115 Technology Drive, Trumbull, Connecticut, 06611

36 Sanford Street, Fairfield, CT 06824

Telephone: 203-459-8712

Michael S. King, MD, FAAAAI, Diplomate of the American Board of Allergy and Immunology

 

Diagnostic Procedures
  Allergen Skin Testing is performed to detect sensitivity to environmental allergens, foods and drugs. The test detects the presence of specific IgE, which causes the symptoms of allergy. Testing is  performed on the arms in two steps. During the  first part of the test, a small amount of the potential allergen is applied to the skin in liquid form on the tips of a plastic applicator that  scratches the surface of the skin. If you are allergic to the substance, a red, raised, itchy hive will develop within fifteen minutes. If no reaction occurs, a more sensitive test is performed using a very small needle to inject a tiny amount of the substance onto the surface of the skin. An allergic reaction consists of a red, raised hive developing within fifteen minutes. Reactions are graded by size on a scale from zero to four. A four-plus reaction is about one and  three quarters inches in diameter. Doing the test in the sequence of scratch test followed by the intradermal test minimizes the risk of a generalized allergic reaction to the material being tested. Foods are only tested using scratch tests because of the high number of false positive results when they are placed under the skin, and the higher risk of severe allergic reactions. Allergy skin testing advantages include ease of performance, speed, accuracy and the large number of substances that can be screened. Using modern techniques, there is minimal discomfort from testing.

The following antihistamines can prevent your skin from reacting to an allergy skin test. If possible, please try to stop any of the following medications five days before your first appointment:

Allegra, Claritin, Xyzal, Clarinex, Zyrtec, Benadryl, Chlorpheniramine, Allerest, Advil Cold and Sinus, Atarax, Hydroxyzine, Seldane, Tavist, Balamine, Rynatan, Semprex, Tussi-12, Children's Tylenol Plus Allergy, Vicks 44, Tylenol Cold and Sinus, Nyquil.

Medications that will not interfere with testing include psuedoephedrine, Nasacort, Rhinocort, Flonase, Omnaris, Veramyst, Nasonex, Astepro and Astelin. Prednisone will not interfere with skin testing except at dosages over thirty milligrams daily. These may be safely continued.

Spirometry is used to measure volume and various rates of flow through the airways of the lungs. It is performed by forcefully blowing for as long as possible into a machine that can measure the rate of air flow and amount of air expired. The test is useful for  diagnosing asthma and differentiating asthma  from other chronic lung diseases. The hallmark of asthma is reversible airway obstruction. This means that air can easily enter the lungs, but becomes trapped in the airways during exhalation. The obstruction to airflow is caused by contraction or shortening of the muscles that surround the airways and by an increase in mucous within the lungs. When airway obstruction is found on spirometry, asthma can be diagnosed if  inhaling albuterol, a medication that dilates the airways, reverses the obstruction. Spirometry is also useful for determining if a chronic cough is related to asthma, and for diagnosing upper airway obstruction from vocal cord dysfunction. It can also be used to determine the strength of the respiratory muscles.

Patch Testing is used to determine if a substance in contact with the skin is responsible for  eczema. Because allergic skin rashes can appear a up to a week after exposure, it is difficult connect the cause of the rash to a particular exposure.. Once the rash is established, it can persist for months after contact has stopped. Patch testing is performed by applying a tape to the back that has ten plastic wells, each filled with a different substance. The patch must be kept clean and dry. It is removed after forty-eight hours. A small patch of eczema develops under the well if you are allergic to the substance. Since reactions can take up to one week, the skin is examined again at seven days. It is important to bring all personal care products so that they may be individually patch tested. If an allergen is identified,  a customized plan for avoiding the offending allergens will be devised by you and Dr. King

Endoscopy of the nose, throat and larynx or voice box is a simple office procedure that can be performed in about fifteen minutes. The endoscope gives unrivaled views of the nose, sinus openings, Eustachian tubes, adenoids and larynx. It is useful for finding the cause of chronic nasal congestion, recurrent ear infections, post-nasal drip, hoarseness, chronic cough and other maladies. Endoscopy can be accomplished without numbing medications, sedation or anesthesia. The procedure is performed by first spraying the nose with a decongestant spray to open up the nasal passages. It is important to keep the mouth closed and breathe through the nose to further open the nasal passages.   A Three millimeter flexible fiberoptic scope  is then gently passed into the expanded nasal cavity with virtually no discomfort or gagging. No removal of tissue occurs during this procedure.