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Schmid AA, Hungerbühler MN, Lombardo P, Boehm IB. Intradermal testing of iodinated contrast media: Should we test up to pure or with diluted compounds only? Fundam Clin Pharmacol 2024; 38:789-798. [PMID: 38481365 DOI: 10.1111/fcp.12998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 12/15/2023] [Accepted: 02/16/2024] [Indexed: 07/09/2024]
Abstract
BACKGROUND Intradermal testing (IDT) with iodinated contrast media (ICMs) is an established diagnostic tool in patients with ICM hypersensitivity. Currently, it is unclear which test concentration is the more useful one, up to pure or up to 1:10 diluted ICMs. METHODS We searched the literature database PubMed for eligible papers dealing with ICM allergy and their IDT results. We analyzed the data presented by the papers and compared the pooled groups tested with diluted and undiluted ICMs. RESULTS We identified 29 eligible original papers, and extracted data of 1137 patients that formed the study population. Although in the cohort tested with diluted ICMs the number of tested ICMs was greater, the percentage of positive tests was significantly less (9.0% vs. 24.7%; P < 0.0001; OR 0.30 [0.26-0.34]). The frequency of positive tested culprit ICMs was also lesser in the group tested with diluted ICMs (31.0% vs. 72.5%; P < 0.0001; OR 0.17 [0.12-0.23]). The number of drug provocation tests (DPTs) was greater in patients with diluted IDTs (374 vs. 89; P < 0.0001; OR 2.54 [1.93-3.36]). We detected an increased sensitivity in patients with undiluted tests (0.774 vs. 0.282) and a nearly identical specificity in both groups (1 vs. 0.983). CONCLUSIONS For the first time, we show that IDT up to pure ICM concentrations is superior to using diluted ICMs only. Possibly, we can reduce the number of DPTs when performing IDTs with pure ICMs. In the undiluted group, there were no hints for skin irritations or unspecific test reactions.
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Affiliation(s)
- Adrian A Schmid
- Department of Radiology, Kantonsspital Münsterlingen, Münsterlingen, Switzerland
| | - Martin N Hungerbühler
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Paolo Lombardo
- Department of Diagnostic, Interventional, and Pediatric Radiology, Inselspital, University of Bern, Bern, Switzerland
| | - Ingrid B Boehm
- Department of Diagnostic, Interventional, and Pediatric Radiology, Inselspital, University of Bern, Bern, Switzerland
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2
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Soria A, Bernier C, Milpied B, Assier H, Castelain F, Amsler E, Barbaud A. Administration of an alternative iodinated contrast media in confirmed severe delayed hypersensitivity reactions. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024; 12:1362-1367.e1. [PMID: 38490579 DOI: 10.1016/j.jaip.2024.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 03/05/2024] [Accepted: 03/09/2024] [Indexed: 03/17/2024]
Affiliation(s)
- Angèle Soria
- Service de Dermatologie et Allergologie, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Médecine Sorbonne Université, Paris, France.
| | - Claire Bernier
- Service de Dermatologie et Plateforme Transversale d'Allergologie, Hôpital Hôtel Dieu, Nantes, France
| | | | - Haudrey Assier
- Service de Dermatologie, Hôpital Henri Mondor, Créteil, France
| | | | - Emmanuelle Amsler
- Service de Dermatologie et Allergologie, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Médecine Sorbonne Université, Paris, France
| | - Annick Barbaud
- Service de Dermatologie et Allergologie, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Médecine Sorbonne Université, Paris, France; Sorbonne Université, INSERM, Institut Pierre Louis d'Epidemiologie et de Sante Publique, Paris, France
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3
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Doña I, Torres MJ, Celik G, Phillips E, Tanno LK, Castells M. Changing patterns in the epidemiology of drug allergy. Allergy 2024; 79:613-628. [PMID: 38084822 DOI: 10.1111/all.15970] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 11/23/2023] [Accepted: 11/26/2023] [Indexed: 03/01/2024]
Abstract
Drug allergy (DA) remains a complex and unaddressed problem worldwide that often deprives patients of optimal medication choices and places them at risk for life-threatening reactions. Underdiagnosis and overdiagnosis are common and due to the lack of standardized definitions and biomarkers. The true burden of DA is unknown, and recent efforts in data gathering through electronic medical records are starting to provide emerging patterns around the world. Ten percent of the general population engaged in health care claim to have a DA, and the most common label is penicillin allergy. Up to 20% of emergency room visits for anaphylaxis are due to DA and 15%-20% of hospitalized patients report DA. It is estimated that DA will increase based on the availability and use of new and targeted antibiotics, vaccines, chemotherapies, biologicals, and small molecules, which are aimed at improving patient's options and quality of life. Global and regional variations in the prevalence of diseases such as human immunodeficiency virus and mycobacterial diseases, and the drugs used to treat these infections have an impact on DA. The aim of this review is to provide an update on the global impact of DA by presenting emerging data on drug epidemiology in adult and pediatric populations.
