Pinho André, Marta Ana, Coutinho Inês, Gonçalo Margarida
Dermatology Department, Hospitais da Universidade de Coimbra, Centro Hospitalar e Universitário de Coimbra, 3000-045, Coimbra, Portugal.
Faculty of Medicine, Clinic of Dermatology, University of Coimbra, 3000-045, Coimbra, Portugal.
Contact Dermatitis. 2017 Apr;76(4):204-209. doi: 10.1111/cod.12720. Epub 2016 Dec 2.
As in contact allergy, T cell-mediated hypersensitivity in non-immediate (NI) cutaneous adverse drug reactions (CADRs) to antibiotics is considered to be lifelong, but, in this setting, patch tests have rarely been repeated after long time intervals.
To evaluate the long-term reproducibility of positive patch test reactions to antibiotics in patients with NI CADRs.
Fifty-six patients with NI CADRs to antibiotics who had relevant positive reactions during patch testing were invited to repeat patch tests with a similar antibiotic series 2-15 years thereafter.
Twenty patients were included (9 males and 11 females; mean age 54.6 years): 18 with maculopapular exanthema, 1 with drug hypersensitivity syndrome, and 1 with acute generalized exanthematous pustulosis. Results were reproducible in 17 of 20 patients after a mean interval of 6.0 years (range 2-14.7 years). Concerning β-lactams, 7 of 8 patients remained positive for aminopenicillins, 4 of 4 for isoxazolyl penicillins, and 1 for cefoxitin. Patch test results were also reproducible for clindamycin in 5 of 7 patients, for vancomycin in 1 patient, and for spiramycin in 1 patient. Reproducibility was not affected by the time interval between tests, sex, or age at testing.
In the context of NI CADRs, we showed high reproducibility of positive patch test reactions to various antibiotics, even after several years.
与接触性过敏一样，抗生素引起的非即刻（NI）皮肤药物不良反应（CADR）中，T细胞介导的超敏反应被认为是终身的，但在这种情况下，长时间间隔后很少重复进行斑贴试验。
评估NI CADR患者对抗生素斑贴试验阳性反应的长期可重复性。
邀请56例对抗生素有NI CADR且在斑贴试验期间有相关阳性反应的患者，在2至15年后用类似的抗生素系列重复进行斑贴试验。
纳入20例患者（9例男性和11例女性；平均年龄54.6岁）：18例为斑丘疹性皮疹，1例为药物超敏综合征，1例为急性泛发性脓疱性皮病。平均间隔6.0年（范围2至14.7年）后，20例患者中有17例结果可重复。关于β-内酰胺类，8例患者中有7例对氨基青霉素仍呈阳性，4例对异恶唑基青霉素均呈阳性，1例对头孢西丁呈阳性。7例患者中有5例对克林霉素、1例对万古霉素、1例对螺旋霉素的斑贴试验结果也可重复。可重复性不受两次试验之间的时间间隔、性别或试验时年龄的影响。
在NI CADR的背景下，我们发现即使在数年之后，对各种抗生素的斑贴试验阳性反应仍具有很高的可重复性。
