Gentowa

How does the skin test reaction look like?

The applied allergens are bound on the antibodies molecules IgE - on the outside part of the mastocytes and through the transfer of the signal their degranulation and the allergic reaction mediators release occur. These initiate the reaction through the affect on the surrounding blood vessels, the symptoms of which are the flush, the itch and the swelling with the diameter of several millimetres in the place of the injection. On the reaction, which starts approximately after 5 minutes from the allergen application, takes part also the so called substance P, which is released from the sensitive nerve ending, after the histamine stimulation. The reaction culminates in the period of 15-20 minutes, when the doctor subtracts it, after this time the reaction decreases.

The skin test realisation is not painful for the patient. On the palm side of the forearm the drops of the examining allergens are applied. In every drop a gentle puncture with the plastic or metal tool with the small sharp top is made. The skin is punctured only on the top skin layer so that the place does not have to bleed at all. After 20 minutes the reaction is judged. Places, which are either red or swollen in the same way as after applying the histamine, indicate that the reaction is positive. The patient can react to one or ore allergens. Beside the reaction when the small papule with the diameter of several millimetres appear, which is the most common reaction, the more extensive local reaction – of several centimetres, in rare cases even the swelling of the hand come about. These reactions cease to occur spontaneously after several hours.

In addition to the immediate reaction the patient can react in the so called later phase, when the papules appear after several hours. The patient deducts and informs the doctor of the reaction by himself/herself. The skin tests represent the allergist diagnosis basis. Together with the detailed taken anamnesis they are sufficient for the majority of the patients sensitive to common inhalation allergens for the typical symptoms of the diagnosis. Their role in the diagnosis is hence important, which relates to the fact that their preparation and realisation should be paid attention to.

The skin tests can be characterised as indirect provoking tests. They are called indirect, since their positives and negatives prove the sensitization of the human body. The presence of the specific IgE antibodies to applied allergen is proved on the skin without giving the information on the reactivity of the particular target organ (unless the target organ is the skin itself). Standard prick tests are used. They are made by the pharmaceutical companies, which prepare them according to the strict formulas. The content of all solutions with the allergens is diluted exactly together with the known analysed components of the particular chemical. The food allergens to the prick tests are chosen similar according to the patients. In the basic scale the eggs, nuts, milk and hesperidium should not be omitted. As far as the patient has not only a food allergy, but also the inhalational allergy, we add the cross reacting foodstuffs (birch-apple, Artemisia-celery, mites-crabs, latex-banana, etc.).

The professional airways allergic illnesses have increasing tendency. The allergens are represented by the whole range of various factors of both, the vegetable and animal origin, but also by the chemical agents. Besides the pharmacotherapy, which does not differ from the common recommended procedures, the fundamental step is the immediate transfer of the patient from the exposition of the cause, which is necessary to be defined. To the testing process the chemicals, which are not tested with the traditional patients, are added, as well.

The contact allergy diagnosis skin tests are made by putting the analysed chemical on the skin. More information is provided in the chapter about the contact allergy.

● Instead of feather pillows and duvets, it is required to use those plastic ones withplastic covers, as well, which do not cause allergic reaction

● Frequent changing and washing of clothes is necessary. Animal allergens often settlein there and can cause irritations even outside the place, where the animal is

.● It is necessary to wipe the floor and the furniture with a damp cloth. For vacuumcleaning only the vacuum cleaner with HEPA (high efficiency particulate arresting)filter is suitable.

The one being allergic should not come into the contact with vacuumcleaning. If he/she has to clean with the vacuum cleaner, he should use the maskprotecting himself from the dust. The air disposal plant is appropriate; it is able tofilter almost all flying dust, though it does not remove all allergens.We have to be aware of the important fact that: although all these activities reduce theamountof allergens in the family surroundings, they can not be substituted for the removal of theanimal. Even the removal itself without a special cleaning of the house means that you willlive in the environment surrounded by clinical important amount of allergens.All mentioned allergens can be, of course, found in dust. The dust by itself is formed by smallgrains of inorganic material - silica, together with other inorganic and organic matters andmentioned organic matters.

The home dust of particular households or working places varies according to the way a houseor working place is furnished.Therefore the diagnosis is made with individual allergens. The term “allergic to dust” does notindicate our actual reactions, therefore has been ceased to be used.The life of allergic people is getting worse even by other harmful substances, which donot start the actual allergic process, but get worse its development.

Pollen information service

The most frequent factor, which causes and starts the allergic reaction, is pollen. Thepollen count in the air directly influences the clinical symptoms, whereas there is a directrelationship between the amounts of pollen in the air and the seriousness of the symptoms. The seasons, when the flowers are in bloom and hence the pollen count is higher, can bepredicted approximately according to the usual duration of blooming time of the particularflower, which is stated in all botanic guidelines.However, the pollen calendars do not always correspond to the real time a flower is in bloom.The real bloom period can differ from the assumption even in several weeks. Moreover thelevel of the air pollen is noticeably influenced by meteorological conditions (rain, wind, coldheat,etc).

The up-to-date information about the situation i.e. what is the amount of pollen grainsand what kind of pollen grains are in the air, are necessary for the doctor and the patient, aswell.Within the information as a part of diagnosis the important anamnestic information –worsening or bettering of the patient’s health within a particular period, follows.Even more important is this information for the planning and conduction of the medicaltreatment.

While the air contains “our” particular allergen in the sufficient amount, the clinicalsymptoms arise.This can be prevented by taking the medicine on time. Its advantage lies in the fact, that in“our” season we can adjust our daily schedule (less walks, travelling to clinically betterenvironment and so on).The pollen count started to be examined already in 1873 by the English doctorBlackeley.

He suffered the allergy himself, and hence was interested in the possibleconnection between the amount of pollen in the air and the clinical seriousness of the allergy.He placed in different levels small glasses covered by glue, which caught the pollen.The need of exact information let to the gradual establishment of pollen stations,which measure the amount of pollen and other substances in the air. In 1930s first stationswere founded in Canada and USA.