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Affiliation(s)
- Immaculada Doña
- Allergy Research Group, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Malaga, Spain
- Allergy Unit, Hospital Regional Universitario de Málaga, Malaga, Spain
| | - Maria Jose Torres
- Allergy Research Group, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Malaga, Spain
- Allergy Unit, Hospital Regional Universitario de Málaga, Malaga, Spain
- Departamento de Medicina, Universidad de Málaga, Malaga, Spain
| | - Gulfem Celik
- Division of Immunology and Allergy, Department of Chest Diseases, Ankara University School of Medicine, Ankara, Turkey
| | - Elizabeth Phillips
- Department of Medicine, Center for Drug Safety and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Institute for Immunology and Infectious Diseases, Murdoch University, Murdoch, Western Australia, Australia
| | - Luciana Kase Tanno
- Division of Allergy, Department of Pulmonology, Allergy and Thoracic Oncology, University Hospital of Montpellier, Montpellier, France
- Desbrest Institute of Epidemiology and Public Health, UMR UA11 University of Montpellier-INSERM, Montpellier, France
- WHO Collaborating Centre on Scientific Classification Support, Montpellier, France
| | - Mariana Castells
- Division of Allergy and Immunology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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4
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de Groot AC. Results of patch testing in Acute generalized exanthematous pustulosis (AGEP): a literature review. Contact Dermatitis 2022; 87:119-141. [PMID: 35187690 DOI: 10.1111/cod.14075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 02/11/2022] [Accepted: 02/15/2022] [Indexed: 11/29/2022]
Abstract
The literature on positive patch test results in acute generalized exanthematous pustulosis (AGEP) is reviewed. 93 drugs were identified that have together caused 259 positive patch tests in 248 patients suffering from AGEP. The drug classes causing the highest number of reactions are beta-lactam antibiotics (25.9%), other antibiotics (20.8%), iodinated contrast media (7.3%) and corticosteroids (5.4%), together accounting for nearly 60% of all reactions. The highest number of reactions to individual drugs was to amoxicillin (n=36), followed by pristinamycin (n=25), diltiazem (n=14), amoxicillin-clavulanic acid (n=13), clindamycin (n=11) and iomeprol (n=8); 59 of the 93 drugs each caused a single case only. The "Top-10" drugs together caused over 50% of all reactions. The sensitivity of patch testing (percentage of positive reactions) in patients with AGEP is largely unknown, but may generally be around 50%, which also applies to pristinamycin. Patch testing in AGEP appears to be safe, although mild recurrence of AGEP skin symptoms or other rashes may occur occasionally. Clinical aspects of AGEP, including epidemiology, etiology and pathophysiology, clinical features, histology, treatment, and prognosis are briefly presented, as are diagnosing the disease and identifying the culprit drugs with patch tests, intradermal tests, in vitro tests, and challenge tests. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Anton C de Groot
- dermatologist np, Schipslootweg 5, 8351 HV Wapserveen, The Netherlands
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5
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Woodruff CM, Botto N. The Role of Patch Testing in Evaluating Delayed Hypersensitivity Reactions to Medications. Clin Rev Allergy Immunol 2022; 62:548-561. [PMID: 35113364 PMCID: PMC9156465 DOI: 10.1007/s12016-022-08924-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2022] [Indexed: 12/19/2022]
Abstract
Confirming drug imputability is an important step in the management of cutaneous adverse drug reactions (CADR). Re-challenge is inconvenient and in many cases life threatening. We review the literature on ideal patch testing technique for specific CADRs. Testing should be performed approximately 3 months after the resolution of the eruption using standard patch testing techniques. Commercially available patch test preparations are available for a minority of drugs, so in most cases, testing should be performed with the drug at various recommended concentrations and in different vehicles. Testing to all known excipients, such as dyes, vehicles and preservatives is also important. Immunosuppressive medications should be discontinued or down titrated to the lowest tolerable dose to decrease the risk of false negative reactions. We provide an overview of expert recommendations and extant evidence on the utility of patch testing for identifying the culprit drug in common CADRs and for specific drug or drug classes. Overall, there appears to be significant variability in the patch test positivity of different drugs, which is likely the result of factors intrinsic to the drug such as dermal absorption (as a function of lipophilicity and molecular size) and whether the drug itself or a downstream metabolite is implicated in the immune reaction. Drugs with high patch test positivity rates include beta-lactam antibiotics, aromatic anticonvulsants, phenytoin, and corticosteroids, among others. Patch testing positivity varies both as a function of the drug and type of CADR. The sum of the evidence suggests that patch testing in the setting of morbilliform eruptions, fixed drug eruption, acute generalized exanthematous pustulosis, and possibly also drug-induced hypersensitivity syndrome, photoallergic and eczematous reactions may be worthwhile, although utility of testing may vary on the specific drug in question for the eruption. It appears to be of limited utility and is not recommended in the setting of other complex CADR, such as SJS/TEN and leukocytoclastic vasculitis.
