Patch testing with carbamazepine: reinduction of an exfoliative dermatitis

Epicutaneous patch testing in drug hypersensitivity syndrome (DRESS)

“…There is only one case published where patch testing induced an exfoliative dermatitis; however, it was performed using crushed tablets in pet. where final drug concentration could not be adequately controlled (26).…”

Generalized pustular psoriasis or drug-induced toxic pustuloderma? The use of patch testing

“…However false‐negative patch test results may occur and a negative result does not therefore imply that repeat exposure is safe. Patch testing is a relatively safe procedure although it is not without potential risk, development of widespread exfoliative dermatitis following patch testing to carbamazepine has been reported 11 …”

The Role of Patch Testing in Evaluating Delayed Hypersensitivity Reactions to Medications

“…Among the antibiotics, rates of positivity seem to be particularly high for beta-lactams (cephalosporins and amoxicillin in particular), pristinamycin and clindamycin [3,25,33,[34][35][36][37][38][39][40]. Some studies suggest sulfonamides and macrolides (with exception of spiramycin) may be less likely to yield positive results, possibly due to metabolites being the immunogenic culprit [34,41,42].…”

“…Other drugs with high patch positivity rates include the aromatic anticonvulsants (carbamazepine [35,41,[43][44][45] and phenytoin [46][47][48]), corticosteroids [49,50], tetrazepam [21,25,51,52], diltiazem [41,53], captopril [41], hydroxyzine [54], pseudophedrine [55,41], and heparin derivatives [56,57].…”

“…In this study, all above drugs were tested in 30% concentration in either petrolatum or aqueous medium. There are several reports for other drugs where patch testing induced recurrence of the original cutaneous reactions, including carbamazepine implicated in an exfoliative dermatitis [35], acetaminopheninduced AGEP [122], metamizole in FDE [123], ranitidine-induced DIHS [124], pseudoephedrine implicated in SDRIFE [125], and pristinamycin-induced AGEP requiring systemic corticosteroids [126].…”