is measured for swelling and redness. If there is a large enough skin reaction, it means that you may be allergic to the allergen placed at that site. The information from these test results and your history of symptoms will help your doctor to determine if you have an allergy.

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Immune Therapy

Often referred to as "Allergy Shots", immune therapy has been available in some form for more than 80 years. They have been proven to work well with certain allergens, but they are not a magic potion for every patient.

Immunotherapy is successful in most rhinitis patients with seasonal allergies. Recent studies have shown at least a 50% reduction in asthma developing in children who are receiving allergy desensitization early on in their course of allergic rhinitis. Each person's case is so different that decisions about undergoing therapy must be made in consultation with an expert, usually a board certified allergist. Some factors to consider are the severity of the asthma, the amount of medication required for control, and the types and exposures of the allergens involved.

Immunotherapy works like a vaccination. The theory is that as you are exposed to small, injected amounts of a particular substance to which you are allergic, you will gradually gain immunity to it. Treatment begins with injections of very small, diluted doses of the allergen once or twice a week.  Gradually, the injections are spread out to once a month. You get slightly higher doses until you reach the maximum dose you can tolerate, called the maintenance level. Most immunotherapy treatments continue at this maintenance level for three to five years. Successful treatment will result in prolonged benefit of varying duration. Allergen immunotherapy should always be administered under the direction of an allergist and always in a medical office. Life threatening reactions are very rare, but can occur. Immunotherapy is strongly recommended for people with sever allergies to insect stings. People with other moderate to severe allergies might also be candidates, as well as those who do not respond to allergy medications and those who are allergic to substances that are hard to avoid, like trees, grasses, and pets.

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