Allergy Skin Prick Testing (OHIP COVERED)

We test for environmental and food allergies for both pediatrics and adult patients.

A skin prick test, also known as a puncture or scratch test, detects immediate allergic reactions to up to 50 different substances in a single session. This test is commonly used to identify allergies to pollen, mold, pet dander, dust mites, and certain foods. For adults, the test is typically performed on the forearm, while for children, it may be conducted on the upper back.

Allergy skin tests are minimally invasive and not painful. The testing involves the use of small poking device that barely penetrate the skin’s surface, causing no bleeding and only mild, brief discomfort, hence the word “scratch” test. After cleaning the test site with alcohol, a licensed health care provider or clinical assistant will make small marks on your skin that contain a drop of each allergen extract next to each mark. Once it has prick into the skin’s surface, it will produce a reaction or none!

To ensure accurate results, two control substances are also applied to your skin:

  • Histamine: Typically causes a skin response in most people. If there’s no reaction, the test might not reveal an allergy even if one exists
  • Glycerin or saline: These substances usually do not cause a reaction. If they do, it may indicate sensitive skin, requiring cautious interpretation of the test results

Approximately 20-30 minutes after the pricks, our licensed providers will check your skin for allergic reactions. If you are allergic to any of the tested substances, a raised, red, itchy bump (wheal) will appear, resembling a mosquito bite. The size of the bump will be measured and recorded to help determine your allergies. Results will be shared with you and your referring provider.

Patch Testing for Allergy and Contact Dermatitis (OHIP Covered)

Patch testing is a specialized diagnostic procedure used to identify allergies caused by skin contact with specific substances, such as fragrances, metals, preservatives, or chemicals. This test helps pinpoint triggers for contact dermatitis, a condition characterized by itchy, red, and inflamed skin. Unlike skin prick tests, patch testing focuses on delayed allergic reactions and involves applying small amounts of potential allergens to the skin using adhesive patches. These patches remain in place for 48 hours, with results read over a series of appointments.

Our clinic offers comprehensive patch testing services to help uncover the root cause of your skin allergy and create a personalized treatment plan.

Penicillin Allergy Testing

Immediate allergic reactions to penicillins typically occur quickly (less than an hour) after receiving a dose of the medication, and often occur in patients who have tolerated previous courses of penicillin without issue. Symptoms frequently involve the skin and include:
•    Hives (also known as welts or urticaria, a raised, itchy rash)
•    Swelling commonly around the face and extremities such as hands and feet)

Treatment of these reactions usually involves an antihistamine and sometimes an oral or injected corticosteroid.

In rare cases, more serious reactions that suggest anaphylaxis can occur, including the following:
•    Swelling of the tongue, throat and lips
•    Respiratory symptoms such as difficulty breathing, coughing, chest tightness, wheezing
•    Light-headedness, loss of consciousness (caused by low blood pressure)

These symptoms require immediate treatment with epinephrine, which can be given with an autoinjector if available, and/or at the nearest emergency room or by calling Emergency Medical Services. Additional treatments may include albuterol to treat respiratory symptoms, IV fluids, and corticosteroids.

Penicillin allergy can be evaluated by an allergist / immunologist, who will obtain a careful history and perform skin testing.

This test involves pricking the skin with two forms of penicillins (each of which mimics the forms of penicillin that are found in the blood when a patient takes the drug) and a subsequent intra-dermal test (placing a small amount of each form of penicillin just under the skin). If these tests are negative, it is very unlikely that a penicillin allergy is present. In many instances after negative testing, a dose of an oral penicillin is also given, followed by an observation period. If there is no reaction, the patient is not at risk of having a serious immediate reaction and penicillins can be used thereafter. It typically takes about 2 to 3 hours to perform all of the testing.

In cases of a positive penicillin test, either the skin prick or intra-dermal test will produce a red, raised bump, signifying the presence of an allergy to the medication.

Penicillins need to be avoided and a different antibiotic will be needed to treat infections. If a penicillin is needed, a desensitization procedure can be performed under the care of an allergist / immunologist to temporarily allow the drug to be used.

