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Book Details
Abstract
With a focus on improving diagnosis and treatment, Drug Allergy Testing is your new go-to resource for understanding various drug allergies and testing methods, the epidemiology of and economic impact of drug allergies, and new drug and allergy developments.
- Features a wealth of up-to-date information for allergists, immunologists, and primary care physicians who diagnose and treat patients with drug allergies and hypersensitivity.
- Covers the basics of drug allergy evaluation and management as well as specific drugs including antibiotics, ASA/NSAIDs, chemotherapeutic agents and monoclonal antibodies.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Drug Allergy Testing | i | ||
| Drug Allergy Testing | iii | ||
| Copyright | iv | ||
| List of Contributors | v | ||
| Preface: Drug Allergy Testing | ix | ||
| Contents | xi | ||
| 1 - Epidemiology of Drug Allergy | 1 | ||
| DRUG HYPERSENSITIVITY REACTIONS | 2 | ||
| SEVERE CUTANEOUS ADVERSE REACTIONS | 3 | ||
| ANAPHYLAXIS | 4 | ||
| PEDIATRIC DRUG ALLERGY | 4 | ||
| LIMITATIONS IN DIAGNOSIS | 5 | ||
| RISK FACTORS | 5 | ||
| GENETICS | 5 | ||
| CONCLUSIONS | 6 | ||
| REFERENCES | 6 | ||
| 2 - Economic Impact of Drug Allergy | 11 | ||
| INTRODUCTION | 11 | ||
| COST OF ADVERSE DRUG REACTIONS, ADVERSE DRUG EVENTS, AND HYPERSENSITIVITY REACTIONS | 11 | ||
| Cost of Adverse Drug Events and Adverse Drug Reactions | 11 | ||
| Cost of Hypersensitivity Reactions | 11 | ||
| COSTS OF OVERREPORTING ALLERGIES | 13 | ||
| COST-EFFECTIVENESS ANALYSES IN DRUG HYPERSENSITIVITY | 15 | ||
| Genetic Screening in Drug Hypersensitivity | 15 | ||
| Aspirin Desensitization | 16 | ||
| SUMMARY | 16 | ||
| REFERENCES | 16 | ||
| 3 - Drug Allergy: Definitions and Phenotypes | 19 | ||
| DEFINITIONS | 19 | ||
| PHENOTYPING OF DRUG HYPERSENSITIVITY REACTIONS BY CHRONOLOGY | 20 | ||
| PHENOTYPING OF DRUG HYPERSENSITIVITY REACTIONS BY CLINICAL MANIFESTATIONS | 23 | ||
| Clinical Phenotypes Often Associated With Immediate (Acute) Drug Hypersensitivity Reactions and typical elicitors | 23 | ||
| Urticaria and angioedema | 23 | ||
| Anaphylaxis | 23 | ||
| Maculopapular exanthem | 24 | ||
| Symmetric drug-related intertriginous and flexural exanthem | 24 | ||
| Acute generalized exanthematous pustulosis | 24 | ||
| Bullous exanthems | 24 | ||
| Drug reaction with eosinophilia and systemic symptoms | 24 | ||
| Fixed drug eruption | 25 | ||
| Vasculitis | 25 | ||
| Organ-specific and miscellaneous drug reactions | 25 | ||
| Drug-induced autoimmune disease | 25 | ||
| REFERENCES | 25 | ||
| 4 - Immune Mechanisms of Drug Allergy | 27 | ||
| INTRODUCTION | 27 | ||
| Gell-Coombs Classification of Immune-Mediated Adverse Drug Reactions | 27 | ||
| THE IMMUNOPATHOGENESIS OF T CELL–MEDIATED DRUG HYPERSENSITIVITY SYNDROME: ESTABLISHED MODELS | 30 | ||
| Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis | 31 | ||
| Drug Reaction With Eosinophilia and Systemic Symptoms | 31 | ||
