4.5 Review

Utility and Safety of Skin Tests in Drug Reaction With Eosinophilia and Systemic Symptoms (DRESS): A Systematic Review

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Patch testing in drug reaction with eosinophilia and systemic symptoms (DRESS): A literature review

Anton C. de Groot

Summary: This article reviews the literature on positive patch test results in drug reaction with eosinophilia and systemic symptoms (DRESS). The study identified 105 drugs that have caused 536 positive patch tests in 437 DRESS patients. Carbamazepine was found to cause the most reactions, followed by amoxicillin, isoniazid, phenytoin, ethambutol, fluindione, phenobarbital, rifampicin, and ceftriaxone. Anticonvulsants, beta-lactam antibiotics, and antituberculosis agents were the drug classes causing the highest number of reactions. Patch testing showed high sensitivity for anticonvulsants, beta-lactam antibiotics, and possibly iodinated contrast media. Multiple drug hypersensitivity was found in 16% of all patients, but the true frequency may be higher.

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