Oral Food Challenge (OFC)

An oral food challenge is a diagnostic procedure used to confirm or rule out a food allergy, such as peanut, tree nuts, milk, or other food allergens. It involves consuming small, measured amounts of the suspected allergen under close medical supervision. This test is particularly beneficial in addition to skin prick test or blood IgE allergy tests. We offer this for both pediatrics and adult patients.

What to Expect:

  1. Preparation:
    • Avoid all antihistamines (allergy medication) that could interfere with test results
    • Ensure you are in good health on the day of the test (e.g., no cold, fever, or respiratory issues).
  2. Testing Process:
    • During the test, you will consume small, gradually increasing doses of the allergen at regular intervals, under the supervision of our licensed allergist & immunologist along with the support of our clinical assistants and licensed physician assistants, nurses, and/or nurse practitioners
    • You’ll remain under observation to monitor for any signs of an allergic reaction, which may include hives, swelling, nausea, or difficulty breathing
  3. Duration:
    • The oral challenge typically lasts between 4–6 hours, depending on your response
    • Please be prepared to stay half the day for your appointment
  4. Outcome:
    • If you tolerate the final dose without a reaction, the allergen is unlikely to cause you harm in normal dietary amounts, and your allergy may be ruled out – this gives a lot of our patients a peace of mind!
    • If a reaction occurs, your care team will manage it promptly and provide further guidance and help you manage with a peace of mind

An oral food challenge is to help gain clarity about food allergies.

This service is currently not being provided due to Covid.

Asthma Testing

It is often not easy for a doctor to make a diagnosis of asthma, as symptoms often come and go. That’s why you should always talk with a doctor preferably an allergist or pulmonologist – who is familiar with asthma diagnosis and treatment guidelines.

To  determine whether asthma or some other cause is responsible for your symptoms, your doctor will use  your family and symptom history; a physical exam and medical tests.

Spirometry Test

If signs begin to point to asthma, your doctor may use a computerized device called a spirometer to check how well your lungs are working. Spirometry is a type of pulmonary function test. You’ll be asked to take a deep breath in and then breathe out as hard as you can into the machine. The spirometer shows the amount of air you are able to breathe in and out and how fast you did it over a certain time period. If your airways are inflamed and narrowed, or if the muscles around your airways tighten up, the results will show it.

Other medical tests may be used to confirm a diagnosis of asthma.

  • Tests for related conditions, such as gastroesophageal reflux disease (GERD) or obstructive sleep apnea
  • A test for sinus disease
  • Allergy testing (skin prick or blood) to determine if allergens are triggering asthma
  • A chest x-ray or electrocardiogram to check for foreign objects in the airways or signs of separate lung or heart disease

Allergy Immunotherapy (Allergy Injections)

Allergen immunotherapy is the repeated administration of allergen extracts to people who have known allergies in order to provide long-term relief of symptoms and improvement in quality of life during subsequent natural allergen exposure.

Allergy shots also known as subcutaneous immunotherapy (SCIT), are the most commonly used and most effective form of allergy immunotherapy. This is the only treatment available that actually changes the immune system, making it possible to prevent the development of new allergies and asthma.

Allergy tablets are a form of sublingual immunotherapy (SLIT) that offer a way to treat certain allergies without shots. Like shots, tablets reduce symptoms by helping the body build resistance to the effects of an allergen. Unlike shots, tablets only treat one type of allergen and do not prevent the development of new allergies and asthma.

Allergy drops are another form of SLIT and work the same way as tablets. Drops are widely accepted and used in many countries around the world.

Oral Immunotherapy (OIT) for Peanut Allergy

Please note that this is different from Oral Challenge. This is a treatment that is currently not covered by OHIP.

Oral Immunotherapy (OIT) is a treatment designed to build your body’s tolerance to peanuts, reducing the risk of severe allergic reactions from accidental exposure. It involves the gradual introduction of small, increasing doses of peanut protein under the guidance of our licensed allergy & immunology specialist.

