Category Archives: Allergic Rhinitis

High Outdoor Mold Counts Set Allergies in Action

Where there isn’t drought, high humidity and rain are hiking up mold counts (and sneezes) in some parts of the country.

By Jaimie Dalessio, Senior Editor

TUESDAY, August 7, 2012 — How well do you know mold? “It’s the fungus among us,” allergist Joseph Leija, MD, says with a chuckle. For 15 years, Dr. Leija has conducted the Gottlieb Allergy Count, the official allergy count for the Midwest, on the roof of Loyola’s Gottlieb Memorial Hospital in Melrose Park, Ill. “We are exposed constantly to mold.”

But many people think mold only grows between bathroom tiles.

On Monday, Leija recorded a mold count above 125,000 per cubic meter of air — the highest count he’s seen in his tenure. For comparison, a mold count of just 50,000 per cubic meter of air gets an air quality warning. More than a month of 80-plus degree temperatures, high humidity, and a weekend of thunderstorms likely triggered the spike, he says. Tuesday’s count dropped to a less extreme but still higher-than-normal 60,000.

Molds are microscopic fungi that produce spores, which spread through the air. Mold is a year-round problem for allergy sufferers, because it grows both outdoors and indoors. Mold can collect in cool, damp places (like basements and bathrooms) any time of the year. Outside, humid weather can cause high mold concentrations, especially during summer.

Dealing With Mold Allergies

High mold counts mean standard allergy symptoms — such as congestion, sneezing, a runny nose, and watering, itchy eyes — for people sensitive to it. And unlike pollen, which you can see piled up on your car windshield, and dust mites, which you can see everywhere, you might not notice that mold spores floating through the air.

If you test positive for mold allergies, Leija says making sure the air you breathe is clean is the most important thing you can do. He suggests pumping up the air conditioner in the car and in the house, and using dehumidifiers inside to prevent mold from growing.

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Wangi Mudarat / Perfume Allergy

Patients with respiratory allergies such as allergic rhinitis and asthma can have their diseases exacerbated by perfume. Perfume particles evaporate and become airborne giving perfumes their smell. Patients with allergic inflammation in their airways have airway hyper-reactivity and can easily become irritated by inhalation of perfume leading to symptoms such as blocked nose, runny nose, sneezing, coughing and wheezing. An asthmatic who begins to cough and wheeze upon exposure to perfume suggests uncontrolled asthma.

Another manifestation of perfume allergy is allergic contact dermatitis. This form of allergy manifests as itchy, dry, scaly rash in areas of the skin exposed to perfume such as the face, neck and wrists. If you suspect skin sensitivity to perfume, one can apply perfume onto the clothes instead of the skin. Patch testing can also be done for accurate determination of the cause of the allergic contact dermatitis.

Please see a qualified Allergy & Immunology specialist for proper evaluation of your allergic diseases.

Below is a newspaper article in Bahasa Malaysia that talks about perfume allergy.

Wangi mudarat
Oleh Shaidah Shafie
shasha@bharian.com.my
2012/04/19

Rutin sembur haruman undang risiko alahan, lelah dan masalah kulit

SUDAH menjadi kelaziman Nadia menyembur minyak wangi setiap kali keluar rumah. Namun, bau wangi itu kerap menyebabkannya bersin sehinggakan selesema.

Tapi bagi eksekutif muda sepertinya, apalah sangat selesema berbanding rutin wajibnya menyembur pewangi berkenaan. Mana tidaknya, pewangi atau haruman sudah menjadi satu keperluan yang tidak dapat tidak, dielakkan.

Ada pewangi yang tidak diketahui kandungannya boleh membuatkan penghidap lelah ini berdepan masalah ‘serangan’ sesak nafas. Ada juga alahan luaran seperti kulit mengalami radang dan menjadi kemerah-merahan akibat tindak balas bahan tertentu dalam wangian yang digunakan. – Dr Kent Woo, Pakar Asma, Alahan dan Imunologi

Alasannya – Nadia berasa yakin untuk berhadapan atau berurusan dengan rakan sekerja, pelanggan mahu pun mereka di sekitarnya. Baginya, pewangi menjadi alat meningkatkan daya keyakinan diri biarpun terpaksa menahan selesema. Malah bukan Nadia seorang, sebaliknya ramai, termasuk remaja mempunyai penggantungan sedemikian terhadap wangian.

