Nested case–control study investigating the diagnostic role of tissue eosinophilia in adverse cutaneous drug reactions
Background Although tissue eosinophilia has traditionally been considered diagnostically supportive of adverse cutaneous drug reactions (ACDRs), studies have suggested it is neither a sensitive nor a specific finding in drug eruptions (DEs). Objectives Determining whether skin tissue eosinophilia is...
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| Veröffentlicht in: | Journal of the European Academy of Dermatology and Venereology 2019-06, Vol.33 (6), p.1152-1157 |
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| container_title | Journal of the European Academy of Dermatology and Venereology |
| container_volume | 33 |
| creator | Samuelov, L. Nathan, A. Slutsky, E. Fruchter, D. Gat, A. Sprecher, E. Goldberg, I. |
| description | Background
Although tissue eosinophilia has traditionally been considered diagnostically supportive of adverse cutaneous drug reactions (ACDRs), studies have suggested it is neither a sensitive nor a specific finding in drug eruptions (DEs).
Objectives
Determining whether skin tissue eosinophilia is a reliable indicator of ACDR.
Methods
A nested case–control retrospective study conducted in a cohort of 170 patients at a single institution. Tissue eosinophilia (number of eosinophils per high‐power field (HPF)) was investigated in skin biopsies obtained from the following groups of patients who demonstrated: (i) in vitro assay and telephone interview‐validated cutaneous drug reactions (true DE); (ii) initial clinical diagnosis of ACDR but drug aetiology was excluded by in vitro assay and telephone interview (false DE); and (iii) non‐drug‐associated cutaneous eruptions, skin tumours and nevi, randomly selected for evaluation (control).
Results
Significantly higher number of eosinophils per HPF was observed in the false DE compared to the true DE group (P = 0.02). The false DE group demonstrated a higher number of eosinophils (P |
| doi_str_mv | 10.1111/jdv.15509 |
| format | Article |
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Although tissue eosinophilia has traditionally been considered diagnostically supportive of adverse cutaneous drug reactions (ACDRs), studies have suggested it is neither a sensitive nor a specific finding in drug eruptions (DEs).
Objectives
Determining whether skin tissue eosinophilia is a reliable indicator of ACDR.
Methods
A nested case–control retrospective study conducted in a cohort of 170 patients at a single institution. Tissue eosinophilia (number of eosinophils per high‐power field (HPF)) was investigated in skin biopsies obtained from the following groups of patients who demonstrated: (i) in vitro assay and telephone interview‐validated cutaneous drug reactions (true DE); (ii) initial clinical diagnosis of ACDR but drug aetiology was excluded by in vitro assay and telephone interview (false DE); and (iii) non‐drug‐associated cutaneous eruptions, skin tumours and nevi, randomly selected for evaluation (control).
Results
Significantly higher number of eosinophils per HPF was observed in the false DE compared to the true DE group (P = 0.02). The false DE group demonstrated a higher number of eosinophils (P < 0.001) while the true DE group eosinophils’ number was not significantly higher as compared to control (P = 0.2032).
