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Patch testing while immunosuppressed: potential risks and benefits.

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Patch testing (PT) for allergic contact dermatitis can be affected by immunosuppressive treatments. For reliable results, perform PT without immunosuppression or use the lowest possible dose.

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Area of Science:

  • Dermatology
  • Immunology

Background:

  • Allergic contact dermatitis (ACD) is a common skin condition diagnosed by patch testing (PT).
  • Systemic inflammatory conditions like atopic dermatitis and psoriasis can coexist with ACD.
  • Immunosuppressive therapies for severe ACD and other conditions may interfere with PT results, creating uncertainty in the literature.

Approach:

  • A comprehensive literature review was conducted using PubMed and Google Scholar.
  • English-language articles relevant to the topic were included.

Key Points:

  • This review examines the impact of immunomodulating therapies on patch testing (PT) outcomes.
  • It summarizes current evidence and offers updated recommendations for common immunomodulating drugs used in patients undergoing PT.
  • The reliability of PT is generally highest when performed without immunosuppression.

Conclusions:

  • If immunosuppression cannot be avoided, maintaining the lowest possible dose is recommended.
  • It may not always be necessary to discontinue or alter immunomodulating medications before PT.