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Affiliation(s)
| | - Nina Botto
- University of California San Francisco, San Francisco, CA, USA
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6
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Vallejo-Yagüe E, Martinez-De la Torre A, Mohamad OS, Sabu S, Burden AM. Drug Triggers and Clinic of Acute Generalized Exanthematous Pustulosis (AGEP): A Literature Case Series of 297 Patients. J Clin Med 2022; 11:397. [PMID: 35054090 PMCID: PMC8780223 DOI: 10.3390/jcm11020397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 01/10/2022] [Indexed: 12/20/2022] Open
Abstract
Acute generalized exanthematous pustulosis (AGEP) is a rare skin reaction, commonly caused by drugs. Available evidence mostly relies on small studies or case reports. We collected published AGEP case reports and, subsequently, described the patient characteristics, suspect and concomitant drugs, time to onset, disease management, and clinical prognosis. This study included 297 AGEP patients (64.3% women) obtained from 250 published case reports or case series with individual patient data. AGEP affected patients of all ages, but the majority of patients (88.2%) were ≥25 years old. The most frequently reported suspect drugs were anti-infectives for systemic use (36.5%), particularly antibacterials for systemic use (31.0%), and especially beta-lactam antibacterials (18.3%) and macrolides (4.3%). Other frequent suspect drugs were antineoplastics (12.2%), and anti-inflammatory/anti-rheumatic products (5.2%) plus hydroxychloroquine (12.8%). Mean time to onset was 9.1 days (standard deviation SD 13.94). Some patients developed fever (64.3%) and systemic involvement (18.9%), and most patients (76.4%) received pharmacological treatment for AGEP. Seven patients died, although five of them were already critically ill prior to AGEP. In conclusion, antibiotics remain the most common suspected cause of AGEP. While case mortality rate may be up to 2.5%, disentangling the role of AGEP on the fatal outcome from the role of the preexisting health conditions remains challenging.
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Affiliation(s)
- Enriqueta Vallejo-Yagüe
- Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, ETH Zurich, CH-8093 Zurich, Switzerland
| | - Adrian Martinez-De la Torre
- Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, ETH Zurich, CH-8093 Zurich, Switzerland
| | - Omar S Mohamad
- Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, ETH Zurich, CH-8093 Zurich, Switzerland
| | - Shweta Sabu
- Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, ETH Zurich, CH-8093 Zurich, Switzerland
| | - Andrea M Burden
- Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, ETH Zurich, CH-8093 Zurich, Switzerland
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Schmid AA, Morelli JN, Hungerbühler MN, Boehm IB. Cross-reactivity among iodinated contrast agents: should we be concerned? Quant Imaging Med Surg 2021; 11:4028-4041. [PMID: 34476187 DOI: 10.21037/qims-20-1325] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 04/14/2021] [Indexed: 11/06/2022]
Abstract
Background Although several papers deal with "cross-reactivity" in patients with iodinated contrast medium (ICM) hypersensitivity reactions (HSRs), there is no in-depth knowledge of this phenomenon. To define ICM-groups as potential reaction partners and to identify any potential clinical relevance in patients with ICM-HSRs. Methods The literature database PubMed was searched for eligible papers dealing with ICM-allergy and "cross-reactivity". The data presented by the papers was analyzed and individual patient data was extracted for re-evaluation based on a definition for both 'polyvalent reactivity' and 'cross-reactivity' as well as for chemical structure-dependent ICM-groups. Results Twenty-five original papers (with n=340 extracted patients) formed the study population. Incidences of polyvalent reactivity were non-significantly higher than incidences of cross-reactivity (both range from 0% to 100%). Crossover evaluation in reaction pairings (culprit ICM A with ICM B versus culprit ICM B with ICM A) showed concordance of only 30%. Data support rather non-cross-reactivity (individual reaction pattern) than cross-reactivity constellations. Conclusions The obtained results favour an individual reaction pattern, rather than a reactivity driven by chemical structures and so-called cross-reactivity.
