{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T01:03:50Z","timestamp":1788397430460,"version":"build-2803163510"},"reference-count":26,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,7,2]],"date-time":"2023-07-02T00:00:00Z","timestamp":1688256000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Contact Dermatitis"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Adverse drug reactions to iodinated contrast media (ICM) have risen due to their increasing use in x\u2010ray\u2010based imaging modalities. Delayed hypersensitivity reactions are mainly caused by nonionic monomeric compounds and represent an issue impacting the diagnostic\u2013therapeutic pathways of cancer, cardiology and surgery patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To prospectively evaluate the usefulness of skin tests in delayed hypersensitivity reactions to ICM and to evaluate the tolerability of iobitridol, a monomeric nonionic low osmolality compound, as a possible safe alternative.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with delayed hypersensitivity reactions to ICM referred to us from 2020 to 2022 were prospectively enrolled in the study. All patients underwent patch test and, if negative, intradermal test with the culprit ICM and iobitridol as alternative.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 37 patients (females 24, 64.9%) were enrolled in the study. Iodixanol and iomeprol were the most frequently involved ICM (48.5% and 35.2%, respectively); 62.2% of patients presented maculopapular eruption, while 37.8% reported delayed urticaria\u2010like rash. Skin tests resulted positive to the culprit ICM in 19 patients (51.4%), 16 to patch test and 3 to intradermal test. Skin tests with iobitridol, tested as alternative, resulted positive in 3\/19 patients (15.8%). All 16 patients with negative results to iobitridol were administered this ICM and tolerated it.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In at least half of patients, delayed\u2010type hypersensitivity was demonstrated by skin tests, particularly by patch test. This diagnostic approach resulted simple, cost\u2010effective and safe, not only to confirm the culprit ICM but also to identify iobitridol as feasible alternative.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cod.14372","type":"journal-article","created":{"date-parts":[[2023,7,3]],"date-time":"2023-07-03T05:03:05Z","timestamp":1688360585000},"page":"352-358","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Delayed hypersensitivity reactions to iodinated contrast media: A diagnostic approach by skin tests"],"prefix":"10.1111","volume":"89","author":[{"given":"Leonardo","family":"Bianchi","sequence":"first","affiliation":[{"name":"Section of Dermatology, Department of Medicine and Surgery University of Perugia  Perugia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6674-4278","authenticated-orcid":false,"given":"Katharina","family":"Hansel","sequence":"additional","affiliation":[{"name":"Section of Dermatology, Department of Medicine and Surgery University of Perugia  Perugia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Biondi","sequence":"additional","affiliation":[{"name":"Section of Dermatology, Department of Medicine and Surgery University of Perugia  Perugia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena Sofia","family":"Caroppo","sequence":"additional","affiliation":[{"name":"Section of Dermatology, Department of Medicine and Surgery University of Perugia  Perugia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tommaso","family":"Galeotti","sequence":"additional","affiliation":[{"name":"Section of Dermatology, Department of Medicine and Surgery 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