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Advances in Diagnosis and Management of Cutaneous Adverse Drug Reactions pp 247–263Cite as

In Vitro and In Vivo Tests in Cutaneous Adverse Drug Reactions

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Abstract

Done with a good practice detailed in this paper, drug skin tests are useful for the diagnosis of drug hypersensitivities (HS). Drug patch tests can be done in all cutaneous adverse drug reactions but anaphylactic shock. Done under hospital surveillance, intradermal tests with immediate readings are useful in investigating immediate HS with beta-lactams, glycopeptides, radiocontrast media, insulins, proton pump inhibitors, platinum salts, corticosteroids, and general anesthetics. For delayed HS they are useful with beta-lactams, radiocontrast media, or heparins. For immediate HS to general anesthetics, quinolones, and beta-lactams, sensitivity of basophil activation tests ranges from 22 to 86% with a good specificity. In delayed HS, no test has a good sensitivity but combine three different cellular assays may help to overcome or bypass the assumed refractoriness of PBMC of SJS/TEN patients.

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Abbreviations

AGEP:

Acute generalized exanthematous pustulosis

AO:

Angioedema

BAT:

Basophil activation test

CADR:

Cutaneous adverse drug reactions

DPTs:

Drug patch tests

DRESS:

Drug reaction with systemic symptoms

ELISpot:

Enzyme-Linked Immunosorbent Spot

FDE:

Fixed drug eruption

HS:

Hypersensitivities

IDTs:

Intradermal Drug Tests

IHS:

Immediate HS

NMBA:

Neuromuscular blocking agents

PBMC:

Peripheral blood mononuclear cells

RCM:

Radiocontrast media

SDRIFE:

Symmetrical drug-related intertriginous and flexural exanthema

SJS/TEN:

Stevens–Johnson syndrome/toxic epidermal necrolysis

UV:

Ultraviolet

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Authors and Affiliations

  1. Department of Dermatology and Allergy, Faculty of Medicine, Tenon Hospital, Sorbonne University, Paris, France

    Annick Barbaud

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  1. Annick Barbaud
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Correspondence to Annick Barbaud .

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Editors and Affiliations

  1. University of Toronto Medical School, Sunnybrook Health Sciences Centre, Toronto, ON, Canada

    Neil H. Shear

  2. Department of Dermatology, Emek Medical Center, Afula, Israel

    Roni P. Dodiuk-Gad

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Barbaud, A. (2019). In Vitro and In Vivo Tests in Cutaneous Adverse Drug Reactions. In: Shear, N., Dodiuk-Gad, R. (eds) Advances in Diagnosis and Management of Cutaneous Adverse Drug Reactions. Adis, Singapore. https://doi.org/10.1007/978-981-13-1489-6_18

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  • DOI: https://doi.org/10.1007/978-981-13-1489-6_18

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