Optimizing the Sensitivity of Patch Testing – Where We Are and Where We Want To Be
Patch testing has proven to be a valuable tool for deciphering the culprit agent for cutaneous drug reactions such as morbilliform drug eruption, drug reaction with eosinophilia and systemic symptoms and acute generalized exanthematous pustulosis. Although a safe procedure concentrations of patch test reagents have not been validated for all drugs and the sensitivity of the patch testing procedure is very much dependent on the clinical phenotype as well as the drug. The modifiers that drive differing sensitivities across drugs and phenotypes are not currently known although it is postulated that this relates to the role of specific drugs and reactive metabolites and their disposition in the skin that may relate to their chemical properties as well as antigen driven resident T cells in the skin. Historically dating back to the first use of patch testing for diagnosis of contact dermatitis procedures were explored to increase exposure of the skin to the suspected culprit product. This webinar will explore the art and science of drug patch testing and open out discussion about mechanisms to further increase the sensitivity of patch testing and utilize it as a tool to understand the mechanisms of cutaneous drug reactions.
This webinar series will be delivered by key opinion leaders in the area of delayed drug hypersensitivity syndromes, such as drug reaction with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS and TEN), acute generalized exanthematous pustulosis (AGEP), and morbilliform drug eruption (MDE), amongst others. The format will be webinars with one to four speakers and moderators per session who will deliver a topic to advance knowledge in the area (as per the topics listed and objectives below) and generate an active discussion afterwards. This discussion will identify further unmet needs and opportunities to be pursued by a specific subset of the working group in between webinars.
Each session would be 1 hour followed by 30 minutes of discussion.
- Primary Care Providers
- Nurses and Nurse Practitioners
- Physician Assistants and Other Allied Health Professionals
Upon completion of this activity, participants should be able to:
- Describe the background in clinical utility of drug patch testing as a tool to define the culprit drug associated with a cutaneous drug eruption as well as cross-reactivity patterns
- Identify the specific drugs and clinical phenotypes where patch testing may have the highest utility as a diagnostic tool
- Explain the current limitations of patch testing
- Discuss opportunities to increase the sensitivity of patch testing in clinical practice
Elizabeth J. Phillips, MD FAAAAI FIDSA
Relevant Relationships: None
Jonathan G. Peter, MD PhD
University of Cape Town/Western Cape Provincial Health
Relevant Relationships: None
Rannakoe Lehloenya, MBChB
University of Cape Town
Relevant Relationships: None
Brian Schroer, MD
Cleveland Clinic Foundation, Cleveland, OH
Relevant relationships: Sanofi, ReadySetFood: asthma & food allergy
The information disclosed by the presenters and planning committee members was reviewed in accordance with the AAAAI Disclosure Policy. All potential conflicts of interest were mitigated by the planners, faculty, and reviewers prior to their participation in the development of this activity.
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