| Drug-Specific Models: The Aromatic Amine Anticonvulsants | 33 | ||
| Drug-Specific Models: Allopurinol | 33 | ||
| Drug-Specific Models: Abacavir Hypersensitivity Syndrome | 34 | ||
| Unexplained Features of T Cell–Mediated Adverse Drug Reactions | 34 | ||
| FUTURE RESEARCH AND IMPLICATIONS FOR CLINICAL PRACTICE | 35 | ||
| ABBREVIATIONS | 36 | ||
| ACKNOWLEDGMENTS | 36 | ||
| REFERENCES | 36 | ||
| 5 - Pharmacogenomics of Drug Allergy | 39 | ||
| INTRODUCTION | 39 | ||
| REACTIONS LACKING IMMUNOLOGIC MEMORY | 41 | ||
| Reactions With a Pharmacologic Component | 41 | ||
| Reactions With an Off-Target Pharmacologic and/or Immunologic Component | 41 | ||
| Non-IgE-mediated mast-cell activation | 41 | ||
| Aspirin exacerbated respiratory disease | 42 | ||
| Other NSAID reactions. Cutaneous hypersensitivities to aspirin and other NSAID drugs can be classified as per the European Acade... | 43 | ||
| Drug-induced thrombocytopenia | 43 | ||
| Heparin-induced thrombocytopenia. Heparin and related anticoagulants are associated with the development of heparin-induced thro... | 43 | ||
| REACTIONS INVOLVING IMMUNOLOGIC MEMORY | 44 | ||
| Immediate/Accelerated Immune-Mediated Reactions | 44 | ||
| Delayed Immune Reactions | 44 | ||
| Human leukocyte antigen | 44 | ||
| PHARMACOGENOMIC SCREENING | 44 | ||
| ACKNOWLEDGEMENT | 49 | ||
| REFERENCES | 49 | ||
| 6 - Cutaneous Reactions to Drugs | 53 | ||
| INTRODUCTION | 53 | ||
| LYMPHOCYTIC AND EOSINOPHILIC EXANTHEMS | 53 | ||
| Morbilliform Exanthem Versus Drug Hypersensitivity | 53 | ||
| Drug-Induced Lichenoid Eruptions | 54 | ||
| Symmetric Drug-Related Intertriginous and Flexural Exanthema | 54 | ||
| NEUTROPHILIC EXANTHEMS | 55 | ||
| Acute Generalized Exanthematous Pustulosis | 55 | ||
| Linear IgA Bullous Dermatosis | 56 | ||
| Drug-Induced Sweet Syndrome | 56 | ||
| URTICARIA, ANGIOEDEMA, AND ANAPHYLAXIS | 56 | ||
| DRUG-INDUCED VASCULITIC REACTIONS | 57 | ||
| SEVERE ADVERSE DRUG REACTIONS | 58 | ||
| Erythema Multiforme | 58 | ||
| Drug Reaction With Eosinophilia and Systemic Symptoms | 58 | ||
| Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis | 60 | ||
| DRUG-INDUCED ACANTHOLYTIC DISORDERS | 61 | ||
| Pemphigus | 61 | ||
| Pemphigoid | 62 | ||
| OTHER ADVERSE DRUG REACTIONS | 63 | ||
| Fixed Drug Eruption | 63 | ||
| Acneiform Eruptions | 63 | ||
| Pigmentary Disorders | 64 | ||
| Nail Disorders | 65 | ||
| Noncicatricial Alopecia | 66 | ||
| Pruritus Without Rash | 66 | ||
| REFERENCES | 66 | ||
| 7 - Basics of Skin Testing and Drug Challenges | 73 | ||
| SKIN TESTING | 73 | ||
| Cephalosporin antibiotics | 75 | ||
| Monobactam antibiotics | 76 | ||
| Carbapenem antibiotics | 76 | ||
| Non-β-Lactam Antibiotics | 76 | ||
| Macrolide antibiotics | 76 | ||
| Quinolone antibiotics | 76 | ||
| Sulfonamide antibiotics | 76 | ||
| Other antibiotics | 76 | ||
| Aspirin and Nonsteroidal Drugs | 76 | ||
| Chemotherapy Drugs | 78 | ||
| Biologics and Monoclonal Antibodies | 78 | ||
