Allergy services | Allergy and immune conditions

Skin prick testing is an integral tool in confirming the diagnosis of IgE mediated allergies in most allergic diseases. On the day of your appointment, your doctor or nurse may request a skin prick test (SPT).

SPT devices are stored in a tray system which holds different allergen extracts. The SPT device is removed from the tray and placed perpendicular to the skin, pressed down under medium pressure. A small circle indicating the correct amount of pressure was applied will be seen.

The site will then be blotted to remove any residual allergen extract. After 15 minutes the test will be read. It is important not to scratch the site where the SPT was undertaken, as it can create false results.

For children under 16 years the SPT is carried out on the volar aspect of the arm and for those over 16 years the SPT is carried out on the back.

Key things to remember:

• Do not take antihistamines for at least 5 days prior to your appointment as they will interfere with SPT
• Most food allergies occur to a limited number of foods where commercial extracts are available for skin prick testing. If there are concerns about allergy to less common food allergens, particular fruit, meats or fish and shellfish, we request you bring a small portion of the food in for skin prick testing
• Your appointment may take up to two hours on the day, so please ensure you come prepared

Your doctor may recommend you undertake respiratory function testing, also known as spirometry.

A spirometry is a device used to measure timed expired and inspired volumes, and from these your doctor can calculate how effectively and quickly the lungs can be emptied and filled.

Spirometry is done to diagnose certain types of lung disease such as asthma, assess the effect of medication and measure progress in disease treatment.

Your doctor may recommend an inpatient challenge to clarify the allergy. A challenge is a procedure where a food or medication is given to determine tolerance or confirm allergy. In some instances latex challenges may also be carried out.

Incremental amounts of the food or medication will be given following a strict protocol over a few hours, with observations taking place throughout to monitor for any signs of reaction.

The first dose is very small and if tolerated, increasing amounts of the challenge substance will be given in subsequent order.

A challenge typically takes around four hours. After the last dose, the patient will be required to stay within the hospital for a further one to two hours for observation.

If there are no signs of reaction, the challenge will be deemed successful and you will be given instructions to continue the challenge at home for the next week.

If a challenge is unsuccessful, you will be given instructions on the day by your nurse and/or doctor. All symptoms are monitored closely and treated accordingly. All symptoms need to be resolved prior to discharge.

Challenges may occasionally need to be conducted over two days.

Sometimes a DBPCC may be carried out. DBPCC is the most scientific method of conducting a food challenge and involves disguising the food in another food vehicle the patient enjoys and is not allergic to.

The patient and the nurse looking after the patient are both blinded to the contents, while a third nurse makes up the ‘meals’. These are prepared according to a code, and some meals will have the challenge food in them (active) and some will not have the challenge food (placebo). This eliminates bias from the supervising nurse, patient and/or parent as neither knows which are the active meals or the placebo meals and symptoms of an allergic reaction can be observed.

Key things to remember:

• Do not take antihistamines for at least 5 days prior to your challenge as this will interfere with the test. If an antihistamine is taken, the clinic will not be able to proceed with a DBPCC
• The patient must be well on the day of the challenge. If the patient is unwell, the challenge will need to be rescheduled 
• Allow extra time for parking and to go to the admissions office
• Your challenge may take up to four hours so please ensure you come prepared

Epworth Allergy Specialists offer both sublingual and subcutaneous immunotherapy. Immunotherapy (desensitisation) treats the cause of environmental allergies by giving small doses of what a person is allergic to, most commonly grass pollen's and house dust mites. This increases "immunity" or tolerance to the allergen and reduces the allergic symptoms.

Sublingual Immunotherapy is given as drops under the tongue and requires a one-off inpatient admission on commencement. After the initial appointment, SLIT can be done in the convenience of your own home.

SLIT treatment must be taken in the morning before food, drink and teeth brushing. If more than one sublingual immunotherapy is prescribed a 15-minute break is needed before commencing additional treatments.

SLIT must be stored in the fridge in an upright position.

Subcutaneous immunotherapy is given via a subcutaneous injection (into the fat layer between the skin and muscle) and requires weekly updosing in our inpatient challenge unit until maintenance is reached (usually over a 1-3 week period). Once this has been completed, monthly maintenance injections are continued at the local GP.

During SCIT appointments pre and post spirometry testing will also be undertaken to assess respiratory function.

It is important to take antihistamine at least 30 minutes prior to your injection to minimise any localised reactions.

If you have had a reaction to a medication or antibiotic, IDT may be indicated.

IDT is typically used to test for allergies to medications or antibiotics when greater sensitivity is required. IDT is the injection of a small amount of the diluted medication into the dermal layer of the skin.

If the intradermal test is negative the patient may proceed with a medication or antibiotic challenge on the day of testing, or at a later date. This is to clarify if they are now tolerant to the medication/antibiotic they have been tested for.

Key things to remember:

• Allow extra time for parking and to go to the admissions office. Your appointment may take all day, so please ensure you come prepared
• Do not take antihistamines for at least 5 days prior to your appointment as it interferes with the IDT procedure
• The patient must be well on the day of the challenge, if they are unwell admission may need to be rescheduled

Skin prick testing is an integral tool in confirming the diagnosis of IgE mediated allergies in most allergic diseases. On the day of your appointment, your doctor or nurse may request a skin prick test (SPT).

