Dooms-Goossens A, Matura M, Drieghe J, Degreef H
Department of Dermatology, University Hospital, Katholieke Universiteit Leuven, Belgium.
Contact Dermatitis. 1995 Aug;33(2):73-7. doi: 10.1111/j.1600-0536.1995.tb00504.x.
The present article reviews the literature (up to 1994) on contact sensitivity to imidazoles and presents the results obtained from 15 patients observed at the Contact Allergy Unit in Leuven. The frequency as well as the cross-reaction patterns described are analyzed. Although allergic contact reactions may have been missed in the past (mainly because of problems with the correct choice of vehicle for patch testing), they seem to be relatively infrequent in view of their widespread use. The imidazole derivatives most frequently reported to be allergens are miconazole, econazole, tioconazole, and isoconazole. As far as cross-reactivity is concerned, statistically significant associations were found in the patient data between miconazole, econazole, and isoconazole; between sulconazole, miconazole, and econazole; and also between isoconazole and tioconazole. Patients sensitive to phenylethyl imidazoles (except ketoconazole) needing antimycotic therapy should be advised to use ketoconazole, clotrimazole, bifonazole, or, perhaps, the new flutrimazole. Clearly, non-imidazole antifungals can also be used.
本文回顾了（截至1994年）关于对咪唑类药物接触性过敏的文献，并展示了在鲁汶接触性过敏科观察的15例患者所得到的结果。对所描述的频率以及交叉反应模式进行了分析。尽管过去可能遗漏了过敏接触反应（主要是因为斑贴试验载体选择正确存在问题），但鉴于其广泛使用，此类反应似乎相对不常见。最常被报道为变应原的咪唑衍生物是咪康唑、益康唑、联苯苄唑和异康唑。就交叉反应而言，在患者数据中发现咪康唑、益康唑和异康唑之间；硫康唑、咪康唑和益康唑之间；以及异康唑和联苯苄唑之间存在统计学上显著的关联。对需要抗真菌治疗的苯乙基咪唑类药物（除酮康唑外）敏感的患者，应建议使用酮康唑、克霉唑、联苯苄唑，或者可能的话，使用新的氟康唑。显然，也可以使用非咪唑类抗真菌药物。