| Perioperative Drugs (Including Local Anesthetics) | 78 | ||
| Radiocontrast Media | 78 | ||
| Corticosteroids | 78 | ||
| Heparins | 79 | ||
| DRUG CHALLENGES | 79 | ||
| REFERENCES | 81 | ||
| 8 - In Vitro and In Vivo Tests for Drug Hypersensitivity Reactions | 85 | ||
| INTRODUCTION | 85 | ||
| SKIN TESTING | 86 | ||
| DRUG PROVOCATION TESTING | 87 | ||
| IN VITRO DIAGNOSTIC TESTING | 87 | ||
| MEDIATORS OF AN ALLERGIC REACTION | 88 | ||
| Measuring Histamine and Histamine Metabolites | 88 | ||
| Serum Tryptase | 88 | ||
| IN VITRO TESTING FOR SPECIFIC IGE-MEDIATED AND NON-IGE-MEDIATED REACTIONS | 88 | ||
| Mediator Release Assays (Histamine and CysLTs) | 90 | ||
| Basophil Activation Test | 90 | ||
| ASSESSING T CELL–MEDIATED DRUG ALLERGY | 90 | ||
| Patch Testing | 90 | ||
| Intracutaneous Testing With Delayed Readings | 91 | ||
| Human Leukocyte Antigen Typing for Drug Hypersensitivity Screening | 91 | ||
| Lymphocyte Transformation Testing | 91 | ||
| Enzyme-Linked Immunosorbent Spot Assays | 92 | ||
| Combining Tests to Increase Sensitivity | 92 | ||
| SKIN BIOPSY | 92 | ||
| CONCLUSION | 92 | ||
| ABBREVIATIONS | 93 | ||
| CONFLICT OF INTEREST | 93 | ||
| REFERENCES | 93 | ||
| 9 - Drug Desensitization | 97 | ||
| POSSIBLE MECHANISMS | 98 | ||
| DESENSITIZATION PROCESS | 99 | ||
| PRETREATMENT | 99 | ||
| BREAKTHROUGH REACTIONS DURING DESENSITIZATION | 101 | ||
| OUTCOMES | 101 | ||
| REFERENCES | 101 | ||
| 10 - Penicillins | 103 | ||
| INTRODUCTION | 103 | ||
| THE EARLY PENICILLIN HYPERSENSITIVITY OBSERVATIONS | 104 | ||
| PENICILLIN SPECIFIC T CELLS RESPONSIBLE FOR DELAYED-ONSET PENICILLIN HYPERSENSITIVITY | 104 | ||
| ANTIPENICILLIN IGG AND SERUM SICKNESS–LIKE REACTIONS | 105 | ||
| OTHER SERIOUS PENICILLIN-ASSOCIATED ADVERSE REACTIONS | 105 | ||
| WHY PENICILLIN “ALLERGY” IS STILL SO COMMON | 106 | ||
| PENICILLIN BIOCHEMISTRY AND EARLY PENICILLIN SKIN TEST STUDIES | 106 | ||
| PENICILLIN ALLERGY TESTING TODAY | 107 | ||
| THE SAFETY AND CURRENT INDICATIONS FOR A DIRECT ORAL CHALLENGE TO VERIFY ACUTE PENICILLIN TOLERANCE | 108 | ||
| PENICILLIN SKIN TESTING BEFORE ORAL CHALLENGE | 109 | ||
| Adverse Reactions Associated With Penicillin Skin Testing | 109 | ||
| COMMERCIALLY AVAILABLE ANTIPENICILLIN IGE BLOOD ALLERGY TESTS ARE NOT CURRENTLY CLINICALLY USEFUL | 110 | ||
| RESENSITIZATION | 110 | ||
| DESENSITIZATION | 110 | ||
| CONCLUSIONS | 111 | ||
| REFERENCES | 111 | ||
| 11 - Cephalosporin Allergy | 115 | ||
| INTRODUCTION | 115 | ||
| CEPHALOSPORIN ALLERGENIC DETERMINANTS | 115 | ||
| CLINICAL MANIFESTATIONS | 118 | ||
| Immediate Reactions | 118 | ||
| Nonimmediate Reactions | 118 | ||
| DIAGNOSIS | 119 | ||
| Clinical History | 119 | ||
| Immediate Reactions | 119 | ||
| In vitro tests | 120 | ||
| Drug provocation tests | 121 | ||
| In vitro tests | 123 | ||
| ADMINISTRATION OF ALTERNATIVE Β-LACTAMS, INCLUDING CEPHALOSPORINS, IN SUBJECTS ALLERGIC TO CEPHALOSPORINS | 123 | ||
| ABBREVIATIONS | 124 | ||
