SPT helps to determine whether a person is sensitive to various allergens, such as food, drugs and aeroallergens. Your doctor might recommend SPT as an investigation to look for the potential allergen that causes conditions such as asthma, rhino-conjunctivitis, food or drug allergy, and latex allergy. A drop of the allergen is applied on your skin, and a tiny prick is made through the drop into your skin using a sterile metallic or plastic lancet. If you are allergic to any of the substances, itchy red bumps usually show up within 15 to 20 minutes. The bumps go away in a few hours.
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Skin Patch test is a test for diagnosis of allergic contact dermatitis and find out the possible allergens that may be the cause(s) of the skin rash. Doctor will apply a plaster that contains up to 60 different allergens on the back. Patient may experience allergic reaction such as redness, swelling or blisters on the skin if allergic to one or more type(s) of allergen.
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Serum specific-IgE is useful to support the diagnosis of an immediate-type allergic reactions, such as food, aeroallergen, latex and venoms. In special circumstances, severe allergic reactions (anaphylaxis) due to medications can also be confirmed with basophil activation test (BAT).
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An oral food challenge (OFC) is the gold standard of determining whether you have an allergy to a food. An OFC involves eating graduated amounts of the food until an age-appropriate serving size is reached. The results of an OFC can help to confirm a food allergy, rule out a food allergy, or determine the appropriate starting dose for oral immunotherapy (OIT).
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A food allergy is when a person’s immune system responds abnormally to a certain food. Food allergy can largely be divided into two categories: acute and delayed-type food allergy.
Acute food allergic reactions typically occurred within minutes to two hours after exposure to the allergen. Reactions including hives, swelling of the lips and tongue, vomiting, difficulty in breathing and dizziness. The most common foods that causes IgE-mediated food allergies in Hong Kong are seafood, egg, milk, peanut and tree nuts. People with food allergy can be allergic to more than one food.
Delayed-type food allergic reactions typically do not appear immediately after the ingestion of the food. Symptoms include eczema flare, vomitng, bloating and diarrhoea. Common foods that causes delayed-type food allergies are egg and milk.
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Common allergenic foods, such as peanut, egg, cow’s milk, and tree nuts, are recommended to be introduced to infants when starting complementary foods at around 6 months of age, preferably before 12 months old. Emerging scientific evidence suggests that early introduction of these allergenic foods may have a role in preventing food allergy in high-risk infants, including those eczema. These infants can also start their weaning diet as early as 4 months of age. Peanut and egg are recommended to be prioritized as the first two allergenic foods to be introduced when starting on complementary foods.
To ensure safe introduction of new food to an infant, you should:
1) Introduce a new food to an infant when the baby is well and awaken, so that symptoms of sicknesses and drowsiness will not be mistaken as allergic reactions triggered by the new food.
2) The new food should be given in an age-appropriate and non-chokable form, starting from very small amount (amount equals to the tip of a teaspoon).
3) You should wait for 5 – 10minutes and observe for symptoms, before further increasing the quantity until an age-appropriate meal-sized portion is achieved.
4) You should only offer one new food per day for easier identification of the culprit food that causes the reaction.
5) To maintain tolerance, once an allergenic food is successfully introduced, it should be regularly incorporated in the baby’s diet, e.g. 2-3 times per week in meal-size portion.
It is important to seek advice from your child’s allergist or paediatrician early if there is one or multiple food allergens identified as early treatment through oral immunotherapy has been shown to be safe and effective, especially among infants and preschoolers.
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A food ladder is a form of dietary advancement therapy. It can be used to manage delayed-type as well as milder forms of immediate-type egg and milk allergies. The goal of the food ladder is to facilitate the development of natural tolerance through the gradual introduction of egg or milk containing food with increasing quantity and allergenicity through different cooking processes, typically with gradual progression from baked products (e.g., biscuits, muffin), to well-cooked forms (e.g., pancakes, hard-boiled eggs) and finally to less processed products (e.g., fresh mousse, fresh ice cream).
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What is food Oral Immunotherapy (OIT)?
The goal of food OIT is to increase your child’s ability to tolerate the food of concern (e.g. protection from accidental exposures). Treatment involves eating small amounts of the food of concern on a daily basis. The amount of food eaten starts at a low dosage and then is gradually increased over a period of months until your child reaches the highest amount of food that has been prescribed by your doctor.
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What is aeroallergen sublingual immunotherapy (SLIT)?
Aeroallergen SLIT is a kind of immunotherapy aimed at increasing your tolerance to the allergens in the environment (such as dust mites, pollen, cats and dogs) in order to achieve symptom improvement. It is most commonly used in treating allergic rhinitis and asthma and in selected eczema patients. SLIT reagents, which contain a small quantity of the allergen that you are allergic to, are applied under your tongue on a daily basis for up to 3-5 years.
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What is aeroallergen subcutaneous immunotherapy (SCIT)?
Aeroallergen SCIT (also known as allergy shots) is a kind of immunotherapy aimed at increasing your tolerance to the allergens in the environment (such as dust mites, pollen, cats, and dogs) in order to achieve symptom improvement. It is most commonly used in treating allergic rhinitis and asthma and in selected eczema patients. SCIT involves a build-up phase where an increasing quantity of allergens is injected under your skin, usually on a weekly basis, followed by a maintenance phase where a fixed quantity of allergen, usually on a monthly basis for up to 3-5 years.
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Biologics are drugs developed through biotechnology that can target specific components of the immune system to control inflammation. In recent years, emerging clinical data have shown that biologics can safely and effectively treat various severe allergic conditions, such as eczema, asthma, nasal allergy and chronic urticaria. The application age of some biological agents is also suitable for children and adolescents under the age of 18
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