Skin tests in the diagnosis of adverse drug reactions

Stingeni, Luca; Bianchi, Leonardo; Tramontana, Marta; Pigatto, Paolo D.; Patruno, Cataldo; Corazza, Monica; Foti, Caterina; Fabbrocini, Gabriella; Micali, Giuseppe; Romita, Paolo; Napolitano, Maddalena; Hansel, Katharina

doi:10.23736/s0392-0488.20.06698-5

Cited by 27 publications

(33 citation statements)

References 125 publications

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“…Among budesonide‐positive patients, those who had never been exposed to budesonide were carefully questioned in order to determine if other CS molecules could be responsible for contact dermatitis. Patients who reported contact dermatitis to other CS molecules were patch tested with the suspected molecules.Those with positive patch test reactions 15 were classified as cross‐reacting patients.…”

Section: Methodsmentioning

confidence: 99%

Patch testing of budesonide in Italy: The SIDAPA baseline series experience, 2018–2019

et al. 2021

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Background Budesonide was included in the European Baseline Series in 2000 as the most suitable marker forcorticosteroid hypersensitivity. In the last two decades, a decreasing trend of budesonide allergy has been observed. Objectives To estimate the prevalence of positive patch test reactions to budesonide in a large, Italian patch test population, characterizing patients according to MOAHLFA index and evaluating the benefit with extended readings of budesonide patch test. Methods Retrospective analysis of patient demographics and patch test results over a 2‐year period (2018–2019) was performed at 14 patch test clinics in Italy. Results Ninety out of 14 544 (0.6%) patients reacted to budesonide 0.01% pet.. Positive reactions were mild in 54.4% and late readings at day 7 showed new positive reactions in 37.8% of patients. The MOAHLFA index showed a significant positive association with male gender, atopic dermatitis, and age >40 years and a significant negative association with hand and face dermatitis. Conclusions We documented a low prevalence of budesonide allergy in Italy, confirming its decreasing trend recently reported in the literature. Nevertheless, budesonide needs to be maintained in the baseline series for its good ability to detect corticosteroid sensitization.

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Section: Methodsmentioning

confidence: 99%

Patch testing of budesonide in Italy: The SIDAPA baseline series experience, 2018–2019

et al. 2021

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“… 12 , 14 Symptoms may occur within seconds to 1 hour after ingestion with pathophysiology thought to be a type 1 hypersensitivity reaction in which affected individuals may react to the same group of chemicals due to a specific epitope. 14 , 15 Although studies have been done to find nonirritating skin test concentrations of acetaminophen, the validity of skin testing is unknown at this point in time, and there is no standard skin testing concentration. 7 Thus, the gold standard is to evaluate individuals with a history of a concerning type 1 hypersensitivity reaction to acetaminophen with an oral-based provocation challenge, which is what we performed in our patient.…”

Section: Discussionmentioning

confidence: 99%

A case of delayed maculopapular eruption to ibuprofen and acute urticaria to acetaminophen

Wong

Sandoval

Naderi

2021

SAGE Open Medical Case Reports

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We present the unique case of a 33-year-old male referred to our clinic in search of analgesic options who was found to have a delayed hypersensitivity reaction to ibuprofen manifesting as a maculopapular rash and acute urticaria to acetaminophen. Non-steroidal anti-inflammatory drugs are associated with predictable reactions as well as immunoglobulin E-mediated reactions or T-cell mediated reactions. This case highlights the importance of knowledge of the different types of reactions to non-steroidal anti-inflammatory agents as well as the risk of cross reactivity. Delayed reaction to a single non-steroidal agent is rare; urticaria to acetaminophen is very rare. This is the first report we have found in the literature where one individual has a delayed reaction manifesting as rash to ibuprofen as well as urticaria to acetaminophen. We challenged our patient to aspirin which helped identify that his delayed reaction was only to ibuprofen and urticaria only to acetaminophen. The case also highlights the importance of an oral provocation challenge when no contraindications exist which helped us find that he could take celecoxib and avoid narcotics as initial therapy.

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“…On D2 and D4 a strong positive reaction (++) to ceftriaxone was documented with infiltrated erythema and pustules (Figure 1D). 6 The patient refused patch test biopsy.…”

Section: Case Reportmentioning

confidence: 99%

Severe adverse drug reaction in SARS‐CoV‐2 infection: AGEP induced by ceftriaxone and confirmed by patch test

et al. 2021

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Skin tests in the diagnosis of adverse drug reactions

Cited by 27 publications

References 125 publications

Patch testing of budesonide in Italy: The SIDAPA baseline series experience, 2018–2019

Patch testing of budesonide in Italy: The SIDAPA baseline series experience, 2018–2019

A case of delayed maculopapular eruption to ibuprofen and acute urticaria to acetaminophen

Severe adverse drug reaction in SARS‐CoV‐2 infection: AGEP induced by ceftriaxone and confirmed by patch test

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