Observational Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Methodol. Mar 26, 2017; 7(1): 25-32
Published online Mar 26, 2017. doi: 10.5662/wjm.v7.i1.25
Patch testing and cross sensitivity study of adverse cutaneous drug reactions due to anticonvulsants: A preliminary report
T N Shiny, Vikram K Mahajan, Karaninder S Mehta, Pushpinder S Chauhan, Ritu Rawat, Rajni Sharma
T N Shiny, Vikram K Mahajan, Karaninder S Mehta, Pushpinder S Chauhan, Ritu Rawat, Rajni Sharma, Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra, Himachal Pradesh 176001, India
Author contributions: Shiny TN collected patients’ data, performed patch testing, analyzed and interpreted data, and drafted preliminary manuscript; Mahajan VK conceptualized, analyzed, interpreted data, and designed, re-drafted, and critically evaluated the manuscript for important intellectual content; Mehta KS helped in manuscript drafting, data collection, analysis and interpretation of data; Chauhan PS helped in analysis and interpretation of data and manuscript drafting; Rawat R and Sharma R helped in clinical material, editing, and drafting of manuscript; all these authors were involved in the revision of the draft manuscript and have agreed to the final content.
Institutional review board statement: The study was reviewed and approved by the Institutional Scientific Protocol Review Committee, Dr R. P. Govt. Medical College, Kangra (Tanda), H.P. 176001 (India).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: No potential conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Vikram K Mahajan, MBBS, MD, Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Tanda Hospital Rd, Kangra, Himachal Pradesh 176001, India. vkm1@rediffmail.com
Telephone: +91-1892-287161 Fax: +91-1892-267115
Received: November 17, 2016
Peer-review started: November 22, 2016
First decision: January 14, 2017
Revised: January 21, 2017
Accepted: March 12, 2017
Article in press: March 13, 2017
Published online: March 26, 2017
Core Tip

Core tip: Anticonvulsants account for 20% of all adverse cutaneous drug reactions (ACDRs) while cross-reactions occur frequently among carbamazepine, phenytoin, phenobarbitone necessitating careful prescriptions. The clinical presentation alone is not diagnostic and identification of offending drug needs causality assessment that may be misleading in patients on multiple medications. Drug provocation, skin prick or intradermal tests have ethical issues for possibility of precipitating more severe reactions. Basophil degranulation/lymphocyte activation or drug specific IgE radioallergosorbent tests, histamine release and passive haemagglutination tests have limited use in clinical practice. Drug patch testing appears useful in anticonvulsant ACDRs, drug imputability and cross-reactions established clinically.