Photoscratch testing in systemic drug‐induced photosensitivity

Because of numerous false‐negative results, photopatch testing is seldom relevant in systemic drug‐induced photosensitivity. These false‐negative photopatch test results can be attributed to the inability of the drug to penetrate into the epidermis. In order to enhance the penetration of the tested drug into the epidermis, some authors proposed to breach the cutaneous barrier. We performed a prospective study comparing photopatch and photoscratch testing. Fifteen patients presenting with a systemic drug‐induced photosensitivity, proved by a favourable outcome after discontinuing the drug, were tested. For each drug, photopatch and photoscratch tests were performed. Two‐thirds of the patients had negative photopatch and photoscratch tests with the suspected drugs. Photopatch and photoscratch tests were positive and relevant, respectively, in 3 and 4 patients. Photoscratch tests induced more false‐positive results due to irritation confirmed on control subjects. Our study proves that photoscratch tests do not change the sensitivity of phototesting.

[1]  L. Verneuil,et al.  Value of patch tests in pristinamycin‐induced drug eruptions , 1999, Contact dermatitis.

[2]  G. Faure,et al.  The use of skin testing in the investigation of cutaneous adverse drug reactions , 1998, The British journal of dermatology.

[3]  C. Torre,et al.  Chronic actinic dermatitis due to simvastatin , 1998, Contact dermatitis.

[4]  L. Vaillant,et al.  Fenofibrate-induced photosensitivity: value of photopatch testing. , 1997, Journal of the American Academy of Dermatology.

[5]  J. Bourrain,et al.  Diagnosis of photosensitivity to flupenthixol by photoprick testing , 1997, Photodermatology, photoimmunology & photomedicine.

[6]  R. Russell Jones,et al.  Calcium antagonist‐induced photo‐exposed telangiectasia , 1997, The British journal of dermatology.

[7]  W. Manuskiatti,et al.  Fenofibrate-induced photosensitivity. , 1996, Journal of the American Academy of Dermatology.

[8]  A. Ishiko,et al.  Ampiroxicam‐induced photosensitivity , 1996, Contact dermatitis.

[9]  C. Jansén,et al.  Photopatch test reactivity: effect of photoallergen concentration and UVA dosaging , 1996, Contact dermatitis.

[10]  J. Moan,et al.  Phototoxicity due to sulphonamide derived oral antidiabetics and diuretics: investigations in a cell culture model , 1996, Photodermatology, photoimmunology & photomedicine.

[11]  A. Kawada,et al.  Photosensitivity to simvastatin with an unusual response to photopatch and photo tests , 1995, Contact dermatitis.

[12]  T. Horio,et al.  Clinical and experimental photosensitivity reaction to tilisolol hydrochloride. , 1994, Photodermatology, photoimmunology & photomedicine.

[13]  G. Plewig,et al.  Pattern analysis of photopatch test reactions. , 1994, Photodermatology, photoimmunology & photomedicine.

[14]  F. Vargas,et al.  PHOTOSENSITIZATION BY FENOFIBRATE. II. In vitro PHOTOTOXICITY OF THE MAJOR METABOLITES , 1994, Photochemistry and photobiology.

[15]  G. Murphy,et al.  Determination of threshold UV‐A elicitation dose in photopatch testing , 1993, Contact dermatitis.

[16]  F. Vargas,et al.  PHOTODEGRADATION AND in vitro PHOTOTOXICITY OF FENOFIBRATE, A PHOTOSENSITIZING ANTI‐HYPEIUIPOPROTEINEMIC DRUG , 1993, Photochemistry and photobiology.

[17]  S. Ghosh,et al.  Photosensitive lichenoid eruption due to enalapril. , 1993, Dermatology.

[18]  Y. Kurumaji,et al.  Scarified photopatch testing in lomefloxacin photosensitivity , 1992, Contact dermatitis.

[19]  J. Ring,et al.  Photopatch testing with different ultraviolet A sources can yield discrepant test results. , 1991, Photodermatology, photoimmunology & photomedicine.

[20]  K. Neldner,et al.  Hydroxyurea therapy. , 1991, Journal of the American Academy of Dermatology.

[21]  M. Lomuto,et al.  Photodermatitis due to nifedipine: report of 2 cases. , 1991, Dermatologica.

[22]  D. Leroy,et al.  Photosensitivity induced by fenofibrate. , 1990, Photodermatology, photoimmunology & photomedicine.

[23]  B. Diffey,et al.  Phototoxic potential of thiazide diuretics in normal subjects. , 1989, Archives of dermatology.

[24]  F. Granier,et al.  Photosensibilisation après traitement au captopril , 1988 .

[25]  W. Frain-Bell,et al.  Thiazide‐induced photosensitivity: a study of 33 subjects , 1987, The British journal of dermatology.

[26]  G. Plewig,et al.  Photodermatoses--diagnostic procedures and their interpretation. , 1987, Photo-dermatology.

[27]  S. Schauder.  How to avoid phototoxic reactions in photopatch testing with chlorpromazine. , 1985, Photo-dermatology.

[28]  D. Macdonald,et al.  The pathogenesis of amiodarone‐induced pigmentation and photosensitivity , 1984, The British journal of dermatology.

[29]  I. White.  Photopatch test in a hydrochlorothiazide drug eruption , 1983, Contact dermatitis.

[30]  A. Kligman,et al.  Identification of systemic phototoxic drugs by human intradermal assay. , 1978, The Journal of investigative dermatology.