What to Expect:

  1. Initial Consultation:
    • Our allergist will assess your medical history and determine if OIT is suitable for you
  2. Starting Dose:
    • The first dose of peanut protein is given in a controlled clinic setting under the supervision of our licensed allergist along with a substantial support staff that consist of clinical assistants and licensed physician assistants, nurses or nurse practitioners
    • You’ll be monitored closely for signs of a reaction, such as hives, swelling, or breathing difficulties
  3. Updosing Phase:
    • Over several months, you will return to the clinic for scheduled “updosing” appointments, where the dose is gradually increased
    • Between visits, you’ll take a daily maintenance dose at home as prescribed
  4. Maintenance Phase:
    • Once the target dose is reached, you will continue a consistent daily maintenance dose to sustain tolerance
  5. Safety Measures:
    • Always carry an epinephrine auto-injector in case of an allergic reaction.

Benefits of OIT:

  • Reduces the risk of severe reactions from accidental peanut exposure
  • Provides peace of mind and improved quality of life

Important Notes:

OIT is not a cure but a desensitization process that allows most patients to tolerate small amounts of peanuts safely as OIT empowers patients to manage their peanut allergy with confidence, offering a path to greater food freedom and reduced anxiety

Regular follow-ups with our clinic are essential to monitor your progress and adjust the treatment plan as needed

Understanding Rheumatology
Rheumatology focuses on diagnosing and treating diseases that affect the joints, muscles, and immune system. Many rheumatologic conditions are autoimmune, meaning the immune system mistakenly attacks healthy tissues, leading to inflammation, pain, and reduced mobility.

Common Rheumatology Diseases We Treat:

  • Rheumatoid Arthritis (RA): A chronic autoimmune condition causing joint pain, swelling, and deformity.
  • Psoriatic Arthritis (PsA): Inflammation of joints, often associated with psoriasis.
  • Ankylosing Spondylitis (AS): A type of arthritis affecting the spine and sacroiliac joints, causing stiffness and pain.
  • Polymyalgia Rheumatica (PMR): An inflammatory condition causing muscle stiffness, particularly in the shoulders and hips.
  • Lupus (Systemic Lupus Erythematosus – SLE): An autoimmune disease that can impact joints, skin, kidneys, and other organs.
  • Gout: A type of arthritis caused by excess uric acid, leading to painful joint flare-ups.
  • Sjögren’s Syndrome: An autoimmune disorder primarily affecting moisture-producing glands, causing dry eyes and mouth.
  • Osteoarthritis: A degenerative joint disease due to wear and tear, leading to joint pain and stiffness.

Symptoms of Rheumatology Diseases:

  • Joint pain, swelling, and stiffness
  • Fatigue
  • Muscle weakness
  • Dry eyes and mouth
  • Back pain or spinal stiffness

If you are experiencing any of these symptoms, speak with your healthcare provider about a referral to a rheumatologist. Early diagnosis can help manage symptoms and prevent joint damage. 

Managing rheumatologic diseases often requires a combination of medication, lifestyle changes, and specialized procedures. Our clinic offers comprehensive, evidence-based treatments tailored to each patient’s condition and needs. Although these are options presented for educational purposes only, the final recommendation and treatment plan is determined by the discretion of our Rheumatologists.

Common Rheumatology / Joint PainTreatments Include:

  1. Medications or Biologic Therapy, including Biosimiliars
    • There are medications on the market that can slow disease progression and prevent joint damage and advanced treatments targeting specific parts of the immune system to reduce inflammation
  2. Joint Injections
    • Corticosteroid Injections: Reduce pain and inflammation in affected joints
    • Viscosupplementation (Hyaluronic Acid): Provides lubrication to improve joint mobility, especially in osteoarthritis
    • Platelet-Rich Plasma (PRP) Therapy – PRP joint injections involve drawing a small amount of your blood, isolating the platelet-rich plasma through a specialized process, and injecting it into the affected joint. It is a form of regenerative medicine.
  3. Lifestyle and Supportive Treatments
    • Exercise and Physical Therapy
    • Dietary Modifications
    • Patient Education and Support

Our Approach:
At our Mississauga rheumatology clinic, we focus on providing a holistic treatment plan that aims to reduce symptoms, slow disease progression, and enhance your overall well-being. Talk to your doctor about a referral to explore the best treatment options for you.