Conclusions
Tissue eosinophilia is not a reliable indicator of ACDRs.</description><identifier>ISSN: 0926-9959</identifier><identifier>EISSN: 1468-3083</identifier><identifier>DOI: 10.1111/jdv.15509</identifier><identifier>PMID: 30770612</identifier><language>eng</language><publisher>England</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Case-Control Studies ; Drug Eruptions - diagnosis ; Drug Eruptions - etiology ; Eosinophilia - complications ; Female ; Humans ; Interferon-gamma - metabolism ; Male ; Middle Aged ; Retrospective Studies ; Skin - metabolism ; Skin - pathology ; Young Adult</subject><ispartof>Journal of the European Academy of Dermatology and Venereology, 2019-06, Vol.33 (6), p.1152-1157</ispartof><rights>2019 European Academy of Dermatology and Venereology</rights><rights>2019 European Academy of Dermatology and Venereology.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3259-f60779150c990cace062656b2cddc6ff1e3100b5bc18a5b8ff2d474f4452021d3</citedby><cites>FETCH-LOGICAL-c3259-f60779150c990cace062656b2cddc6ff1e3100b5bc18a5b8ff2d474f4452021d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjdv.15509$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjdv.15509$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30770612$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Samuelov, L.</creatorcontrib><creatorcontrib>Nathan, A.</creatorcontrib><creatorcontrib>Slutsky, E.</creatorcontrib><creatorcontrib>Fruchter, D.</creatorcontrib><creatorcontrib>Gat, A.</creatorcontrib><creatorcontrib>Sprecher, E.</creatorcontrib><creatorcontrib>Goldberg, I.</creatorcontrib><title>Nested case–control study investigating the diagnostic role of tissue eosinophilia in adverse cutaneous drug reactions</title><title>Journal of the European Academy of Dermatology and Venereology</title><addtitle>J Eur Acad Dermatol Venereol</addtitle><description>Background
Although tissue eosinophilia has traditionally been considered diagnostically supportive of adverse cutaneous drug reactions (ACDRs), studies have suggested it is neither a sensitive nor a specific finding in drug eruptions (DEs).
Objectives
Determining whether skin tissue eosinophilia is a reliable indicator of ACDR.
Methods
A nested case–control retrospective study conducted in a cohort of 170 patients at a single institution. Tissue eosinophilia (number of eosinophils per high‐power field (HPF)) was investigated in skin biopsies obtained from the following groups of patients who demonstrated: (i) in vitro assay and telephone interview‐validated cutaneous drug reactions (true DE); (ii) initial clinical diagnosis of ACDR but drug aetiology was excluded by in vitro assay and telephone interview (false DE); and (iii) non‐drug‐associated cutaneous eruptions, skin tumours and nevi, randomly selected for evaluation (control).
Results
Significantly higher number of eosinophils per HPF was observed in the false DE compared to the true DE group (P = 0.02). The false DE group demonstrated a higher number of eosinophils (P < 0.001) while the true DE group eosinophils’ number was not significantly higher as compared to control (P = 0.2032).
Conclusions
Tissue eosinophilia is not a reliable indicator of ACDRs.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Case-Control Studies</subject><subject>Drug Eruptions - diagnosis</subject><subject>Drug Eruptions - etiology</subject><subject>Eosinophilia - complications</subject><subject>Female</subject><subject>Humans</subject><subject>Interferon-gamma - metabolism</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Retrospective Studies</subject><subject>Skin - metabolism</subject><subject>Skin - pathology</subject><subject>Young Adult</subject><issn>0926-9959</issn><issn>1468-3083</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kMFO3DAQhi3UCrbAgRdAPpZDYOzE3viIaEuLEFyAa-TY48UoGy92srA33qFv2CfBJdBb5zLSzDe__vkJOWBwzHKdPNj1MRMC1BaZsUrWRQl1-YnMQHFZKCXUDvmS0gMAMCbqbbJTwnwOkvEZeb7CNKClRif88_LbhH6IoaNpGO2G-n6dt36hB98v6HCP1Hq96EOeGZoxpMHRwac0IsWQfB9W977zOh9SbdcYE1IzDrrHMCZq47igEbUZfOjTHvnsdJdw_73vktsf32_OfhaX1-e_zk4vC1NyoQons1XFBBilwGiDILkUsuXGWiOdY1gygFa0htVatLVz3FbzylWV4MCZLXfJ10l3FcPjmN9plj4Z7LrJVcOZgkqBkjKjRxNqYkgpomtW0S913DQMmr9BNzno5i3ozB6-y47tEu0_8iPZDJxMwJPvcPN_pebi290k-QppTosi</recordid><startdate>201906</startdate><enddate>201906</enddate><creator>Samuelov, L.