{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T10:51:36Z","timestamp":1791456696698,"version":"4.3.4"},"reference-count":31,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Dermatitis\u00ae"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Cutaneous adverse drug reactions (CADRs) occur in 2\u20135% of inpatients, primarily due to delayed (T-cell-mediated) reactions, such as maculopapular exanthemas (MPEs). The lymphocyte transformation test (LTT) detects drug-specific T-cell responses with varied sensitivity. Patch testing may complement LTT, although in CADRs, its positivity could be low. There is a paucity of data about combined diagnostics, temporal association, and correlations in Mediterranean populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We retrospectively analyzed patients with clinically suspected delayed CADRs, primarily maculopapular exanthema (MPE). Patients underwent LTT, with a stimulation index &gt;3 considered positive, as well as patch testing with various drugs. Clinical information collected included demographics, type of reaction, latency, and the time interval between the reaction and testing. The performance of LTT and patch testing was evaluated in terms of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Correlations between test results and clinical characteristics were assessed using Jamovi software (Windows Version 2.7.2).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Among 38 patients (79% female, mean age 55.2 \u00b1 19.9 years), 143 agents were tested (49% antibiotics). LTT was positive in 44.7% per patient (21.7% per agent), patch testing in 15.8% (per patient). Combined positivity was 7.9%; both tests were negative in 50%. LTT showed sensitivity 64.3%, specificity 90.0%, PPV 90.0%, NPV 64.3%; patch testing: 21.4%, 100%, 100%, 47.6%, respectively. Combined sensitivity reached 71.4%. Highest LTT positivity was observed for contrast agents (60%), corticosteroids (47%), and NSAIDs (43%). LTT positivity correlated with atopy (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.004) and shorter reaction-to-testing intervals (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.013).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>LTT offers high specificity and PPV, particularly for the identification of non-antibiotic culprits in atopic patients with recent MPE. Early integration with patch testing enhances diagnostic yield and supports safe drug delabeling to minimize unnecessary avoidance and improve patient safety.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17103568261468627","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T02:07:32Z","timestamp":1790647652000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic Performance of the Lymphocyte Transformation Test and Patch Testing in Delayed Hypersensitivity Drug Reactions"],"prefix":"10.1177","author":[{"given":"Dimitra","family":"Koumaki","sequence":"first","affiliation":[{"name":"From the Department of Dermatology, University Hospital of Heraklion, Heraklion, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stamatios","family":"Gregoriou","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, Andreas Sygros Hospital, Medical School of Athens, National and Kapodistrian University of Athens, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasiliki","family":"Koumaki","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Medical School of Athens, National and Kapodistrian University of Athens, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Katoulis","sequence":"additional","affiliation":[{"name":"2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, \u201cAttikon\u201d General University Hospital, Rimini 1, Haidari, 124 61, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aikaterini","family":"Chatziperrou","sequence":"additional","affiliation":[{"name":"From the Department of Dermatology, University Hospital of Heraklion, Heraklion, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danae","family":"Petrou","sequence":"additional","affiliation":[{"name":"From the Department of Dermatology, University Hospital of Heraklion, Heraklion, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Evangelou","sequence":"additional","affiliation":[{"name":"From the Department of Dermatology, University Hospital of Heraklion, Heraklion, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aikaterini I.","family":"Liakou","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, Andreas Sygros Hospital, Medical School of Athens, National and Kapodistrian University of Athens, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aikaterini","family":"Doxastaki","sequence":"additional","affiliation":[{"name":"From the Department of Dermatology, University Hospital of Heraklion, Heraklion, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A.","family":"Talaganis","sequence":"additional","affiliation":[{"name":"From the Department of Dermatology, University Hospital of Heraklion, Heraklion, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios","family":"Mylonakis","sequence":"additional","affiliation":[{"name":"From the Department of Dermatology, University Hospital of Heraklion, Heraklion, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eirini","family":"Kavvalou","sequence":"additional","affiliation":[{"name":"From the Department of Dermatology, University Hospital of Heraklion, Heraklion, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonios","family":"Rogdakis","sequence":"additional","affiliation":[{"name":"From the Department of Dermatology, University Hospital of Heraklion, Heraklion, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanouil","family":"Karampinis","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University General Hospital Larissa, University of Thessaly, Larissa, Greece."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Krasagakis","sequence":"additional","affiliation":[{"name":"From the Department of Dermatology, University Hospital of Heraklion, Heraklion, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"e_1_3_1_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2022.06.014"},{"key":"e_1_3_1_3_1","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/2386654"},{"key":"e_1_3_1_4_1","doi-asserted-by":"publisher","DOI":"10.1159\/000448284"},{"key":"e_1_3_1_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2007.01553.x"},{"key":"e_1_3_1_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/cea.13076"},{"key":"e_1_3_1_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jim.2026.114035"},{"key":"e_1_3_1_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2004.00547.x"},{"key":"e_1_3_1_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2222.1997.tb00690.x"},{"key":"e_1_3_1_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.12886"},{"key":"e_1_3_1_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jim.2021.113098"},{"key":"e_1_3_1_12_1","doi-asserted-by":"publisher","DOI":"10.2174\/1381612822666161107165917"},{"key":"e_1_3_1_13_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2022.959321"},{"issue":"1","key":"e_1_3_1_14_1","first-page":"52","article-title":"The lymphocyte transformation test in delayed hypersensitivity reactions induced by ibuprofen and\/or metamizole","volume":"33","author":"Nin-Valencia A","year":"2023","unstructured":"13.Nin-Valencia A, , Dom\u00ednguez-Ortega J, , Caba\u00f1as R, et al. The lymphocyte transformation test in delayed hypersensitivity reactions induced by ibuprofen and\/or metamizole. 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