Allergy, asthma & immunology associates, p

ALLERGY & ASTHMA SPECIALISTS OF NORTH FLORIDA, P.A.
Edward A. Mizrahi, M.D.
Patrick J. DeMarco, M.D.
3636 University Blvd. S. Ste. A-3 1895 Kingsley Ave. Suite 401 11701-32 San Jose Blvd. #117 5913 Normandy Blvd. Suite 1 Jacksonville, FL 32216 Orange Park, FL 32073 Jacksonville, FL 32223 Jacksonville, FL 32205 (904) 730-4870 (904) 272-5251 ALLERGY SKIN TESTING INSTRUCTIONS
What is allergy skin testing?
Skin testing is the most sensitive method of measuring antibodies to allergens.
Why is it performed?
To evaluate possible allergic triggers to symptoms. Information obtained is very useful in the management of one’s
allergic symptoms.

How is it performed?
Commonly tested allergens include inhaled allergens (pollens, molds, pet allergens, dust mite, cockroach), foods,
insects, and a few medications. Small amounts of purified extract are applied to the skin using two methods. Prick-
puncture testing is generally the first screen and is performed by “pricking” the skin on the back (or arm) with a small
plastic applicator coated with allergen. Intradermal testing is performed by injecting small amounts of suspected
allergen into the most superficial layer of skin. If you have sensitivity to a specific allergen, a small wheal and flare
(similar to a small mosquito bite) is seen within 15-20 minutes. This is measured by the technician performing the test.
The entire process usually takes approximately 60-90 minutes. A follow-up appointment is generally scheduled on the
same day to discuss the results with your physician, correlating the results of your testing with your clinical symptoms.
Please plan on being in the office for approximately 2 hours.
What are the side-effects?
Skin testing is generally well tolerated. The most common reaction is local itching and swelling of the test site which
resolves within a few hours. An area of swelling (especially at the site of the intradermal tests) occasionally may begin
to swell several hours after the test and may persist for a few days after the test. This is usually treated with ice to the
local area and anti-inflammatory medications (e.g. over-the-counter topical steroid cream or ibuprofen). Please let the
staff know if this reaction persists for longer or does not respond to the above treatment. Other possible side-effects
include itching of the eyes, nose, throat; runny nose, wheezing, light-headedness, hives, nausea. Strongly positive
reactions may induce hypotension and shock in an extremely rare circumstance. The staff is trained in appropriate
management of each of the above possible reactions.
What medications should I stop before the test?
Since we are in essence measuring histamine in your skin, histamine will be placed on your skin to see if your skin is
reacting sufficiently at the time of the test. Therefore, no antihistamines should be used for specific intervals prior to
skin testing since they may inhibit what we are measuring. Please read not only prescription medications but also over-
the-counter products since these medications are often contained as part of cold, sinus, flu and sleeping preparations.
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STOP AT LEAST 14 DAYS PRIOR TO TEST
TCA antidepressants (may be held only with the permission of your PCP/psychiatrist) include: amitriptyline,
clomipramine, desipramine, doxepin, Elavil, imipramine, Limbitrol, mirtazapine, nortriptyline, Pamelor,
Remeron, Sinequan.
STOP AT LEAST 6 DAYS PRIOR TO TEST
Over-the-counter-antihistamines include: Alavert, cetirizine, Claritin, clemastine, Contac, loratidine, Zyrtec.
Prescription antihistamines include: Allegra, Astelin nasal spray, Astepro nasal spray, Atarax, Clarinex,
cyproheptadine, desloratidine, fexofenadine, hydroxyzine, Patanase nasal spray, Periactin, Xyzal.
STOP AT LEAST 3 DAYS PRIOR TO TEST
Oral antihistamines include (OTC and prescription): Actifed, Aller-X, Benadryl, brompheniramine,
chlorpheniramine, Chlor-Trimeton, dexbrompheniramine, Dimetapp, diphenhydramine, Dristan, Drixoral, Ny-
quil, Phenergan, promethazine, Rondec, Rynatan, Semprex, Tavist, Tussionex, Tylenol PM.
Allergy eye drops include: azelastine, Beprive, Elestat, ketotifen, Optivar, Pataday, Patanol, Zaditor.
HOLD MORNING OF TEST
If not contraindicated by cardiologist or other physician, please hold beta-blockers (specific medications for heart and
blood pressure) ONLY on AM of test.
DO NOT STOP PRIOR TO TEST
Please continue ALL OTHER medications unchanged. This includes ALL of your inhalers for asthma. Additionally,
you should continue nasal sprays (EXCEPT ASTELIN, ASTEPRO OR PATANASE), singulair, accolate, Zyflo,
phenylephrine, pseudophedrine, prednisone, theophylline, medrol, guaifenesin, Afrin and all antibiotics.

OTHER IMPORTANT INFORMATION:

***PLEASE MAKE EVERY EFFORT POSSIBLE TO KEEP YOUR SCHEDULED APPOINTMENT AND
ARRIVE ON TIME. IF A CHANGE IS NECESSARY, PLEASE NOTIFY OFFICE AT LEAST 72 HOURS
PRIOR TO APPOINTMENT. LAST MINUTE CHANGES RESULT IN TIME THAT MAY HAVE BEEN
UTILIZED FOR ANOTHER PATIENT SINCE THERE ARE ONLY A LIMITED NUMBER OF TESTING
SLOTS AVAILABLE EACH DAY. THEREFORE, A FEE (CURRENTLY $50) MAY BE CHARGED IF
SUFFICIENT NOTICE IS NOT RECEIVED OR YOU DO NOT SHOW FOR YOUR SCHEDULED
APPOINTMENT. THIS FEE IS NOT PAYABLE OR REIMBURSED BY INSURANCE.

***IF YOU TYPICALLY NEED REFERRALS FOR VISITS, PLEASE MAKE SURE THAT THE
APPROPRIATE REFERRALS ARE OBTAINED PRIOR TO TESTING.

***IF APPLICABLE, YOU WILL BE RESPONSIBLE FOR PART OR ALL OF THE COST OF THE TEST
THAT IS NOT COVERED BY INSURANCE.
***IF YOU HAVE ANY OTHER QUESTIONS, PLEASE CONTACT OFFICE.

Source: http://www.jaxallergy.com/pdf/skintesting.pdf