Department of Cutaneous Allergy, St John's Institute of Dermatology, St Thomas' Hospital, Westminster Bridge Road, London SE1 7EH, UK.
Contact Dermatitis. 2010 Mar;62(3):165-9. doi: 10.1111/j.1600-0536.2009.01695.x.
Currently, there is little data available on the reliability of patch testing in patients taking immunosuppressive agents other than systemic corticosteroids.
We present data from 38 patients who were patch tested whilst taking various immunomodulating agents to determine if positive reactions can be elicited. PATIENT/MATERIALS/METHODS: Between September 2006 and May 2009, 38 patients attending the St John's Institute of Dermatology were patch tested whilst taking immunosuppressive agents including azathioprine, ciclosporin, infliximab, adalimumab, etanercept, methotrexate, mycophenolate mofetil, and tacrolimus.
Positive patch test reactions of varying degrees and significance were elicited in: 2 of 10 patients on azathioprine; 5 of 11 patients on ciclosporin; 1 patient on ciclosporin and Fumaderm; 1 patient on infliximab; 1 patient on infliximab and methotrexate; 1 of 2 patients on adalimumab; 1 patient on etanercept and methotrexate; 3 of 4 patients on methotrexate; 1 of 3 patients on mycophenolate mofetil; and 1 patient on mycophenolate mofetil and tacrolimus. Negative patch test reactions occurred in 1 patient on azathioprine and ciclosporin; 1 patient on infliximab and azathioprine; and 1 patient on mycophenolate and ciclosporin.
Positive patch test reactions can be elicited in patients taking azathioprine, ciclosporin, infliximab, adalimumab, etanercept, methotrexate, mycophenolate mofetil, and tacrolimus. However, it remains unclear what effect these immunosuppressive drugs may have on suppressing allergic patch test reactions and further studies should be carried out to determine the reliability of testing in these circumstances.
目前，关于除全身皮质类固醇以外的免疫抑制剂患者斑贴试验的可靠性数据很少。
我们提供了 38 例正在接受各种免疫调节剂治疗的患者进行斑贴试验的数据，以确定是否可以引起阳性反应。
患者/材料/方法：2006 年 9 月至 2009 年 5 月期间，在圣约翰皮肤病研究所就诊的 38 例接受免疫抑制剂治疗的患者（包括硫唑嘌呤、环孢素、英夫利昔单抗、阿达木单抗、依那西普、甲氨蝶呤、霉酚酸酯和他克莫司）进行了斑贴试验。
在接受以下药物治疗的患者中，引起了不同程度和意义的阳性斑贴试验反应：10 例硫唑嘌呤患者中的 2 例；11 例环孢素患者中的 5 例；1 例环孢素和 Fumaderm 患者；1 例英夫利昔单抗患者；1 例英夫利昔单抗和甲氨蝶呤患者；2 例阿达木单抗患者中的 1 例；1 例依那西普和甲氨蝶呤患者；4 例甲氨蝶呤患者中的 3 例；3 例霉酚酸酯患者中的 1 例；1 例霉酚酸酯和他克莫司患者。在接受以下药物治疗的患者中，出现阴性斑贴试验反应：1 例硫唑嘌呤和环孢素患者；1 例英夫利昔单抗和硫唑嘌呤患者；1 例霉酚酸酯和环孢素患者。
在接受硫唑嘌呤、环孢素、英夫利昔单抗、阿达木单抗、依那西普、甲氨蝶呤、霉酚酸酯和他克莫司治疗的患者中可以引起阳性斑贴试验反应。然而，这些免疫抑制剂药物对抑制过敏斑贴试验反应的影响尚不清楚，需要进一步研究以确定在这些情况下进行测试的可靠性。
