Patch testing and sensitization to multiple drugs

Liippo, Jussi; Pummi, Kati; Hohenthal, Ulla; Lammintausta, Kaija

doi:10.1111/cod.12076

Cited by 10 publications

(5 citation statements)

References 34 publications

(18 reference statements)

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Section: Discussionmentioning

confidence: 70%

“…Multiple drug hypersensitivity (MDH) has been reported in the literature with incidence rates between 10% and 18% when considering severe drug reactions proven by positive skin or in vitro tests. 3,4,11,12 Our case series suggests that hypersensitivity to antibiotics in DRESS from a nonantibiotic culprit is much more common. We confirmed this reactivity in 53% of positive patch tested patients, with four patients (patients 1, 4, 7, and 12) having similar PT reactions years later and two cases by accidental reintroduction (patients 1 and 7).…”

Section: Discussionmentioning

confidence: 81%

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Hypersensitivity to antibiotics in drug reaction with eosinophilia and systemic symptoms (DRESS) from other culprits

et al. 2020

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Background: Antibiotics have been implicated in the reactivation of exanthema and systemic involvement in drug reaction with eosinophilia and systemic symptoms (DRESS); however, it is not clear whether these patients become sensitized to the antibiotic.Objective: To evaluate if, after DRESS, patients become sensitized to antibiotics. Methods:We retrospectively reviewed the patch test (PT) data and clinical files of DRESS patients who were administered antibiotics during DRESS from other culprits.

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Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 81%

Hypersensitivity to antibiotics in drug reaction with eosinophilia and systemic symptoms (DRESS) from other culprits

et al. 2020

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“…For the diagnosis of fixed drug eruptions (FDEs), it may be recommended to do patch testing at the site of the reaction, especially if acetaminophen (paracetamol) or other NSAIDs (nonsteroidal antiinflammatory drugs) are involved as possible culprit agents . Given that patch testing has been shown to successfully detect delayed‐type sensitization to multiple related drugs , this test procedure appears to be useful (recommendation open) to confirm immunological cross‐reactivities to drugs with similar chemical structures.…”

Section: Indication For Patch Testing – First Key Questionmentioning

confidence: 99%

S3 guidelines: Epicutaneous patch testing with contact allergens and drugs – Short version, Part 1

Mahler

Nast

Bauer

et al. 2019

J Deutsche Derma Gesell

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Summary Epicutaneous patch testing is the diagnostic standard for the detection of allergic contact dermatitis. The present guidelines are aimed at residents and board‐certified physicians in the fields of dermatology and allergology as well as other medical specialties involved in establishing the indication for patch testing and its execution in patients with contact dermatitis and other forms of delayed‐type hypersensitivity. The target audience also includes other health care providers and insurance funds. Based on a systematic literature search and a formal consensus process (S3), the guidelines were developed by dermatologists in collaboration with pediatricians, occupational medicine physicians, nursing staff as well as patient representatives. The systematic methodological approach and appraisal of evidence upon which the recommendations are based are outlined in a separate method report that also contains evidence tables. The guidelines address general aspects of patch testing as well as medicolegal issues. The recommendations given relate to topics such as the indication for patch testing, informed patient consent, as well as the choice of test substances, test chambers and test site, duration of exposure, reading times and interpretation of test reactions. Furthermore, recommendations are provided with respect to endogenous and exogenous factors, specific patient groups (children, pregnant women, immunosuppressed individuals) as well as possible risks and adverse events associated with patch testing using contact allergens. Note: This publication is part 1 of the short version of the S3 guidelines for “Epicutaneous patch testing using contact allergens and drugs” (registry no. 013 – 018; date: March 20, 2019; valid until December 31, 2021). Part 2 of the short version will be published in the next issue. The long version of these guidelines can be accessed at http://www.awmf.org. The method report is available as online publication (https://www.awmf.org/leitlinien/detail/ll/013-018.html) and contains the evidence tables in its appendix.

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“…For ten occupations with some of the highest numbers of recognised occupational hand eczema patients in 2010 [28], the information will be standardised and written information will be available (Table 2). In case of other occupations, or with specific problems, a work visit will be offered and arranged.…”

Section: Methodsmentioning

confidence: 99%

Protocol for a randomised trial on the effect of group education on skin-protective behaviour versus treatment as usual among individuals with newly notified occupational hand eczema – the Prevention of Hand Eczema (PREVEX) Trial

et al. 2013

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BackgroundThe incidence of occupational hand eczema is approximately 0.32 per 1,000 person years. The burden of the disease is high, as almost 60% has eczema-related sick leave during the first year after notification, and 15% are excluded from the workforce 12 years after disease onset. New treatments and prevention strategies are needed.Methods/DesignTrial design: The PREVEX trial is a randomised, parallel-group, superiority trial.Participants: All individuals from the Capital Region of Denmark and Region Zealand with a suspected occupational skin disorder notified to the National Board of Industrial Injuries between June 2012 and December 2013 are invited to participate in the trial. Inclusion criteria are: self-reported hand eczema and informed consent. Exclusion criteria are: age <18 years or >65 years; permanent exclusion from the workforce; inability to understand the Danish language; any serious medical condition; and lack of written informed consent. We plan to randomise 742 participants. Interventions: The experimental intervention is an educational course in skin-protective behaviour and written information about skin care related to the participants' specific occupation. Also, a telephone hotline is available and a subgroup will be offered a work-place visit. The experimental and the control group have access to usual care and treatment. All participants are contacted every eighth week with questions regarding number of days with sick leave or other absence from work. 12 months after randomisation follow-up is completed. Objective: To assesses the effect of an educational course versus treatment as usual in participants with newly notified occupational hand eczema. Randomisation: Participants are centrally randomised according to a computer-generated allocation sequence with a varying block size concealed to investigators. Blinding: It is not possible to blind the participants and investigators, however, data obtained from registers, data entry, statistical analyses, and drawing of conclusions will be blinded. Outcomes: The three co-primary outcomes, assessed at 12 months, are: total number of self-reported days with sick leave; health-related quality of life; and subjective assessment of hand eczema severity. Explorative outcomes are: self-reported eczema-related sick leave, absence from work registered by the DREAM-register and by self-report, risk behaviour, knowledge of skin protection and performance management (self-efficacy; and self-evaluated ability to self-care).DiscussionThe PREVEX trial will be the first individually randomised trial to investigate the benefits and harms of group-based education in patients with newly notified occupational hand eczema.Trial registrationClinicalTrials.gov Identifier: NCT01899287

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Patch testing and sensitization to multiple drugs

Cited by 10 publications

References 34 publications

Hypersensitivity to antibiotics in drug reaction with eosinophilia and systemic symptoms (DRESS) from other culprits

Hypersensitivity to antibiotics in drug reaction with eosinophilia and systemic symptoms (DRESS) from other culprits

S3 guidelines: Epicutaneous patch testing with contact allergens and drugs – Short version, Part 1

Protocol for a randomised trial on the effect of group education on skin-protective behaviour versus treatment as usual among individuals with newly notified occupational hand eczema – the Prevention of Hand Eczema (PREVEX) Trial

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