{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T04:24:38Z","timestamp":1787199878913,"version":"build-2736575974"},"reference-count":107,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100011824","name":"European Academy of Allergy and Clinical Immunology","doi-asserted-by":"publisher","award":["40710"],"award-info":[{"award-number":["40710"]}],"id":[{"id":"10.13039\/501100011824","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Allergy"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>These updated EAACI guidelines aim to standardize skin testing methodologies for both immediate and non\u2010immediate drug hypersensitivity reactions. For immediate reactions, the optimal testing window is 4\u20136\u2009weeks post\u2010reaction; whereas beyond 6\u2009months, false\u2010negative results increase. For chemotherapy\u2010related reactions, earlier testing (within 2\u2009weeks) remains necessary due to treatment urgency. The previously published multicenter ENDA study established the international reference method for positive immediate intradermal test reading: injection of exactly 0.02\u2009mL with a wheal at 20\u2009min measuring \u2265\u2009initial wheal +3\u2009mm, representing a major standardization achievement. For patch testing, exact active ingredient concentrations must be systematically documented. When tablets are crushed and diluted at 30% in petrolatum, significant variability in final concentrations has been observed. The guidelines present validated nonirritant concentrations for major drug classes including antibiotics, contrast media, anesthetics, proton pump inhibitors, chemotherapies, and biologicals. Specific recommendations are based on negative controls demonstrating specificity, while conditional recommendations are provided when few or no negative controls are available. Risk stratification algorithms now allow direct drug provocation testing for mild maculopapular exanthema, bypassing preliminary skin tests. However, more severe reactions such as anaphylaxis require skin testing before considering drug provocation tests. For DRESS\/AGEP\/SJS\/TEN, skin tests are useful and safe for identifying culprit drugs. These harmonized methods enable safe drug allergy delabeling while preserving diagnostic accuracy and patient safety. Strict adherence to these standardized protocols is essential to ensure reproducible results and safe clinical practice in drug hypersensitivity evaluation.<\/jats:p>","DOI":"10.1111\/all.70466","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T03:57:23Z","timestamp":1787198243000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Updated EAACI Statement on Drug Hypersensitivity Skin Testing: Methodology and Non\u2010Irritative Concentrations"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8889-1589","authenticated-orcid":false,"given":"Annick","family":"Barbaud","sequence":"first","affiliation":[{"name":"D\u00e9partement de Dermatologie et Allergologie INSERM, Institut Pierre Louis d'Epid\u00e9miologie et de Sant\u00e9 Publique, AP\u2010HP, Sorbonne Universit\u00e9, H\u00f4pital Tenon  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7777-4501","authenticated-orcid":false,"given":"Lene Heise","family":"Garvey","sequence":"additional","affiliation":[{"name":"Allergy Clinic, Department of Dermatology and Allergy Copenhagen University Hospital\u2010Herlev and Gentofte  Copenhagen Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7623-3383","authenticated-orcid":false,"given":"Elizabeth","family":"Phillips","sequence":"additional","affiliation":[{"name":"Department of Medicine Center for Drug Safety and Immunology, Vanderbilt University Medical Center  Nashville Tennessee USA"},{"name":"Institute for Immunology and Infectious Diseases Murdoch University  Murdoch Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1466-2016","authenticated-orcid":false,"given":"Michael","family":"Ardern\u2010Jones","sequence":"additional","affiliation":[{"name":"Clinical Experimental Sciences, Faculty of Medicine University of Southampton  Southampton UK"},{"name":"Department of Dermatology University Hospitals NHS Foundation Trust  Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7884-0830","authenticated-orcid":false,"given":"Sevim","family":"Bavbek","sequence":"additional","affiliation":[{"name":"Division of Allergy and Clinical Immunology, Department of Chest Diseases, School of Medicine Ankara University  Ankara Turkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5703-5314","authenticated-orcid":false,"given":"Patrizia","family":"Bonadonna","sequence":"additional","affiliation":[{"name":"Allergy Unit San Bortolo Hospital  Vicenza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3130-095X","authenticated-orcid":false,"given":"Jean\u2010Christoph","family":"Caubet","sequence":"additional","affiliation":[{"name":"Pediatric Allergy Unit, Department of Woman, Child and Adolescent Geneva University Hospitals  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9183-5032","authenticated-orcid":false,"given":"Ana\u2010Maria","family":"Copaescu","sequence":"additional","affiliation":[{"name":"Division of Clinical Immunology and Allergy, Department of Medicine McGill University Health Centre and Research Institute of the McGill University Health Centre  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7753-0614","authenticated-orcid":false,"given":"Valentina","family":"Gueli","sequence":"additional","affiliation":[{"name":"Allergy Unit and Asthma Center University Hospital of Verona, Policlinico G.B. Rossi  Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5909-8979","authenticated-orcid":false,"given":"Jose Julio","family":"Laguna","sequence":"additional","affiliation":[{"name":"Allergy Unit, Allergo\u2010Anaesthesia Unit, Hospital Central de la Cruz Roja, Faculty of Biomedical and Health Sciences Alfonso X El Sabio University, ARADyAL, REI  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3358-3578","authenticated-orcid":false,"given":"Ricardo","family":"Madrigal\u2010Burgaleta","sequence":"additional","affiliation":[{"name":"Allergy &amp; Severe Asthma Service St Bartholomew's Hospital, Barts Health NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7483-0128","authenticated-orcid":false,"given":"Francesca","family":"Mori","sequence":"additional","affiliation":[{"name":"Allergy Unit Meyer Children's Hospital IRCCS  Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1321-314X","authenticated-orcid":false,"given":"Vito","family":"Sabato","sequence":"additional","affiliation":[{"name":"Immunology Allergology Rheumatology University of Antwerp and Antwerp University Hospital  Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5228-471X","authenticated-orcid":false,"given":"Maria J","family":"Torres","sequence":"additional","affiliation":[{"name":"Allergy Unit Regional University Hospital of Malaga\u2010IBIMA\u2010UMA\u2010ARADyAL  Malaga Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2775-3681","authenticated-orcid":false,"given":"Knut","family":"Brockow","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergy Biederstein, School of Medicine and Health Technical University of Munich  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.15889"},{"issue":"3","key":"e_1_2_12_3_1","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1007\/s12016-021-08877-y","article-title":"Hypersensitivity Reactions to Platinum Agents and Taxanes","volume":"62","author":"Tsao L. 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