Patch Testing in Adverse Drug Reactions

Gonçalo, Margarida; Bruynzeel, Derk P.

doi:10.1007/978-3-030-36335-2_26

Cited by 3 publications

(6 citation statements)

References 121 publications

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“…Provocation test, intradermal test or skin prick test are of significant value, but they are having higher risk to re-precipitate life-threatening reaction. 6,7 In this study, the most common underlying diseases in this study was tuberculosis (4/14 patients), that gave maculopapular eruption. All of them received antituberculosis drugs, that may consist of ofloxacin, ethambutol, dapsone, rifampicin, ofloxacin, isoniazid or pirazinamide.…”

Section: Discussionmentioning

confidence: 63%

“…Genetic polymorphisms can determine changes in gene expression or gene function that affect the immune response, such as the Human Leukocyte Antigen (HLA) gene, which forms a specific type of immunological system-mediated drug eruption. 7,17,18 The negative result of DPT did not exclude the possibility of hypersensitivity reaction in CADR. If the DPT result was negative, other examination such as drug provocation test should be considered.…”

Section: Discussionmentioning

confidence: 99%

“…The sensitivity of DPT also depends on the rute of administration, duration, dose, macromolecules size and hapten of the drugs. 6,7 Negative result of DPT in CADR occured in 30-50%. Negative result of CADR may be caused by drug metabolite which did not appear after procedure (drug metabolite appeared after the drug was metabolized in the liver), no immunological involvement, low drug bioavaibility or low drug penetration in DPT.…”

Section: Discussionmentioning

confidence: 99%

“…Drug patch test (DPT) is a test, which is performed to CADR patient, using suspected drug materials to determine the culprit drug. 6,7 A study by Damayanti et al showed the incidence of severe CADR (SCADR) at dr. Soetomo Hospital ward was 14 patient in 2015; consist of 10 SJS cases, 2 TEN cases and 2 AGEP cases. Other study by Anggraeni et al showed the incidence of CADR at Dermatology and Venereology Outpatient Clinic Dr. Soetomo Hospital Surabaya in 2015 was 87 from 17.871 patient (0.48%); consist of maculopapular eruption (56.32%), SJS/TEN (17.24%) and FDE (17.24%).…”

Section: Introductionmentioning

confidence: 99%

“…There are still a few literature discussing the clinical relevance in DPT. 6,7 This study evaluates the clinical relevance between anamnesis and DPT result in patient with history of CADR. This study was a retrospectivedescriptive study, collecting secondary data from medical record of DPT procedure in CADR patient in one year in Dermatology and Venereology Outpatient Clinic Dr. Soetomo General Academic Hospital.…”

Section: Introductionmentioning

confidence: 99%

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Drug Patch Test as a Diagnostic Test to Determine the Culprit Drug of Cutaneous Adverse Drug Reaction (CADR)

Damayanti,

Hari Sukanto,

Marsudi Hutomo

et al. 2021

Indian Journal of Forensic Medicine & Toxicology

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Background: Cutaneous Adverse Drug Reaction (CADR) is a frequent problem in clinical practice since there were new drugs or drug misuse, which leads to high morbidity and mortality rate. It is often difficult to determine the offending drug only from the history. Provocation test, intradermal test or skin prick test are of significant value, but having higher risk to re-precipitate life-threatening reaction. Drug patch test (DPT) is a test, which is performed to CADR patient to determine the culprit drug. The main advantages of DPT are, it gives rarely adverse reaction and any commercialized form of drugs can be used.Methods: This is a retrospective study, aimed to analize the clinical relevance between anamnesis and DPT result in patient with history of CADR. All patient, who were performed with DPT in one year period in Dr. Soetomo General Academic Hospital Surabaya Indonesia, were evaluated in this study.Results: There were 14 patients with history of CADR, who performed DPT; consist of 7 maculopapular eruption cases, 4 Stevens-Johnson Syndrome (SJS) cases, 1 Fixed Drug Eruption (FDE) case, 1 Acute Generalized Exanthematous Pustulosis (AGEP) case and 1 Drug Reaction with Eosinophilia and Systemic Reaction (DRESS) case. There were 9 patients (64.3 %), who got positive result of DPT. The relevance between anamnesis and positive result of DPT were shown in 8 patient (88.9%) of 9 patient with positive DPT result. Conclusion:DPT has important role in identifying the culprit drug in CADR, especially when multiple drugs are involved.

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Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Drug Patch Test as a Diagnostic Test to Determine the Culprit Drug of Cutaneous Adverse Drug Reaction (CADR)

Damayanti,

Hari Sukanto,

Marsudi Hutomo

et al. 2021

Indian Journal of Forensic Medicine & Toxicology

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Patch Testing With Benzophenone-3 and -4: The North American Contact Dermatitis Group Experience, 2013–2020

et al. 2023

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Positive drug patch tests and the acute cutaneous adverse drug reaction share many histopathologic features

Gonçalo¹,

Flor²,

Cardoso³

2023

PJDV

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Patch testing (PT) has been used to evaluate the culprit drug and cross-reactive chemicals in non-immediate cutaneous adverse drug reactions (CADR), but histopathology of patch tests is seldom performed. With the objective of characterizing the patterns of positive drugs patch tests in correlation with the acute skin reaction, we performed skin biopsies in 16 patients with different CADR, five cases of acute generalized exanthematous pustulosis (AGEP), six cases of maculopapular exanthema (MPE), four cases of drug reaction with eosinophilia and systemic symptoms (DRESS) and one case of toxic epidermal necrolysis (TEN). Particular macroscopic features of drug patch tests included pustules, particularly in AGEP, and epidermal necrosis in TEN and on histopathology, we highlight the occurrence of subcorneal spongiform pustules in AGEP, full-thickness epidermal necrolysis in the case of TEN and vacuolization of basal cells, lymphocyte exocytosis with occasional necrotic keratinocytes and a perivascular and interstitial lymphocyte infiltrate both in DRESS and MPE, although less intense in the latter. Similarities between the acute eruption and the patch test suggest the patch test can be considered a form of localized drug provocation test that can be used to further investigate the pathophysiology of CADR.

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Patch Testing in Adverse Drug Reactions

Cited by 3 publications

References 121 publications

Drug Patch Test as a Diagnostic Test to Determine the Culprit Drug of Cutaneous Adverse Drug Reaction (CADR)

Drug Patch Test as a Diagnostic Test to Determine the Culprit Drug of Cutaneous Adverse Drug Reaction (CADR)

Patch Testing With Benzophenone-3 and -4: The North American Contact Dermatitis Group Experience, 2013–2020

Positive drug patch tests and the acute cutaneous adverse drug reaction share many histopathologic features

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