Allergy and Immunology

• Asthma
• Allergic rhinitis
• Chronic rhinitis, conjunctivitis, sinusitis, and polyps
• Skin diseases such as urticaria, angioedema, eczema, contact dermatitis
• Allergy to foods, medications and antibiotics, cosmetics, metals used in jewelry or orthopedic implants
• Eosinophilic disease such as hypereosinophilic syndrome
• Immunodeficiency disorders
• Chronic cough

• Allergy testing for environmental allergens
• Patch testing for contact dermatitis
• Spirometry for evaluating lung function
• Fiberoptic rhinolaryngoscopy
• Drug and food allergy testing and challenge
• Mixing and administering allergy shots
• Prescribing biologics for severe asthma, eczema, chronic sinusitis with polyps, and hereditary angioedema
• Prescribing immunoglobulins for immunodeficiency

We test for 58 different allergens that are common in and around the Greater Houston area. These allergens include a comprehensive panel of molds, grass weed, and tree pollens, indoor allergens like dust mite, cockroach, and animal dander. Our nurses perform a series of prick skin tests which involves scratching the skin surface with a small plastic device that performs 10 pricks simultaneously for rapid, accurate, and safe results for individualized patient treatments. Since a very small concentration of allergen is applied to the skin through which a prick is performed, skin testing is considered a safe procedure.

• Testing for Food allergies. We test for 22 common food allergens by skin prick testing. 
• Penicillin testing and delabeling. 
• Testing for Contact Dermatitis. We apply a panel of 36 common chemicals present in creams, lotions, implants, adhesives, topical chemicals, soaps, cosmetics, nail polish, jewelry and read these panels to identify the agent that is contributing to contact dermatitis.
• Skin biopsy. For patients who have chronic hives that are difficult to treat medically, or a rash that has been difficult to diagnose, we can perform skin biopsies and send them to pathology for diagnosis.
• Spirometry. For patients who have symptoms suggestive of asthma and have known asthma, we perform spirometry in the clinic.
• Fiberoptic rhinophayngoscopy. We perform fiberoptic rhinophayngoscopy to determine the extent and factors contributing to postnasal drainage, cough, nasal obstruction, and other reasons.

Environmental allergies. We use positive results from this gold standard method of testing as guide management. Avoidance is always the first step in any kind of allergen sensitivity. For example, reducing exposure to household dust, dander, and mold are effective ways to reduce allergy symptoms. Where avoidance is not enough, we develop a medication plan to treat symptoms. Finally, based on your input, we may use the results of environmental allergy testing to make highly specific allergen immunotherapy (allergy shot) mixes for each patient.
 
Food allergies. We use the results of food allergy tests together with a detailed history to develop a plan for the avoidance of specific foods, and rapidly treat reactions from accidental exposures. However, unlike environmental allergies, the results of food allergy tests are not used for allergen immunotherapy because of their high risk and low efficacy.

Medications and biologics. For treatment of allergies of your nose and eyes, effective medications include intranasal steroids, intranasal antihistamines, eye drops, antihistamines like cetirizine and fexofenadine. For difficult-to-treat chronic rhinitis with polyps, we prescribe monoclonal antibody biologic if needed, For treating hives, we prescribe cocktails of antihistamines and other medications such as a monoclonal antibody biologic if needed. For asthma, we prescribe all combinations of inhalers and other medications, and if this is not enough to control your symptoms, we can prescribe monoclonal antibody biologic.

Subcutaneous Immunotherapy (SCIT). Based on your skin test result and your history, we make individualized patient serums that can only be used for you. This serum modifies your immune response to these allergens in a highly specific manner. To ascertain patient safety, this treatment is administered and monitored by our highly trained staff. Over time, SCIT is very effective in altering a person’s allergic response to these allergens, both improving allergy symptoms and decreasing the need for medications. The usual duration of treatment is four years, and the effect of this treatment can last long after it has been stopped.