Department of Dermatology, Coimbra University Hospital, 3000-075 Coimbra, Portugal.
Contact Dermatitis. 2011 Oct;65(4):202-7. doi: 10.1111/j.1600-0536.2011.01942.x. Epub 2011 Jun 20.
Patch tests help to confirm the aetiology of the cutaneous adverse drug reactions involving delayed hypersensitivity mechanisms, but the results vary with the pattern of skin reaction and the culprit drug.
To analyse the results of patch tests in patients with cutaneous adverse drug reactions imputable to clindamycin and assess their contribution to the diagnosis.
Between 2005 and 2009, we studied patients with delayed cutaneous adverse drug reactions following administration of clindamycin, usually associated with other drugs. After resolution of the cutaneous adverse drug reaction, patch tests were performed with a series of antibiotics, including pure clindamycin 10% in petrolatum.
We studied 30 patients (23 females and 7 males) aged 33-86 years (mean 59.97 years) with generalized maculopapular exanthema where clindamycin was among the highly suspected drugs. Two patients had a previous positive involuntary rechallenge. Patch tests with clindamycin were positive in 9 of 30 patients (30%). More than 50 control patients patch tested with clindamycin were negative.
We considered the positive patch tests results with clindamycin, in the 9 patients with maculopapular exantema, to be specific, versus the negative results observed in the control group. Although the sensitivity is low (30%), they confirmed the responsibility of this antibiotic in cutaneous adverse drug reactions in which, with only chronological criteria, it was not possible to conclude on the culprit drug.
斑贴试验有助于确定涉及迟发型超敏反应机制的皮肤不良反应的病因，但结果因皮肤反应模式和罪魁祸首药物而异。
分析可归咎于克林霉素的皮肤不良反应患者的斑贴试验结果，并评估其对诊断的贡献。
在 2005 年至 2009 年间，我们研究了因克林霉素（通常与其他药物联合使用）引起的迟发型皮肤不良反应患者。在皮肤不良反应消退后，用一系列抗生素进行斑贴试验，包括纯克林霉素 10%在凡士林中。
我们研究了 30 名年龄在 33-86 岁（平均 59.97 岁）的患者（23 名女性和 7 名男性），他们患有全身性斑丘疹性皮疹，克林霉素是高度怀疑的药物之一。有 2 名患者之前有过非自愿再挑战的阳性结果。在 30 名患者中，有 9 名（30%）对克林霉素斑贴试验呈阳性。超过 50 名接受克林霉素斑贴试验的对照患者结果为阴性。
我们认为，在 9 名患有斑丘疹性皮疹的患者中，克林霉素的阳性斑贴试验结果是特异性的，而对照组观察到的结果为阴性。尽管敏感性较低（30%），但它们证实了这种抗生素在皮肤不良反应中的责任，在这些反应中，仅根据时间标准，无法确定罪魁祸首药物。