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Affiliation(s)
- Adrian A Schmid
- Department of Orthopaedics and Traumatology, Spital Altstaetten, Altstaetten, Switzerland
| | - John N Morelli
- Department of Radiology, St. John's Medical Center Tulsa, OK, USA
| | - Martin N Hungerbühler
- Department of Diagnostic, Interventional, and Pediatric Radiology, Inselspital, University of Bern, Bern, Switzerland
| | - Ingrid B Boehm
- Department of Diagnostic, Interventional, and Pediatric Radiology, Inselspital, University of Bern, Bern, Switzerland
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8
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Soria A, Amsler E, Bernier C, Milpied B, Tétart F, Morice C, Dezoteux F, Ferrier-Le Bouedec MC, Barbaud A, Staumont-Sallé D, Assier H. DRESS and AGEP Reactions to Iodinated Contrast Media: A French Case Series. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2021; 9:3041-3050. [PMID: 33757916 DOI: 10.1016/j.jaip.2021.02.060] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/23/2021] [Accepted: 02/28/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Drug reactions with eosinophilia and systemic symptoms (DRESSs) and acute generalized exanthematous pustulosis (AGEP) are potentially severe cutaneous adverse drug reactions. OBJECTIVE To describe the clinical findings and sensitization profiles of DRESS and AGEP patients who had been administered iodinated contrast media (ICM). METHODS All adult patients in the dermatologist's French Investigators for Skin Adverse Reactions to Drugs (FISARD) network diagnosed with a DRESS or AGEP highly suspected to have been caused by an ICM were included retrospectively. RESULTS Thirteen DRESS patients and 19 AGEP patients who had been administered ICM were included, and the median delay in DRESS and AGEP occurrence after ICM administration was short, 4 and 1 days, respectively. Five AGEP patients had systemic involvement. A high cosensitization rate (46%) was observed among the DRESS patients, mainly with beta-lactam antibiotics. Overall, 77% of our patients were sensitized to several ICM. Patch tests identified the suspected ICM for 21 cases (72%). The retrospective nature, the limited number of subjects, the absence of a control group of healthy individuals, and the lack of detailed information on previous exposure to sensitizing drugs are limitations of this study. CONCLUSIONS We report a large series of DRESSs and AGEPs related to ICM administration. Skin tests appear useful for diagnosis and potentially to identify alternative ICM.
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Affiliation(s)
- Angèle Soria
- Sorbonne Universités, Service de Dermatologie et d'Allergologie, Hôpital Tenon, Paris HUEP, APHP, Centre d'Immunologie et des Maladies Infectieuses, INSERM U1135, Paris, France.
| | - Emmanuelle Amsler
- Sorbonne Universités, Service de Dermatologie et d'Allergologie, Hôpital Tenon, Paris HUEP, APHP, Paris, France
| | - Claire Bernier
- Service de Dermatologie, Hôpital Hôtel Dieu, CHU Nantes, France
| | | | - Florence Tétart
- Clinique dermatologique CHU de Rouen et Centre Erik Satie, Allergologie CHU Rouen, France
| | | | | | | | - Annick Barbaud
- Sorbonne Universités, Service de Dermatologie et d'Allergologie, Hôpital Tenon, Paris HUEP, APHP, Paris, France
| | | | - Haudrey Assier
- Service de Dermatologie, Hôpital Henri Mondor, APHP, Créteil, France
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Schönmann C, Brockow K. Adverse reactions during procedures: Hypersensitivity to contrast agents and dyes. Ann Allergy Asthma Immunol 2019; 124:156-164. [PMID: 31765812 DOI: 10.1016/j.anai.2019.11.022] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 11/06/2019] [Accepted: 11/18/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE This review provides an overview of the literature on hypersensitivity reactions during procedures to commonly used contrast agents and dyes. A synthesis of current knowledge on clinical symptoms, epidemiology and risk factors, pathomechanism, and management of hypersensitivity reactions to these substances is presented. DATA SOURCES A literature search was conducted through Medline. Included were peer-reviewed articles written in English between 2000 and 2019. STUDY SELECTIONS Relevant clinical studies, experimental studies, and review articles have been selected. Additionally, case reports have been included if they carried significant information about rare clinical forms of hypersensitivity reactions, disease mechanisms, or therapy. RESULTS An allergological workup is only indicated for patients with a history of immediate (IHR) and nonimmediate hypersensitivity reactions (NIHR) but not for toxic or unrelated adverse events. Skin tests with or without experimental cellular laboratory tests in patients with previous reactions can provide evidence for an allergic mechanism. Positive skin tests indicating allergy are more common in severe reactions. If the adverse event was allergic, skin testing of alternatives is helpful for the selection of other contrast agents for future procedures. Premedication alone may be insufficient in these cases, and breakthrough reactions occur. For nonallergic reactions, change of contrast agent and premedication is often but not always sufficient to suppress reactions. CONCLUSION Patients with previous NIHR or IHR, especially moderate and severe IHR, needing potential re-administration of contrast agents should be skin tested to identify an allergic mechanism as well as alternative agents to be used for future procedures.
