Patch testing in patients treated with systemic immunosuppression and cytokine inhibitors

Area of Science:

• Dermatology
• Immunology
• Allergy Testing

Background:

• Limited data exists on patch testing reliability in patients using immunosuppressive agents beyond systemic corticosteroids.
• Understanding this reliability is crucial for accurate allergy diagnosis in this population.

Purpose of the Study:

• To evaluate the ability to elicit positive patch test reactions in patients undergoing treatment with various immunomodulating agents.
• To assess the potential impact of immunosuppressive therapy on patch test outcomes.

Main Methods:

• Patch testing was performed on 38 patients receiving immunosuppressive medications including azathioprine, ciclosporin, infliximab, adalimumab, etanercept, methotrexate, mycophenolate mofetil, and tacrolimus.
• Data was collected between September 2006 and May 2009 at the St John's Institute of Dermatology.

Main Results:

• Positive patch test reactions were observed in patients taking azathioprine, ciclosporin, infliximab, adalimumab, etanercept, methotrexate, and mycophenolate mofetil.
• Specific positive reaction rates varied by agent, with notable findings in patients on ciclosporin (5/11) and methotrexate (3/4).
• Negative reactions were also noted in some patients on combination therapies.

Conclusions:

• Positive patch test reactions are achievable in patients treated with a range of immunosuppressive agents.
• The precise influence of these drugs on suppressing allergic patch test responses remains uncertain.
• Further research is necessary to establish definitive guidelines on patch test reliability in immunosuppressed individuals.