Apakah tepat tindakannya itu? Hakikatnya, sama ada disedari atau tidak, pewangi juga boleh membawa alahan sekiranya individu itu adalah penghidap asma, mereka yang mengalami masalah rhinitis dan alahan teruk.

Malah, mungkin ramai tidak ketahui ada pewangi menyebabkan kulit mengalami radang akibat alah dengan bahan kandungan dalam pewangi berkenaan.

Pakar Asma, Alahan dan Imunologi, Dr Kent Woo Chee Keen, berkata pewangi bukan perkara wajib untuk digunakan kerana jika individu prihatin mengenai kebersihan diri, tidak akan ada keperluan terhadap penggunaan wangian.
“Jika kita menjaga kebersihan diri dengan betul dan mandi mengikut kesesuaian, kita tidak perlu memakai wangian ketika menjalankan urusan seharian.

“Namun, kebanyakan daripada kita berasa lebih yakin sekiranya mengenakan pewangi sejurus sebelum meneruskan urusan harian dan ia boleh digunakan selagi tidak memudaratkan diri,” katanya yang berkhidmat di Hospital Gleneagles Kuala Lumpur.

Dr Woo yang ditemui baru-baru ini berkata, penggunaan minyak wangi atau wangian akan mencetuskan sensasi bauan terhadap deria hidu manusia dan ia mempengaruhi semangat seharian kala bekerja. Hal ini dikira positif kerana tidak mendatangkan kemudaratan kepada pemakai, namun jika individu menghidap asma, mereka mungkin alah kepada pewangi.

Bagaimanapun, tegasnya, jika individu berkenaan menghidap asma atau sensitif kepada alahan, mereka sewajarnya berhati-hati terhadap penggunaan wangian kerana ia dikhuatiri memburukkan keadaan asma yang dihidapi. Malangnya, tidak ramai yang mungkin menyedari risiko itu dan membiarkannya.

“Ada pewangi yang tidak diketahui kandungannya berupaya membuatkan penghidap asma atau lelah ini berdepan masalah ‘serangan’ sesak nafas kerana sebenarnya alah dengan bau atau pewangi yang disembur ke badan.

“Jika wangian berkenaan tidak sesuai dengan individu yang menghidap asma, dia boleh sesak nafas selepas beberapa minit menyembur pewangi ke badan. Namun jika tiada sebarang alahan, tiada kesan dialami.

“Perlu diingat, ia adalah alahan jenis dalaman kerana menyerang sistem pernafasan. Ada juga alahan luaran seperti kulit mengalami radang dan menjadi kemerah-merahan kerana tindak balas bahan tertentu dalam wangian yang digunakan,” katanya.

Memperincikan lagi, Dr Woo berkata, minyak wangi adalah campuran kompleks juzuk bauan asli dan tiruan. Lebih daripada 5,000 sebatian yang dikenali digunakan dalam pembuatan wangi dan ada sebatian tertentu tersejat dan menjadi bawaan udara menyebabkan ia berlegar-legar dalam udara.

“Jadi, jika ada individu bermasalah asma dan yang mempunyai masalah saluran pernafasan seperti alahan rinitis yang tidak dikawal, menyedut udara yang berbaur dengan wangian itu tadi, mereka akan mengalami bersin dan kesesakan hidung selepas terhidu bau itu.

“Dalam satu kajian yang diterbitkan jurnal perubatan pada 1995, sebanyak 36 peratus mengalami gangguan asma teruk, 17 peratus (sederhana) dan 8 peratus (sangat sederhana) dan gejala ini adalah disebabkan oleh kerengsaan saluran udara oleh wangian,” katanya.

Justeru, apakah yang harus dilakukan andai berdepan kemungkinan itu? Menurut Dr Woo, langkah segera perlu dilakukan seperti menemui doktor bagi mengesahkan sama ada anda sebenarnya mengalami alahan atau tidak terhadap wangian.

Alahan pada kulit akibat penggunaan haruman boleh diketahui dengan melakukan ujian tampalan pada bahagian belakang badan. Ujian itu dilakukan di hospital dengan pengendalian doktor.

