Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Oct;91(4):321-326.
doi: 10.1111/cod.14654. Epub 2024 Jul 30.

Patch tests in non-immediate cutaneous adverse drug reactions: Late readings on Day 4 is more sensitive than on Day 3

Ilaria Matei  1 , Thomas Bettuzzi  1   2   3 , Amandine Weill  1 , Gwendeline Gener  1 , Kamar Bel Hareth  1 , Fleck Margaux  1 , Muriel Verlinde-Carvalho  4 , Muriel Paul  2   4 , Saskia Ingen-Housz-Oro  1   2   3 , Haudrey Assier  1   3
Affiliations

Patch tests in non-immediate cutaneous adverse drug reactions: Late readings on Day 4 is more sensitive than on Day 3

Ilaria Matei et al. Contact Dermatitis. 2024 Oct.

Abstract

Background: Patch tests (PTs) are recommended to identify the culprit drug in non-immediate cutaneous adverse drug reactions (NICADRs). We recently reported that, in patients with NICADRs, a unique reading of PTs at day (D)2 compared with an additional second late reading at D4 missed almost half (45.3%) of the positive PTs.

Objectives: To assess the change in sensitivity of the PT reading on D4 compared with the reading on D3.

Methods: We performed a retrospective (July 2020-June 2023) monocentric study of patients who had PTs with two readings for a NICADR. We compared reading on D3 and the second reading on D4 for the suspected drug (primary outcome) and for the related drugs tested simultaneously (secondary outcome).

Results: During the study period, 249 patients underwent patch testing with D3 and D4 readings. Regarding the primary outcome, the first reading at D3 was positive for 13.7% of patients, and the reading at D4 for 24.9% of patients (p < 0.0001). Regarding the secondary outcome, only 9.6% of patients had all their positive PT at D3 compared with 24.9% of patients at D4 (p < 0.0001). Considering the evaluated drug classes, no statistical difference was observed. However, we highlight that D3 reading detected all positive carbamazepine PTs (n = 3) while positive clindamycin PTs (n = 4) were identified only with the help of the second reading on D4.

Conclusion: This study showed that, an additional D4 reading compared with a single D3 reading enhanced the sensitivity of PTs to identify culprit drugs and related. Further studies should replicate these findings and evaluate the medico-economic balance and safety of a single reading of PTs on D4.

Keywords: adverse drug reactions; cross‐reactions; epidemiology; patch tests.

PubMed Disclaimer

References

REFERENCES

    1. Bhujoo Z, Ingen‐Housz‐Oro S, Gener G, et al. Patch tests in nonimmediate cutaneous adverse drug reactions: the importance of late readings on day 4. Contact Dermatitis. 2022;86(1):29‐33.
    1. Brockow K, Ardern‐Jones M, Mockenhaupt M, et al. EAACI position paper on how to classify cutaneous manifestations of drug hypersensitivity. Allergy. 2019;74(1):14‐27.
    1. Kardaun SH, Kuiper H, Fidler V, Jonkman MF. The histopathological spectrum of acute generalized exanthematous pustulosis (AGEP) and its differentiation from generalized pustular psoriasis. J Cutan Pathol. 2010;37(12):1220‐1229.
    1. Sidoroff A, Halevy S, Bavinck JNB, Vaillant L, Roujeau JC. Acute generalized exanthematous pustulosis (AGEP) – a clinical reaction pattern: acute generalized exanthematous pustulosis. J Cutan Pathol. 2001;28(3):113‐119.
    1. Arimone Y, Bidault I, Dutertre JP, et al. Updating the French method for the causality assessment of adverse drug reactions. Therapie. 2013;68(2):69‐76.

LinkOut - more resources