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Patch Test Results in Psoriasis Patients on Biologics

Kim, Noori MD; Notik, Shimrat MD; Gottlieb, Alice B. PhD, MD; Scheinman, Pamela L. MD

doi: 10.1097/DER.0000000000000056

Objectives The objective of this study was to determine the prevalence of positive patch tests in patients with psoriasis receiving biologics and whether these results differ from those of patients with psoriasis not on biologics.

Methods An institutional review board–approved retrospective chart review was conducted for patients with psoriasis patch tested January 2002–2012 at Tufts Medical Center. Patients had a history of psoriasis, psoriatic arthritis, and patch testing as identified by International Classification of Diseases, Ninth Revision codes 696.1, 696.0, and 95044, respectively, in their records. Patients were tested to a modified North American Contact Dermatitis Group standard and cosmetics series. Readings were performed at 48 hours and 72 to 96 hours. The North American Contact Dermatitis Group grading system was used to grade reactions.

Results Fifteen patients with psoriasis on biologics (cases) and 16 patients with psoriasis not on biologics (control subjects) were studied. The biologics used were ustekinumab (n = 7), etanercept (n = 4), adalimumab (n = 3), and infliximab (n = 1). Eighty percent (12/15) of cases had at least 1 positive reaction compared with 81% (13/16) of the control subjects; 67% (10/15) of cases had 2+ reactions compared with 63% (10/16) of the control subjects, and 27% (4/15) of cases had 3+ reactions, compared with 38% (6/16) of control subjects. These differences were not statistically significant.

Conclusions Given the limitation of small numbers of patients, biologics do not appear to influence the abilities of patients with psoriasis to mount a positive patch test.

From the Department of Dermatology, Tufts Medical Center, Boston, MA.

Address reprint requests to requests to Noori Kim, MD, Tufts Medical Center, Department of Dermatology, 800 Washington St, Box 114, Boston, MA 02111. E-mail:

The work presented in this article was funded by a clinical research fellowship grant from the American Contact Dermatitis Society awarded to the first author.

Dr Gottlieb is an investigator with the following: Abbott (Abbvie) Laboratories, Amgen Inc, Celgene Corporation, Coronado Biosciences, Immune Control, Janssen Biotech Inc, Lerner Medical Devices, Inc, Lilly ICOS LLC, Novartis Pharmaceuticals Corp, Novo Nordisk A/S, Pfizer Inc, UCB. Dr Gottlieb has consulting/advisory board agreements with the following: Abbott (Abbvie) Laboratories, Actelion, Akros Pharma, Amgen Inc, Astellas Pharma US Inc, Beiersdorf Inc, Bristol Myers Squibb Co, Canfite, Celgene Corporation, Coronado Biosciences, CSL Behring, DermiPsor Ltd., Glaxo Smith Kline, Incyte Corporation, Janssen Biotech Inc, Karyopharm, Lilly ICOS LLC, Merck & Co Inc, Novartis Pharmaceuticals Corp, Novo Nordisk A/S, Pfizer Inc, TEVA, UCB, Vertex, and Xenoport, Inc. Dr Gottlieb has research/educational grants with the following: Abbott (Abbvie) Laboratories, Amgen Inc, Celgene Corporation, Coronado, Levia, Janssen Biotech Inc, Lilly ICOS LLC, Novartis Pharmaceuticals Corp, Pfizer Inc. All research/educational grant income goes to Tufts Medical Center. Drs Kim, Notik, and Scheinman do not have any conflicts of interest to declare.

The information in this work was presented at the annual American Contact Dermatitis Society meeting, March 2013.

© 2014 American Contact Dermatitis Society
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