| REFERENCES | 124 | ||
| 12 - Macrolide Allergy | 129 | ||
| INTRODUCTION | 129 | ||
| CLINICAL MANIFESTATIONS | 129 | ||
| IMMEDIATE REACTIONS | 129 | ||
| NONIMMEDIATE REACTIONS | 129 | ||
| Maculopapular Exanthema | 129 | ||
| Allergic Contact Dermatitis | 130 | ||
| Fixed Drug Eruption | 130 | ||
| Acute Generalized Exanthematous Pustulosis | 130 | ||
| Symmetric Drug-Related Intertriginous and Flexural Exanthema | 130 | ||
| Drug Reaction With Eosinophilia and Systemic Symptoms | 130 | ||
| Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis | 130 | ||
| Eosinophilic Pneumonia | 130 | ||
| Vasculitic Syndromes | 130 | ||
| DIAGNOSIS | 130 | ||
| SKIN TESTING | 130 | ||
| PATCH TESTING | 132 | ||
| IN VITRO TESTING FOR SPECIFIC IGE | 132 | ||
| OTHER FORMS OF IN VITRO TESTING | 132 | ||
| DRUG PROVOCATION TESTING | 132 | ||
| History of Delayed Reactions | 133 | ||
| DESENSITIZATION PROTOCOLS | 133 | ||
| CROSS-REACTIVITY | 133 | ||
| HYPERSENSITIVITY REACTIONS TO IMMUNOSUPPRESSANT MACROLIDES | 134 | ||
| CONCLUSION | 134 | ||
| REFERENCES | 134 | ||
| 13 - Quinolone Allergy | 137 | ||
| INTRODUCTION | 137 | ||
| CLASSIFICATION AND CHEMICAL STRUCTURE | 137 | ||
| EPIDEMIOLOGY AND RISK FACTORS | 137 | ||
| CLINICAL SYMPTOMS | 138 | ||
| Immediate Reactions | 138 | ||
| Delayed Reactions | 138 | ||
| DIAGNOSIS | 138 | ||
| Clinical History | 138 | ||
| Skin Tests | 139 | ||
| In vitro tests | 139 | ||
| Drug provocation test | 141 | ||
| CROSS-REACTIVITY | 141 | ||
| MANAGEMENT | 142 | ||
| CONCLUSIONS | 142 | ||
| CONFLICT OF INTEREST | 142 | ||
| FUNDING | 142 | ||
| REFERENCES | 142 | ||
| 14 - Sulfonamide Drug Allergy | 145 | ||
| INTRODUCTION | 145 | ||
| TERMINOLOGY AND CLASSIFICATION | 145 | ||
| Sulfonamide | 145 | ||
| Sulfonamide Antibiotics | 145 | ||
| Sulfonamide Nonantibiotics | 145 | ||
| MECHANISMS OF REACTIONS TO SULFONAMIDE ANTIBIOTICS | 146 | ||
| Metabolism | 146 | ||
| Cellular Mechanisms | 146 | ||
| Humoral Mechanisms | 147 | ||
| Reactions in HIV | 147 | ||
| Hypersensitivity to Trimethoprim | 148 | ||
| APPROACH TO THE PATIENT | 148 | ||
| Types of Reactions to Sulfonamide Antibiotics | 148 | ||
| Types of Reactions in HIV | 149 | ||
| Adverse Effects | 149 | ||
| CLINICAL EVALUATION | 149 | ||
| History | 149 | ||
| Physical Examination | 149 | ||
| Laboratory Testing | 150 | ||
| Diagnostic Testing | 150 | ||
| CROSS-REACTIVITY | 150 | ||
| Cross-reactivity Among Sulfonamide Antibiotics | 150 | ||
| Cross-reactivity Between Sulfonamide Antibiotics and Nonantibiotics | 150 | ||
| SULFONAMIDE–NONANTIBIOTIC HYPERSENSITIVITY | 151 | ||
| Loop Diuretics | 151 | ||
| Thiazide Diuretics | 151 | ||
| Sulfonylureas | 151 | ||
| COX-2 Inhibitors | 151 | ||
| Sulfasalazine | 152 | ||
| Protease Inhibitors | 152 | ||
| Dapsone | 152 | ||
| Carboxy Anhydrase Inhibitors | 152 | ||
| 5-HT Agonists | 152 | ||
| MANAGEMENT | 153 | ||
| Desensitization | 153 | ||
| TMP-SMX Desensitization in HIV Negative Patients | 153 | ||
