Unfortunately, there is not sufficient evidence about the influence of immunosuppressive drugs on test results.15,59,60 A randomized, double-blind study revealed that 20 mg/day of oral prednisone suppressed reactivity in DPTR in patients with nickel sensitivity.59 A prospective study reported positive reactions in DPTR in patients taking azathioprine, cyclosporine, mycophenolate mofetil, methotrexate, infliximab, adalimumab, etanercept, and tacrolimus.60 The positive predictive value of DPTR in DRESS varies greatly across studies and management guidelines, described as positive in up to 80% of cases in patients with DRESS after the use of carbamazepine, but in only 20% after exposure to phenobarbital.58,61 Intradermal Tests (IDT) Intradermal tests can be used to identify both immediate and delayed hypersensitivity reactions to medications
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