Wolkenstein P, Chosidow O, Fléchet M L, Robbiola O, Paul M, Dumé L, Revuz J, Roujeau J C
Department of Dermatology, Hôpital Henri-Mondor, Créteil, France.
Contact Dermatitis. 1996 Oct;35(4):234-6. doi: 10.1111/j.1600-0536.1996.tb02364.x.
Patch testing may help to assess the culpability of a drug in an adverse reaction. Our aim was to study patch testing in severe cutaneous adverse drug reactions (ADRs) (Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN), acute generalized exanthematous pustulosis (AGEP), and other cutaneous ADRs). 59 patients with cutaneous ADRs were included: 22 had SJS/TEN, 14 AGEP, and 23 other cutaneous ADRs. Patients were patch tested with the suspect drug, and with a standard series of drugs. 2 patients among the 22 SJS/TEN cases had a relevant positive test. 7 patients among the 14 AGEP cases had a relevant positive test. 6 patients among the 23 other cutaneous ADRs had a relevant positive test. Our results suggest that patch testing has a weak sensitivity in SJS/TEN and is not appropriate in these diseases. Patch testing seems more adapted to other cutaneous ADRs, such as AGEP, in which the proportion of positive patch tests was significantly higher (p < 0.02). Nevertheless, the difference of sensitivity of patch testing in SJS/ TEN, AGEP or other cutaneous ADRs could be linked not only to the clinical type of eruption, but also to the different spectrum of culprit drugs in each type of eruption.
斑贴试验有助于评估药物在不良反应中的罪责。我们的目的是研究严重皮肤药物不良反应（ADR）（史蒂文斯-约翰逊综合征/中毒性表皮坏死松解症（SJS/TEN）、急性泛发性脓疱性皮病（AGEP）及其他皮肤ADR）中的斑贴试验。纳入了59例皮肤ADR患者：22例患有SJS/TEN，14例患有AGEP，23例患有其他皮肤ADR。对患者进行可疑药物及标准系列药物的斑贴试验。22例SJS/TEN病例中有2例斑贴试验呈相关阳性。14例AGEP病例中有7例斑贴试验呈相关阳性。23例其他皮肤ADR病例中有6例斑贴试验呈相关阳性。我们的结果表明，斑贴试验在SJS/TEN中的敏感性较低，不适用于这些疾病。斑贴试验似乎更适用于其他皮肤ADR，如AGEP，其中斑贴试验阳性比例显著更高（p < 0.02）。然而，SJS/TEN、AGEP或其他皮肤ADR中斑贴试验敏感性的差异不仅可能与皮疹的临床类型有关，还可能与每种皮疹类型中致病药物的不同范围有关。