“Doktor akan menampal sejenis bahan pada bahagian belakang anda. Tampalan berkenaan hanya boleh dibuka selepas 48 jam kerana kesannya akan dapat dilihat selepas tempoh berkenaan.

“Sistem imunisasi badan akan bertindak mengeluarkan tanda sekiranya anda alahan terhadap wangian seperti ada bintik merah, melecur dan radang kulit. Ada juga yang tidak akan menunjukkan sebarang tanda dan ia tidak bermakna anda tidak mengalami alahan,” katanya.

Bagaimanapun, katanya ada juga alahan yang tidak akan muncul walaupun selepas 48 jam, tapi ia mungkin akan muncul selepas beberapa hari atau selepas seminggu. Paling membimbangkan ialah alahan wangian yang berlaku pada bahagian wajah kerana ia mungkin akan menyebabkan muka bengkak, ada kesan terbakar mahupun kegatalan.

“Kadang kala ada juga alahan berlaku disebabkan oleh bahan makanan kerana ada bahan tertentu yang digunakan dalam masakan turut digunakan dalam pembuatan minyak wangi seperti kulit kayu manis, cengkih dan vanila.

“Jadi anda perlu berhati-hati kerana bahan dalam makanan ada juga yang sama dengan bahan di dalam minyak wangi. Dan alahan ini tidak semestinya disebabkan oleh minyak wangi saja, makanan yang diambil juga boleh menyebabkan alahan,” katanya.

Wanita paling banyak terdedah kepada bahan alahan di dalam wangian mahupun krim badan atau kelengkapan solekan yang digunakan pada wajah kerana ada antaranya mengandungi bahan kimia yang berbau wangi.

Bagi mengelak alahan, individu boleh membaca label pada wangian sebelum mengambil keputusan membeli atau menggunakannya pada badan bahkan krim badan juga mempunyai bahan wangian.

Wanita paling banyak terdedah kepada bahan alahan di dalam wangian mahupun krim badan atau kelengkapan solekan yang digunakan pada wajah kerana ada antaranya mengandungi bahan kimia berbau wangi.

“Cara terbaik menggunakan wangian ialah menyemburnya pada pakaian kerana ia tidak akan mengena kulit secara langsung. Jadi sekiranya kulit anda mengalami alahan, cara begini dapat mengelakkan alahan berlaku,” katanya.

“Pastikan anda membaca label pada sebarang alat penjagaan badan yang dibeli. Perkataan ‘unscented’ tidak bermakna bahawa ia adalah tiada bahan wangian sebaliknya pastikan ada tertulis ‘fragrance free’ kerana ia adalah bebas daripada sebarang bahan wangian,” katanya.

FAKTA: Antara tanda alahan pewangi

  • Bersin apabila tercium bau minyak wangi dalam masa beberapa minit, anda mula sakit kepala.
  • Pening selepas menggunakannya atau mencium bau wangian
  • Tangan menjadi ruam atau gatal selepas terkena cecair

Ujian alahan

  • Doktor akan menampal sejenis bahan pada bahagian belakang anda.
  • Tampalan berkenaan hanya boleh dibuka selepas 48 jam kerana kesannya akan dapat dilihat selepas tempoh itu.
  • Sistem imunisasi badan akan bertindak mengeluarkan tanda sekiranya anda alahan terhadap wangian seperti ada bintik merah, melecur dan radang kulit.
  • Ada juga tidak akan menunjukkan sebarang tanda.

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Perfume Allergy

Perfume is a complex mixture of natural and synthetic sweet-smelling constituents. More than 5,000 compounds are known to be in used in the making of perfume. Certain compounds evaporate and become airborne thus lending perfume its smell.

Patients with allergic airway diseases can have exacerbations of their symptoms upon inhalation of these perfume compounds. For example, patients with allergic rhinitis that is not controlled can start sneezing and develop nasal congestion after smelling perfume. Patients with uncontrolled asthma may develop chest tightness and wheezing.

In a study published in the Annals of Allergy, asthmatic exacerbations after perfume challenge occurred in 36%, 17%, and 8% of patients with severe, moderate, and mild asthma, respectively. These symptoms were mainly assumed to be due to the irritant effects of perfumes.

