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A multicentre study to determine the value and safety of drug patch tests for the three main classes of severe cutaneous adverse drug reactions: Drug patch tests for SCAR

Barbaud, A., Collet, E., Milpied, B., Assier, H., Staumont, D., Avenel-Audran, M., Grange, A., Amarger, S., Girardin, P., Guinnepain, M.-T., Truchetet, F., Lasek, A., Waton, J., on behalf of the Toxidermies group of the French Society of Dermatology·2013·British Journal of Dermatology

Abstract

BACKGROUND: Drug patch tests (PTs) can reproduce delayed hypersensitivity to drugs and entail a moderate re-exposure of patients to offending drugs. OBJECTIVES: To determine the value of PTs for identifying the responsible drug in severe cutaneous adverse drug reactions (SCARs) such as acute generalized exanthematous pustulosis (AGEP), drug reaction with eosinophilia and systemic symptoms (DRESS) and Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN). METHODS: In a multicentre study, PTs were conducted on patients referred for DRESS, AGEP or SJS/TEN within 1 year of their SCAR. All drugs administered in the 2 months prior to and the week following the onset of the SCAR were tested. RESULTS: Among the 134 patients included (48 male, 86 female; mean age 51·7 years), positive drug PTs were obtained for 24 different drugs. These included positive tests for 64% (46/72) of patients with DRESS, 58% (26/45) of those with AGEP and 24% (4/17) of those with SJS/TEN, with only one relapse of AGEP. The value of PTs depended on the type of drug and the type of SCAR (e.g. carbamazepine was positive in 11/13 DRESS cases but none of the five SJS/TEN cases). PTs were frequently positive for beta lactams (22 cases), pristinamycin (11 cases) and in DRESS with pump proton inhibitors (five cases), but were usually negative for allopurinol and salazopyrin. Of 18 patients with DRESS, eight had virus reactivation and positive PTs. In DRESS, multiple drug reactivity was frequent (18% of cases), with patients remaining sensitized many years later. CONCLUSIONS: PTs are useful and safe for identifying agents inducing SCAR.

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Metadata

Authors
Barbaud, A., Collet, E., Milpied, B., Assier, H., Staumont, D., Avenel-Audran, M., Grange, A., Amarger, S., Girardin, P., Guinnepain, M.-T., Truchetet, F., Lasek, A., Waton, J., & on behalf of the Toxidermies group of the French Society of Dermatology
Venue
British Journal of Dermatology
Published
2013-02-28
Volume
168
Issue
3
Pages
555-562
ISSN
0007-0963 (ISSN-L)
OpenAlex
W1901880560
Cited by
398
References
16
FWCI
11.36
Type
journal article
Language
en
Open access
closed

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CoChat. (2026). Citation check: A multicentre study to determine the value and safety of drug patch tests for the three main classes of severe cutaneous adverse drug reactions: Drug patch tests for SCAR. https://app.cochat.ai/papers/10.1111/bjd.12125
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Barbaud, A., Collet, E., Milpied, B., Assier, H., Staumont, D., Avenel-Audran, M., Grange, A., Amarger, S., Girardin, P., Guinnepain, M.-T., Truchetet, F., Lasek, A., Waton, J., & on behalf of the Toxidermies group of the French Society of Dermatology. (2013). A multicentre study to determine the value and safety of drug patch tests for the three main classes of severe cutaneous adverse drug reactions: Drug patch tests for SCAR. British Journal of Dermatology. https://doi.org/10.1111/bjd.12125

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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