SPT devices are stored in a tray system which holds different allergen extracts. The SPT device is removed from the tray and placed perpendicular to the skin, pressed down under medium pressure. A small circle indicating the correct amount of pressure was applied will be seen.

The site will then be blotted to remove any residual allergen extract. After 15 minutes the test will be read. It is important not to scratch the site where the SPT was undertaken, as it can create false results.

For children under 16 years the SPT is carried out on the volar aspect of the arm and for those over 16 years the SPT is carried out on the back.

Key things to remember:

• Do not take antihistamines for at least 5 days prior to your appointment as they will interfere with SPT
• Most food allergy occurs to a limited number of foods where commercial extracts are available for skin prick testing. If there are concerns about allergy to less common food allergens, particular fruit, meats or fish and shellfish, we request you bring a small portion of the food in for skin prick testing.
• Your appointment may take up to two hours on the day, so please ensure you come prepared

Your doctor may recommend you undertake respiratory function testing, also known as spirometry.

A spirometry is a device used to measure timed expired and inspired volumes, and from these your doctor can calculate how effectively and quickly the lungs can be emptied and filled.

Spirometry is done to diagnose certain types of lung disease such as asthma, assess the effect of medication and measure progress in disease treatment.

Your doctor may recommend an inpatient challenge to clarify the allergy. A challenge is a procedure where a food or medication is given to determine tolerance or confirm allergy. In some instances latex challenges may also be carried out.

Incremental amounts of the food or medication will be given following a strict protocol over a few hours, with observations taking place throughout to monitor for any signs of reaction.

The first dose is very small and if tolerated, increasing amounts of the challenge substance will be given in subsequent order.

A challenge typically takes around four hours. After the last dose, the patient will be required to stay within the hospital for a further one to two hours for observation.

If there are no signs of reaction, the challenge will be deemed successful and you will be given instructions to continue the challenge at home for the next week.

If a challenge is unsuccessful, you will be given instructions on the day by your nurse and/or doctor. All symptoms are monitored closely and treated accordingly. All symptoms need to be resolved prior to discharge.

Challenges may occasionally need to be conducted over two days.

Sometimes a DBPCC may be carried out. DBPCC is the most scientific method of conducting a food challenge and involves disguising the food in another food vehicle the patient enjoys and is not allergic to.

The patient and the nurse looking after the patient are both blinded to the contents, while a third nurse makes up the ‘meals’. These are prepared according to a code, and some meals will have the challenge food in them (active) and some will not have the challenge food (placebo). This eliminates bias from the supervising nurse, patient and/or parent as neither knows which are the active meals or the placebo meals and symptoms of an allergic reaction can be observed.

Key things to remember:

• Do not take antihistamines for at least 5 days prior to your challenge as this will interfere with the test. If an antihistamine is taken, the clinic will not be able to proceed with a DBPCC.
• The patient must be well on the day of the challenge. If the patient is unwell, the challenge will need to be rescheduled. 
• Allow extra time for parking and to go to the admissions office.
• Your challenge may take up to four hours so please ensure you come prepared.

Epworth Allergy Specialists offer both sublingual and subcutaneous immunotherapy. Immunotherapy (desensitisation) treats the cause of environmental allergies by giving small doses of what a person is allergic to, most commonly grass pollen's and house dust mites. This increases "immunity" or tolerance to the allergen and reduces the allergic symptoms.

Sublingual Immunotherapy is given as drops under the tongue and requires a one-off inpatient admission on commencement. After the initial appointment, SLIT can be done in the convenience of your own home.

SLIT treatment must be taken in the morning before food, drink and teeth brushing. If more than one sublingual immunotherapy is prescribed a 15-minute break is needed before commencing additional treatments.

SLIT must be stored in the fridge in an upright position.

Subcutaneous immunotherapy is given via a subcutaneous injection (into the fat layer between the skin and muscle) and requires weekly updosing in our inpatient challenge unit until maintenance is reached (usually over a 1-3 week period). Once this has been completed, monthly maintenance injections are continued at the local GP.

During SCIT appointments pre and post spirometry testing will also be undertaken to assess respiratory function.

It is important to take antihistamine at least 30 minutes prior to your injection to minimise any localised reactions.

If you have had a reaction to a medication or antibiotic, IDT may be indicated.

IDT is typically used to test for allergies to medications or antibiotics when greater sensitivity is required. IDT is the injection of a small amount of the diluted medication into the dermal layer of the skin.

If the intradermal test is negative the patient may proceed with a medication or antibiotic challenge on the day of testing, or at a later date. This is to clarify if they are now tolerant to the medication/antibiotic they have been tested for.

Key things to remember:

• Allow extra time for parking and to go to the admissions office. Your appointment may take all day, so please ensure you come prepared
• Do not take antihistamines for at least 5 days prior to your appointment as it interferes with the IDT procedure
• The patient must be well on the day of the challenge, if they are unwell admission may need to be rescheduled