However compounds found in perfumes can also cause allergic sensitization. The most common cause of cosmetic allergy is allergic contact dermatitis to the fragrance found in cosmetics. Recent estimates show that 1-4% of the general population are sensitized to ingredients of the fragrance mix.  Allergy to fragrance in cosmetics occurs predominantly in women with facial or neck eczema.  It can also present as itchy red patches where perfume are usually dabbed on, such as on the wrists or behind the ears.

Some patients with severe allergy to fragrance have been reported to develop to skin rash after eating spices such as cinnamon, cloves and vanilla which containing similar compounds found in fragrances. This is a situation where the person with allergic contact dermatitis to a compound has their rash exacerbated after eating certain cross reactive foods.

For patients who have allergies to perfume, they should also carefully read product labels. The use of the term unscented does not mean that it is fragrance free; they should instead choose a fragrance-free product which is typically free of allergenic fragrance.

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Pollen allergy with fruit or vegetable cross reactivity

A person with allergy to pollen can manifest itching of the mouth, palate and inside the ears when eating certain fruits or vegetables. This condition has been termed “Pollen-Food allergy syndrome”. It is important to understand that itching of the mouth termed “Oral Allergy Syndrome” can also be an early manifestation of a potentially dangerous food allergy. Thus one should seek medical attention with a qualified Allergy & Immunology specialist.

The figure below lists some of the known cross reactivity of pollen with fruits/vegetables. By all means, this list is not all inclusive as a person can react to other foods not on this list.

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Rhinitis Medicamentosa

‘Rhinitis Medicamentosa’ also known as rebound rhinitis occurs upon overuse of over-the-counter nasal decongestants. Examples of such sprays include Afrin, Vicks Sinex.

These sprays work by constricting the blood vessels in your nose by acting on the vessel constricting receptors in the nose. When these blood vessels contrict, nasal congestion is reduced and air can move freely through the nose.

Unfortunately these sprays work so well that patients continue to use them without addressing the initial underlying problem. On continued use, these sprays become less and less effective as the vessel constricting receptors become reduced in the nose. As a result, more sprays and at increasing frequency are needed to achieve the same initial result. Finally the nose becomes very inflammed with worsened congestion leading to the condition rhinitis medicamentosa.

This condition can be difficult to treat as the patient is convinced that they need to continue using the decongestants. However, a gradual tapering regimen of the decongestants along with concurrent nasal corticosteroids can restore normal function back to the nose. Finally by seeing a qualified Allergy & Immunology specialist, the initial cause of the problem can be accurately diagnosed and appropriately treated.

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Pollen-food allergy syndrome

Ragweed

Patients who have allergy to ragweed pollen can experience itching of the lips , mouth and throat when they eat fruits such as melons. Sometimes, itchy bumps can develop in the mouth within minutes after eating such fruits.

This condition is described as oral allergy syndrome. In this condition, when a person develops allergy to ragweed pollen,  allergy antibodies (IgE) to ragweed is made by the immune system. When these antibodies react to ragweed pollen in the nose, allergic rhinitis results. Sometimes, these same antibodies will react to fruit containing similar allergens found in both the fruit and the ragweed pollen. So when a person eats such fruit, the same allergic reaction that occurs in the nose is occuring in the mouth. Depending on the individual, symptoms can range from mild (itching) to severe (throat swelling)


Fortunately, this condition is usually mild and self limiting. Symptoms can usually be relieved by antihistamines. Cooking the fruit will also remove allergic reactions because the cooking process changes the structure of the allergens in the fruit.

However, patients should not just take antihistamines to reduce their symptoms of oral allergy syndrome in order to eat more of such fruits. There is concern that by suppressing these symptoms and eating more of the fruit, a more severe allergic reaction might occur later on. Talk to your Allergist, appropriate immunotherapy (by a board certified Allergist) has been shown to reduce the symptoms of allergic rhinitis and oral allergy syndrome.

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Allergic Rhinitis

 

Rhinitis means inflammation of the lining of the nose. The inflammation can cause the nose to be  runny, stuffy and even itchy. If the cause is due to allergies, then it is termed allergic rhinitis.

 

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