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key in determining which patient re- ally needs the treatment. "Ninety- five percent of people who think they are allergic to penicillin actually are not," according to the doctor. She says it is also important to deter- mine what other medications the pa- tient is taking and what over-the counter herbal remedies, vitamins and supplements they use in case the combination may be contributing to an adverse reaction. And some aller- gic reactions to drugs—particularly rashes, hives, and asthma—can re- semble certain diseases. Patients are encouraged to focus on the sus- pected drug, and take pictures of any rash or other physical symptoms associated with the reaction. Eventu- ally, a skin test might be recom- mended to deterzmine if the patient is truly allergic. However, there is an increasing in- cidence of asthma, rhinitis/sinusitis, anaphylaxis and other allergic condi- tions over the past decades. "One of the theories explaining this is the "Hygiene Theory", which posits that in developed countries such as the USA, a lack of early childhood expo- sure to infectious agents such as bac- teria, viruses, or parasites, increases susceptibility to allergic diseases. As to what does Dr. de Asis see as a future direction in her field? "We have exciting new immunologic/bio- logic therapies for severe asthma, eczema, food allergies. It is amazing how far we have come in improving patients' health and quality of life for so many conditions." www.rballergy.com www.nyackhospital.org September/October 2017 HOOK MAGAZINE 51 g However, there is an increasing incidence of asthma, rhinitis/ sinusitis, anaphy- laxis and other allergic conditions over the past decades. "One of the theories explaining this is the "Hygiene Theory", which posits that in devel- oped countries such as the USA, a lack of early child- hood exposure to infectious agents such as bacteria, viruses, or para- sites, increases susceptibility to allergic diseases. Aerial photograph by Daniel Spitzer, MD

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