Fast Five Quiz: Test Your Knowledge About Fall Allergies

Michael A. Kaliner, MD

Disclosures

September 21, 2018

Immediate hypersensitivity skin testing is the most useful method to detect immunoglobulin E antibodies against mold allergens. Testing can be performed by using the prick or intradermal method. The preferred site is the upper part of the back for the prick method or the arms for the intradermal method. Histamine and normal sodium chloride solution are most commonly used as positive and negative controls, respectively.

Results are recorded 15 minutes after the test is performed. Wheal diameter more than 3 mm above the reaction of the negative control is considered a positive result.

Mold allergen extracts used for the skin test depend on the prevalence of various molds in the region, as identified with annual atmospheric sampling. The most common molds are Alternaria, Aspergillus, Cephalosporium, Curvularia, Epicoccum, Fusarium, Helminthosporium, Hormodendrum, Mucor, Penicillium, Phoma, Pullularia, Rhizopus, and Stemphylium species.

Although uncommon, sinusitis or lower respiratory tract disease (eg, allergic bronchitis, bronchial asthma) subsequently develops in some patients.

The history of mold-induced asthma may not differ from that of any other allergic asthma. The onset may be acute or insidious. The patient's history usually includes cough, wheezing, and tachypnea with dyspnea with prolonged expiration.

Pharmacologic intervention may be necessary to help alleviate the symptoms of acute allergic conjunctivitis. Various classes of medication may be effective against the symptoms of acute allergic conjunctivitis; each is directed at a specific point in the inflammatory and allergic cascade. As a rule, topical steroids should be prescribed only for a short period and for severe cases that do not respond to conventional therapy. Severe forms of ocular allergy may require chronic steroid maintenance therapy to avoid permanent structural damage to the ocular surface and central corneal stroma.

For more on mold allergy, read here.

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