In Vitro and In Vivo Tests in Cutaneous Adverse Drug Reactions

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.