Video Experimental Relacionado

Updated: Apr 30, 2026

An In Vitro Skin Irritation Test SIT using the EpiDerm Reconstructed Human Epidermal RHE Model

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Published on: July 14, 2009

Pruebas epicutáneas y de provocación de fármacos en reacciones cutáneas graves: una experiencia de 20 años en un solo

Zohra Chadli¹, Khadija Mansour¹, Ghada Jaouahdou¹

¹Department of Pharmacology, University Hospital of Monastir, Faculty of Medicine, University of Monastir, Monastir, Tunisia.

Contact dermatitis

|February 19, 2026

Abstracto

Background:

Identifying and discontinuing the offending drug(s) in severe cutaneous adverse drug reactions (SCARs) can be particularly challenging, especially in polymedicated patients. For many years, patch tests (PTs) were considered the only safe and reliable method for investigating SCARs. However, intradermal tests (IDTs), once thought to be contraindicated, have recently garnered increasing interest. Similarly, oral provocation tests, previously avoided due to safety concerns, are now being more frequently employed in SCAR assessment.

Methods:

We analysed SCARs reported at Monastir University Hospital. Allergy work-up included PTs, IDTs and oral provocation tests, with evaluation of cross-reactivity, co-sensitisation and neo-sensitization.

Results:

We identified 190 SCAR episodes in 188 patients. DRESS was most frequent (75%), followed by AGEP (19%) and SJS/TEN (6%). Causative drugs were identified in 97.9% of cases, mainly anti-infectives. Skin tests were conducted in 69.5% of patients, yielding positivity rates of 49% for PTs and 77% for IDTs in DRESS, and 52% and 66%, respectively, in AGEP. Cross-reactivity was noted in 7% of DRESS and 11.1% of AGEP, while neo-sensitization was documented in 32.5% of DRESS patients.

Conclusion:

Allergological investigations are valuable tools in SCAR management, enabling identification of culprit drugs, assessment of cross-reactivity, detection of neo-sensitization and selecting safe alternatives.

Palabras clave:

AGEP DRESS SCARs SJS/TEN estudio alergológico pruebas intradérmicas pruebas de provocación oral pruebas del parche pruebas cutáneas

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