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Patch testing with the standard series when receiving immunosuppressive medications.

Ashley B Wentworth1, Mark D P Davis

  • 1From the *Mayo Clinic College of Medicine, Mayo Medical School; and †Department of Dermatology, Mayo Clinic, Rochester, MN.

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Patch testing for allergic contact dermatitis can be valid in patients taking immunosuppressants. Positive patch test results were observed during methotrexate therapy, though the extent of immune suppression remains unclear.

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Area of Science:

  • Dermatology
  • Immunology
  • Allergy Testing

Background:

  • The validity of patch testing for allergic contact dermatitis in patients on immunosuppressants is debated.
  • Corticosteroids are known to suppress patch test reactions.
  • The impact of increasingly used immunomodulators on patch testing requires investigation.

Purpose of the Study:

  • To report patch test results in patients undergoing immunosuppressant therapy.
  • To review existing literature on immunosuppressants and their effect on patch testing.

Main Methods:

  • Retrospective review of patient data.
  • Patch testing conducted using the standard series.
  • Data collected from January 1, 2008, to December 31, 2011, at Mayo Clinic.

Main Results:

  • Positive patch test results were observed in patients receiving methotrexate.
  • The degree of immune suppression by various immunosuppressants on patch test reactions was evaluated.

Conclusions:

  • Methotrexate therapy did not preclude positive patch test results.
  • The precise impact of immunosuppression on allergic contact dermatitis patch testing requires further research.