</creator><creator>Nathan, A.</creator><creator>Slutsky, E.</creator><creator>Fruchter, D.</creator><creator>Gat, A.</creator><creator>Sprecher, E.</creator><creator>Goldberg, I.</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201906</creationdate><title>Nested case–control study investigating the diagnostic role of tissue eosinophilia in adverse cutaneous drug reactions</title><author>Samuelov, L. ; Nathan, A. ; Slutsky, E. ; Fruchter, D. ; Gat, A. ; Sprecher, E. ; Goldberg, I.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3259-f60779150c990cace062656b2cddc6ff1e3100b5bc18a5b8ff2d474f4452021d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Case-Control Studies</topic><topic>Drug Eruptions - diagnosis</topic><topic>Drug Eruptions - etiology</topic><topic>Eosinophilia - complications</topic><topic>Female</topic><topic>Humans</topic><topic>Interferon-gamma - metabolism</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Retrospective Studies</topic><topic>Skin - metabolism</topic><topic>Skin - pathology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Samuelov, L.</creatorcontrib><creatorcontrib>Nathan, A.</creatorcontrib><creatorcontrib>Slutsky, E.</creatorcontrib><creatorcontrib>Fruchter, D.</creatorcontrib><creatorcontrib>Gat, A.</creatorcontrib><creatorcontrib>Sprecher, E.</creatorcontrib><creatorcontrib>Goldberg, I.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the European Academy of Dermatology and Venereology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Samuelov, L.</au><au>Nathan, A.</au><au>Slutsky, E.</au><au>Fruchter, D.</au><au>Gat, A.</au><au>Sprecher, E.</au><au>Goldberg, I.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Nested case–control study investigating the diagnostic role of tissue eosinophilia in adverse cutaneous drug reactions</atitle><jtitle>Journal of the European Academy of Dermatology and Venereology</jtitle><addtitle>J Eur Acad Dermatol Venereol</addtitle><date>2019-06</date><risdate>2019</risdate><volume>33</volume><issue>6</issue><spage>1152</spage><epage>1157</epage><pages>1152-1157</pages><issn>0926-9959</issn><eissn>1468-3083</eissn><abstract>Background
Although tissue eosinophilia has traditionally been considered diagnostically supportive of adverse cutaneous drug reactions (ACDRs), studies have suggested it is neither a sensitive nor a specific finding in drug eruptions (DEs).
Objectives
Determining whether skin tissue eosinophilia is a reliable indicator of ACDR.
Methods
A nested case–control retrospective study conducted in a cohort of 170 patients at a single institution. Tissue eosinophilia (number of eosinophils per high‐power field (HPF)) was investigated in skin biopsies obtained from the following groups of patients who demonstrated: (i) in vitro assay and telephone interview‐validated cutaneous drug reactions (true DE); (ii) initial clinical diagnosis of ACDR but drug aetiology was excluded by in vitro assay and telephone interview (false DE); and (iii) non‐drug‐associated cutaneous eruptions, skin tumours and nevi, randomly selected for evaluation (control).
Results
Significantly higher number of eosinophils per HPF was observed in the false DE compared to the true DE group (P = 0.02). The false DE group demonstrated a higher number of eosinophils (P < 0.001) while the true DE group eosinophils’ number was not significantly higher as compared to control (P = 0.2032).
Conclusions
Tissue eosinophilia is not a reliable indicator of ACDRs.</abstract><cop>England</cop><pmid>30770612</pmid><doi>10.1111/jdv.15509</doi><tpages>6</tpages></addata></record> |
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| source | MEDLINE; Wiley Online Library All Journals |
| subjects | Adolescent Adult Aged Aged, 80 and over Case-Control Studies Drug Eruptions - diagnosis Drug Eruptions - etiology Eosinophilia - complications Female Humans Interferon-gamma - metabolism Male Middle Aged Retrospective Studies Skin - metabolism Skin - pathology Young Adult |
| title | Nested case–control study investigating the diagnostic role of tissue eosinophilia in adverse cutaneous drug reactions |
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