Allergy Diagnosis

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Allergy

Congestion. Pain and pressure in the sinuses and teeth. Runny nose. Coughing and sneezing. Sore throat. Let's put a hold on Spring!
This time of year is a common time for sinusitis, which simply means inflammation of the sinuses. Let's take a look at the causes of these bothersome symptoms:

Pain and Pressure :

The inflammation causes mucus to build up in the sinus cavities behind the cheeks and forehead, causing pain and pressure in the face and head.

Sneezing

When some of the mucus runs down the nose, it triggers sneezing.

Coughing

When mucus drips down the back of the throat into the lungs and upper airway, it causes the coughing.

Sore Throat

The sore throat is due to post-nasal drip. The mucus tends to accumulate in the back of the throat while we're sleeping overnight, so the sore throat is often worse first thing in the morning. Patients often ask for or expect to be prescribed antibiotics for sinusitis. However, the most common cause is allergy, not infection, so antibiotics are often not the best choice. Allergy symptoms can occur year-round (perennial) or just during the times when certain triggers are present in the environment (seasonal). The timing, frequency, duration and severity of allergic sinusitis vary from one person to the next, and can change over time. Allergies are immune reactions to something in the environment. For allergic sinusitis, it is typically something in the air. Pollens (from grasses, trees and other plants), animal dander, and molds are some of the more common allergic triggers, but there are hundreds of possible causes.
Allergy can develop at any time in life - with the very first exposure, after thousands of exposures, or any time in between. So even if you've never been diagnosed with allergy before, it is always something to consider if you have sinusitis.

Diagnosis

For assessing the presence of allergen-specific IgE antibodies, allergy skin testing is preferred over blood allergy tests because it is more sensitive and specific, simpler to use, and less expensive. Skin testing is also known as "puncture testing" and "prick testing" due to the series of tiny puncture or pricks made into the patient's skin. Small amounts of suspected allergens and/or their extracts (pollen, grass, mite proteins, peanut extract, etc.) are introduced to sites on the skin marked with pen or dye (the ink/dye should be carefully selected, lest it cause an allergic response itself). A small plastic or metal device is used to puncture or prick the skin. Sometimes, the allergens are injected "intradermally" into the patient's skin, with a needle and syringe. Common areas for testing include the inside forearm and the back. If the patient is allergic to the substance, then a visible inflammatory reaction will usually occur within 30 minutes. This response will range from slight reddening of the skin to a full-blown hive (called "wheal and flare") in more sensitive patients. Interpretation of the results of the skin prick test is normally done by allergists on a scale of severity, with +/- meaning borderline reactivity, and 4+ being a large reaction. Increasingly, allergists are measuring and recording the diameter of the wheal and flare reaction. Interpretation by well-trained allergists is often guided by relevant literature.Some patients may believe they have determined their own allergic sensitivity from observation, but a skin test has been shown to be much better than patient observation to detect allergy. If a serious life threatening anaphylactic reaction has brought a patient in for evaluation, some allergists will prefer an initial blood test prior to performing the skin prick test. Skin tests may not be an option if the patient has widespread skin disease or has taken antihistamines sometime the last several days.

Diseases :