| Trimethoprim-Sulfamethoxazole Desensitization in HIV Positive Patients | 153 | ||
| CONCLUSION | 155 | ||
| REFERENCES | 155 | ||
| 15 - Other Antibiotic Allergy | 157 | ||
| INTRODUCTION | 157 | ||
| VANCOMYCIN | 157 | ||
| Red Man Syndrome | 157 | ||
| Linear IgA Bullous Dermatosis | 158 | ||
| Other Adverse Reactions | 158 | ||
| METRONIDAZOLE | 158 | ||
| TETRACYCLINES | 159 | ||
| DAPSONE | 160 | ||
| CLINDAMYCIN | 160 | ||
| AMINOGLYCOSIDES | 161 | ||
| REFERENCES | 161 | ||
| 16 - Multiple Drug Intolerance Syndrome | 165 | ||
| INTRODUCTION | 165 | ||
| EPIDEMIOLOGY | 165 | ||
| TRUE IMMUNOLOGICALLY MEDIATED MULTIPLE DRUG INTOLERANCE | 166 | ||
| RISK FACTORS FOR MULTIPLE DRUG INTOLERANCE | 166 | ||
| CLINICAL MANAGEMENT OF TYPICAL CASES | 166 | ||
| DRUG CHALLENGES | 167 | ||
| CONCLUSIONS | 167 | ||
| REFERENCES | 168 | ||
| 17 - Aspirin-Exacerbated Respiratory Disease | 169 | ||
| INTRODUCTION | 169 | ||
| Definition and Classification | 169 | ||
| Prevalence | 169 | ||
| DIAGNOSIS BASED ON CLINICAL HISTORY | 170 | ||
| DIAGNOSTIC TESTING WITH PROVOCATION CHALLENGES | 171 | ||
| Safety Requirements and Circumstances for Performing Provocation Challenges | 171 | ||
| Oral Aspirin Challenge | 171 | ||
| Intranasal Challenge With Ketorolac | 173 | ||
| IN VITRO DIAGNOSIS | 173 | ||
| SUMMARY | 174 | ||
| REFERENCES | 174 | ||
| 18 - Other NSAIDs Reactions | 177 | ||
| INTRODUCTION | 177 | ||
| CLASSIFICATION AND MECHANISMS | 179 | ||
| EPIDEMIOLOGY | 180 | ||
| TYPES OF NSAIDS IN SPECIFIC NSAID HYPERSENSITIVITY PHENOTYPES | 180 | ||
| PHENOTYPES OF NSAID HYPERSENSITIVITY | 181 | ||
| NSAID-Exacerbated Cutaneous Disease | 181 | ||
| NSAID-Induced Urticaria and Angioedema | 181 | ||
| Single NSAID-Induced Urticaria, Angioedema, and Anaphylaxis | 182 | ||
| Single NSAID-Induced Delayed Reactions | 183 | ||
| Maculopapular exanthema | 184 | ||
| Fixed drug eruption | 184 | ||
| Acute generalized exanthematous pustulosis | 184 | ||
| Drug rash with eosinophilia and systemic symptoms | 184 | ||
| Stevens-Johnson syndrome/toxic epidermal necrolysis | 184 | ||
| Contact dermatitis and photoallergic dermatitis | 184 | ||
| MIXED REACTIONS | 185 | ||
| COFACTORS, RISK FACTORS, AND ATOPY | 185 | ||
| NATURAL HISTORY OF NSAID HYPERSENSITIVITY | 186 | ||
| DIAGNOSIS | 186 | ||
| In Vivo Tests | 186 | ||
| In Vitro Tests | 187 | ||
| Drug Provocation Tests | 187 | ||
| CHALLENGE WITH ALTERNATIVE DRUGS | 188 | ||
| DESENSITIZATION | 189 | ||
| REFERENCES | 190 | ||
| 19 - Chemotherapy Allergy | 197 | ||
| INTRODUCTION | 197 | ||
| PLATIN HYPERSENSITIVITY | 198 | ||
| TAXANES HYPERSENSITIVITY | 201 | ||
| EVALUATION OF PATIENTS WITH HYPERSENSITIVITY REACTIONS TO CHEMOTHERAPY | 202 | ||
| PREMEDICATIONS AND PROTOCOLS FOR RAPID DRUG DESENSITIZATION FOR CHEMOTHERAPY | 202 | ||
| OUTCOMES OF RAPID DRUG DESENSITIZATION FOR CHEMOTHERAPY AND MONOCLONAL ANTIBODIES | 204 | ||
| CONCLUSION | 204 | ||
| REFERENCES | 208 | ||
| 20 - Hypersensitivity Reactions to Monoclonal Antibodies | 211 | ||
