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Related Experiment Video

Updated: Jul 18, 2026

Basophil Activation Test for Investigation of IgE-Mediated Mechanisms in Drug Hypersensitivity

Basophil Activation Test for Investigation of IgE-Mediated Mechanisms in Drug Hypersensitivity

Published on: September 16, 2011

Fixed drug eruption: topical provocation and subsequent phenomena.

Atiya Mahboob¹, Tahir Saeed Haroon, Zafar Iqbal

¹Department of Dermatology, Shaikh Zayed FPGMI, Lahore. saleemi54@yahoo.com

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP

|November 28, 2006

Summary

Topical provocation tests, especially with a 5% drug concentration, are effective in identifying the specific medication causing fixed drug eruptions (FDE). This method offers a reliable first-line investigation for diagnosing FDE and pinpointing the causative agent.

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Last Updated: Jul 18, 2026

Basophil Activation Test for Investigation of IgE-Mediated Mechanisms in Drug Hypersensitivity

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Published on: September 16, 2011

Precision Implementation of Minimal Erythema Dose (MED) Testing to Assess Individual Variation in Human Inflammatory Response

Precision Implementation of Minimal Erythema Dose (MED) Testing to Assess Individual Variation in Human Inflammatory Response

Published on: October 3, 2019

Area of Science:

Dermatology
Pharmacology
Clinical Medicine

Background:

Fixed Drug Eruption (FDE) is a cutaneous adverse drug reaction characterized by recurrent lesions upon re-exposure to the causative agent.
Accurate identification of the incriminated drug is crucial for patient management and preventing future reactions.

Purpose of the Study:

To evaluate the diagnostic utility of topical provocation testing (TPT) in identifying the drug responsible for Fixed Drug Eruption.
To compare the effectiveness of different drug concentrations in TPT for FDE diagnosis.

Main Methods:

A quasi-experimental study involving 305 clinically diagnosed FDE patients.
Topical provocation tests were performed using 1%, 2%, and 5% drug concentrations in white soft paraffin on normal skin.
Positive responses were observed for 48 hours; oral provocation was used for non-reactive cases.

Main Results:

The 5% drug concentration yielded a significantly higher positive response rate (312/523) compared to 1% (12/316) and 2% (28/422) concentrations (p < 0.000).
Sulphamethoxazole at 5% concentration showed a 91% sensitivity rate in detecting the causative agent.
Novel phenomena like lesion reactivation, marching, see-sawing, and lightening were observed during testing.

Conclusions:

Topical provocation testing with a 5% drug concentration on normal skin is a valuable and effective first-line investigation for diagnosing Fixed Drug Eruption.
The study highlights the importance of higher drug concentrations for improved diagnostic yield in TPT for FDE.