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Affiliation(s)
- Christine Schönmann
- Department of Dermatology and Allergy Biederstein, School of Medicine, Technical University of Munich, Munich, Germany
| | - Knut Brockow
- Department of Dermatology and Allergy Biederstein, School of Medicine, Technical University of Munich, Munich, Germany.
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Machet P, Marcé D, Ziyani Y, Dumont M, Cornillier H, Jonville‐Bera A, Machet L. Acute generalized exanthematous pustulosis induced by iomeprol with cross‐reactivity to other iodinated contrast agents and mild reactions after rechallenge with iopromide and oral corticosteroid premedication. Contact Dermatitis 2019; 81:74-76. [DOI: 10.1111/cod.13242] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 02/01/2019] [Accepted: 02/12/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Pauline Machet
- Department of Allergology University of Tours Tours France
| | - Diane Marcé
- Department of Dermatology University of Tours Tours France
| | - Youssef Ziyani
- Department of Allergology University of Tours Tours France
- Department of Dermatology University of Tours Tours France
| | - Marion Dumont
- Department of Allergology University of Tours Tours France
| | | | | | - Laurent Machet
- Department of Dermatology University of Tours Tours France
- Inserm U1253 University of Tours Tours France
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Kim SH, Lee SY, Choi YH, Kim CH, Hyun IK, Choi JH. Radiocontrast media-induced acute generalized exanthematous pustulosis: A safe administration of alternative radiocontrast media using patch tests. ALLERGY ASTHMA & RESPIRATORY DISEASE 2018. [DOI: 10.4168/aard.2018.6.5.270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Sun-Hyung Kim
- Department of Pulmonology and Allergy, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
| | - Seung-Youn Lee
- Department of Pulmonology and Allergy, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
| | - Young-Hee Choi
- Department of Pathology, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
| | - Cheol-Hong Kim
- Department of Pulmonology and Allergy, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
| | - In-Kyu Hyun
- Department of Pulmonology and Allergy, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
| | - Jeong-Hee Choi
- Department of Pulmonology and Allergy, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
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12
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Velter C, Schissler C, Moulinas C, Tebacher-Alt M, Siedel JM, Cribier B, Lipsker D. Acute generalized exanthematous pustulosis caused by an iodinated contrast radiocontrast medium for computed tomography arthrography of the knee. Contact Dermatitis 2017; 76:371-373. [DOI: 10.1111/cod.12724] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 10/04/2016] [Accepted: 10/12/2016] [Indexed: 12/14/2022]
Affiliation(s)
- Charles Velter
- Department of Dermatology; Universite de Strasbourg Faculte de Medecine; Strasbourg 67085 France
| | - Catherine Schissler
- Department of Dermatology; Universite de Strasbourg Faculte de Medecine; Strasbourg 67085 France
| | - Chloé Moulinas
- Department of Dermatology; Universite de Strasbourg Faculte de Medecine; Strasbourg 67085 France
| | - Martine Tebacher-Alt
- Faculte de Medecine, Department of Pharmacovigilance, Centre Regional de Pharmacovigilance et d'Information sur les Medicaments Strasbourg, Universite de Strasbourg; Strasbourg 67085 France
| | - Jean-Marie Siedel
- Department of Radiology, Cabinet de Radiologie; 67000 Strasbourg France
| | - Bernard Cribier
- Department of Dermatology; Universite de Strasbourg Faculte de Medecine; Strasbourg 67085 France
| | - Dan Lipsker
- Department of Dermatology; Universite de Strasbourg Faculte de Medecine; Strasbourg 67085 France
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