| BASICS OF MAB PRODUCTION | 211 | ||
| IMMUNOGENICITY | 211 | ||
| CLASSIFICATION OF ADVERSE REACTIONS TO MABS | 212 | ||
| INFUSION REACTIONS | 213 | ||
| RITUXIMAB | 214 | ||
| CETUXIMAB | 214 | ||
| OMALIZUMAB | 215 | ||
| MANAGEMENT | 216 | ||
| DIAGNOSTIC TESTING | 216 | ||
| DESENSITIZATION | 217 | ||
| CONCLUSIONS | 218 | ||
| ABBREVIATIONS | 218 | ||
| REFERENCES | 218 | ||
| 21 - Perioperative Allergy | 223 | ||
| INTRODUCTION | 223 | ||
| INCIDENCE | 223 | ||
| DEFINITION OF TERMS AND CLASSIFICATION | 223 | ||
| MECHANISMS AND DIFFERENTIAL DIAGNOSES | 224 | ||
| CLINICAL PRESENTATION AND MANAGEMENT IN THE OPERATING ROOM | 226 | ||
| ALLERGY EVALUATION | 226 | ||
| Serum Tryptase | 227 | ||
| Specific IgE | 228 | ||
| Basophil Histamine Release and Basophil Activation Tests | 228 | ||
| Skin Testing | 228 | ||
| Drug Provocation | 229 | ||
| CAUSES | 230 | ||
| Anesthetic Agents | 230 | ||
| Local Anesthetics | 230 | ||
| Opioids and Other Analgesics | 230 | ||
| Neuromuscular Blocking Agents | 231 | ||
| Reversal Agents | 231 | ||
| Antibiotics | 231 | ||
| Plasma Expanders | 231 | ||
| Blood and Blood Products | 232 | ||
| “Hidden Allergens”—Substances Not Administered IV and Not Always Documented on Charts | 232 | ||
| Latex | 232 | ||
| Disinfectants | 232 | ||
| Sterilizing Agents | 233 | ||
| Blue Dyes | 233 | ||
| Oxytocin | 233 | ||
| Other Hidden Exposures in the Perioperative Setting | 233 | ||
| ABBREVIATIONS | 233 | ||
| REFERENCES | 234 | ||
| 22 - Adverse Reactions to Contrast Media | 239 | ||
| INTRODUCTION | 239 | ||
| IODINATED CONTRAST MEDIA | 239 | ||
| Types of Iodinated Contrast Media | 239 | ||
| Types of Adverse Reactions | 240 | ||
| Epidemiology | 243 | ||
| Diagnostic Testing | 244 | ||
| Prevention of Immediate Hypersensitivity Reactions | 246 | ||
| Approach to High-Risk Patients | 250 | ||
| Management of Acute Reactions | 251 | ||
| GADOLINIUM-BASED CONTRAST MEDIA | 251 | ||
| Types of Gadolinium-Based Contrast Media | 251 | ||
| Types of Adverse Reactions, Frequency, and Management | 253 | ||
| REFERENCES | 253 | ||
| 23 - Corticosteroids | 261 | ||
| INTRODUCTION | 261 | ||
| IMMEDIATE HYPERSENSITIVITY REACTIONS | 261 | ||
| Skin Testing for Corticosteroids | 261 | ||
| Succinate ester | 262 | ||
| Lactose | 263 | ||
| Carboxymethylcellulose | 263 | ||
| Polyethylene glycol | 263 | ||
| Summary and Recommendations for Immediate Hypersensitivity Reactions | 263 | ||
| CONTACT DERMATITIS | 263 | ||
| Structure and Cross-Reactivity | 263 | ||
| Patch Testing | 265 | ||
| Summary and Recommendations for Contact Dermatitis | 265 | ||
| REFERENCES | 265 | ||
| Index | 269 | ||
| A | 269 | ||
| B | 269 | ||
| C | 269 | ||
| D | 270 | ||
| E | 271 | ||
| F | 271 | ||
| G | 272 | ||
| H | 272 | ||
| I | 272 | ||
| L | 272 | ||
| M | 272 | ||
| N | 273 | ||
| O | 273 | ||
| P | 273 | ||
| Q | 274 | ||
| R | 274 | ||
| S | 274 | ||
| T | 275 | ||
| U | 275 | ||
| V | 275 | ||
| W | 275 |