Allergic and non-allergic drug reactions require an accurate diagnostic approach, or which an oral provocation test (OPT) is essential. At present, skin tests (prick, intradermal, patch) have been validated only for a limited number of drug molecules. The place of laboratory assays in diagnosis is growing but requires further investigation due to a lack of data and standardized protocols. The place of OPTs is well recognized; they must be done under strict security conditions with consideration of contraindications. They can have several different objectives, one of which is to confirm the diagnosis of either an allergic or a non-allergic reaction, given that there are no other fully validated diagnostic means, in particular for non-steroidal anti-inflammatory drugs (NSAIDs). The other objective is to be able to propose an alternative therapy. © 2012 Elsevier Masson SAS.
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