Jappe Uta, Uter Wolfgang, Menezes de Pádua Cristiane A, Herbst Rudolf A, Schnuch Axel
Department of Dermatology, University of Heidelberg, Germany.
Acta Derm Venereol. 2006;86(6):509-14. doi: 10.2340/00015555-0162.
Topically applied ophthalmic drugs are a potential cause of allergic contact dermatitis of the periorbital region. The objectives of this study were to assess the frequency and spectrum of contact allergy to topically applied beta-blocker containing eye drops. Data of the Information Network of Departments of Dermatology (IVDK) collected between 1993 and 2004 was analysed. Out of 112,430 patch-tested patients, 332 had been tested with their own topical anti-glaucoma eye drops containing different beta-blockers because of suspected allergic contact dermatitis. The frequency of positive test reactions was related to exposure intensity, as estimated by annual prescription rates in Germany. A total of 43/332 (12.95%) showed at least one positive patch test reaction. Positive reactions were observed to products containing timolol (n = 21), metipranolol (n = 13) and levobunolol (n = 11) without conceivable cross-reactivity. Whereas exposure to beta-blocker-containing eye drops remained stable over the years, as estimated by the prescription rates, a slight, non-significant increase in positive patch-reactions to these substances was noted. This is the first systematic analysis of a large set of data on patients' own beta-blocker topical medications, the results indicating that contact allergy should be considered as important, if rare, adverse event caused by this family of drugs.
局部应用的眼科药物是眶周区域过敏性接触性皮炎的一个潜在病因。本研究的目的是评估对局部应用的含β受体阻滞剂滴眼液发生接触过敏的频率和范围。分析了1993年至2004年期间皮肤科部门信息网络（IVDK）收集的数据。在112430名接受斑贴试验的患者中，332名因疑似过敏性接触性皮炎而使用了自己含不同β受体阻滞剂的局部抗青光眼滴眼液进行检测。阳性试验反应的频率与暴露强度相关，暴露强度由德国的年处方率估算得出。共有43/332（12.95%）至少有一项阳性斑贴试验反应。对含噻吗洛尔（n = 21）、美替洛尔（n = 13）和左布诺洛尔（n = 11）的产品观察到阳性反应，且不存在可想象的交叉反应。尽管根据处方率估算，多年来含β受体阻滞剂滴眼液的暴露量保持稳定，但对这些物质的阳性斑贴反应有轻微的、无统计学意义的增加。这是对大量关于患者自用β受体阻滞剂局部用药数据的首次系统分析，结果表明接触过敏应被视为这类药物引起的重要但罕见的不良事件。
