López Tiro J J, Orea Solano M, Flores Sandoval G, Gómez Vera J
Hospital Regional Lic. Adolfo López Mateos, ISSSTE, México, DF.
Rev Alerg Mex. 2001 May-Jun;48(3):80-7.
Currently, the skin tests are the most accepted methods for the diagnosis of allergy to penicillin.
To evaluate the efficacy and diagnosis security of the skin tests with high and minor determinants of penicillin, crystalline and penicillin, in patients with hypersensitivity reaction to penicillin.
Patients with doubtful antecedents of reaction to penicillin (problem group) and healthy patients (control group) were included. Both groups were submitted at the following tests: 1) Skin tests with high and minor determinants of penicillin, and crystalline penicillin, by prick and intradermoreaction methods. 2) In case of negativity, tests of direct challenge with penicillin were practiced. The formation of wheal with or without erythema 3 mm related to the negative control or systemic reaction, was considered positive test.
47 patients were included (24 for problem group, and 23 for control group), 50% of the group problem showed positive reactions with the method of prick, none patient of the control group (p < 0.001); with the intradermoreaction method, 79% in the problem group and only 13.4% in the control group showed positive reaction (p < 0.001). Cutaneous tests showed local adverse effects. Clinical history showed a sensitivity or 88%, method of prick, 50%, and intradermoreaction method, 95%.
目前，皮肤试验是诊断青霉素过敏最常用的方法。
评估青霉素主要和次要决定簇、结晶青霉素皮肤试验在青霉素过敏反应患者中的有效性及诊断安全性。
纳入有青霉素反应可疑病史的患者（问题组）和健康患者（对照组）。两组均接受以下检查：1）采用点刺和皮内注射法进行青霉素主要和次要决定簇、结晶青霉素皮肤试验。2）若试验结果为阴性，则进行青霉素直接激发试验。与阴性对照相比，风团形成伴或不伴3mm红斑或出现全身反应，均视为试验阳性。
共纳入47例患者（问题组24例，对照组23例），问题组50%的患者采用点刺法显示阳性反应，对照组无患者出现阳性反应（p<0.001）；采用皮内注射法时，问题组79%的患者显示阳性反应，而对照组仅13.4%的患者显示阳性反应（p<0.001）。皮肤试验显示有局部不良反应。临床病史显示敏感性为88%，点刺法为50%，皮内注射法为95%。
