Non-Immediate Cutaneous Hypersensitivity Drug Reactions: Are Positive Patch Tests Long-Lasting?
Autor(a) principal: | |
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Data de Publicação: | 2017 |
Outros Autores: | , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.29021/spdv.75.2.770 |
Resumo: | Introduction: Like in allergic contact dermatitis, in non-immediate (NI) cutaneous adverse drug reactions (CADR) delayed hypersensitivity to antibiotics and anticonvulsants is considered to be lifelong. Although in allergic contact dermatitis patch tests remain positive for several years, this has seldom been assessed in the setting of NI-CADR to systemic drugs.Objective: To evaluate the long term behaviour of positive patch test reactions in NI-CADR to beta-lactams, clindamycin and carbamazepine. Methods: The drugs associated with the largest number of positive patch test reactions (beta-lactams, clindamycin and carbamazepin) were selected and 64 patients with history of NI-CADR to these drugs and relevant positive reactions were invited to repeat patch tests, at least 2 years thereafter. New patch test reactions were compared with the original ones.Results: In the 23 patients included in the study (10 males/ 13 females, median age 51 years) there were 44 positive reactions at the first patch tests and 40 (91.1%) of these remained positive after a median interval of 6.5 years (min. 2.0 – max. 30.7 years). Concerning beta-lactams, 17/19 reactions persisted positive for aminopenicillins (amoxicillin or ampicillin), 8/8 for isoxazolyl penicillins (flucloxacillin or dicloxacillin), 3/3 for benzylpenicillin, 1/1 for cefoxitin and 1/1 with piperacillin. Reactions with clindamycin remained positive in 5/7 cases. All five patch tests repeated with carbamazepine were positive. In 62.5% of the tests the same intensity of reaction was observed and was not affected by the time interval between tests, gender or age at performing patch tests.Conclusion: In NI-CADR to several antibiotics and carbamazepine, most of the patch test reactions remained positive after several years. |
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Non-Immediate Cutaneous Hypersensitivity Drug Reactions: Are Positive Patch Tests Long-Lasting?Reações Cutâneas de Hipersensibilidade Retardada a Medicamentos: Serão os Testes Epicutâneos Positivos Persistentes?beta-LactamsCarbamazepineClindamycinDrug EruptionsDrug HypersensitivityHypersensitivityDelayed/ chemically inducedPatch Testsbeta-LactâmicosCarbamazepinaClindamicinaErupção por MedicamentosHipersensibilidade a MedicamentosHipersensibilidade Retardada/induzida quimicamenteTestes EpicutâneosIntroduction: Like in allergic contact dermatitis, in non-immediate (NI) cutaneous adverse drug reactions (CADR) delayed hypersensitivity to antibiotics and anticonvulsants is considered to be lifelong. Although in allergic contact dermatitis patch tests remain positive for several years, this has seldom been assessed in the setting of NI-CADR to systemic drugs.Objective: To evaluate the long term behaviour of positive patch test reactions in NI-CADR to beta-lactams, clindamycin and carbamazepine. Methods: The drugs associated with the largest number of positive patch test reactions (beta-lactams, clindamycin and carbamazepin) were selected and 64 patients with history of NI-CADR to these drugs and relevant positive reactions were invited to repeat patch tests, at least 2 years thereafter. New patch test reactions were compared with the original ones.Results: In the 23 patients included in the study (10 males/ 13 females, median age 51 years) there were 44 positive reactions at the first patch tests and 40 (91.1%) of these remained positive after a median interval of 6.5 years (min. 2.0 – max. 30.7 years). Concerning beta-lactams, 17/19 reactions persisted positive for aminopenicillins (amoxicillin or ampicillin), 8/8 for isoxazolyl penicillins (flucloxacillin or dicloxacillin), 3/3 for benzylpenicillin, 1/1 for cefoxitin and 1/1 with piperacillin. Reactions with clindamycin remained positive in 5/7 cases. All five patch tests repeated with carbamazepine were positive. In 62.5% of the tests the same intensity of reaction was observed and was not affected by the time interval between tests, gender or age at performing patch tests.Conclusion: In NI-CADR to several antibiotics and carbamazepine, most of the patch test reactions remained positive after several years.Introdução: Tal como na dermatite de contacto alérgica, nas reações adversas medicamentosas cutâneas (RAMc) retardadas a hipersensibilidade é considerada permanente. No entanto, enquanto na dermatite de contacto alérgica os testes epicutâneos permanecem positivos por longos períodos de tempo, isto tem sido pouco estudado nas RAMc retardadas medicamentos sistémicos.Objetivo: Avaliar, a longo prazo, a persistência das reações positivas dos testes epicutâneos nas RAMc retardadas a antibióticos betalactâmicos, à clindamicina e à carbamazepina. Métodos: Foram selecionados os medicamentos com maior número de reações positivas em testes epicutâneos (betalactâmicos, clindamicina e carbamazepina) e 64 doentes com história de RAMc retardadas com testes positivos a estes fármacos foram convidados a repetir os testes, pelo menos 2 anos depois dos primeiros. As reações dos novos testes foram comparadas com as dos testes originais.Resultados: Nos 23 doentes que aceitaram participar (10 homens/13 mulheres, idade mediana 51 anos) foram observadas 44 reações positivas nos testes iniciais e 40 (91,1%) destas mantiveram-se positivas, após uma mediana de 6,5 anos (min. 2,0 – máx. 30,7 anos). Relativamente aos betalactâmicos, 17/19 reações permaneceram positivas com aminopenicilinas (amoxicilina ou ampicilina), 8/8 com isoxazolilpenicilinas (flucloxacilina ou dicloxacilina), 3/3 com benzilpenicilina, 1/1 cefoxitina e 1/1 com piperacilina. Os testes com clindamicina mantiveram-se positivos em 5/7 ocasiões. Todos os cinco testes repetidos com carbamazepina foram positivos. Em 62,5% das reações observou-se a mesma intensidade da reação original, não sendo esta afetada pelo tempo decorrido entre os testes, pela idade ou género dos doentes.Conclusão: Nas RAMc retardadas a vários antibióticos e à carbamazepina, a maioria das reações dos testes epicutâneos permaneceu positiva, após vários anos.Sociedade Portuguesa de Dermatologia e Venereologia2017-07-20T00:00:00Zjournal articleinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://doi.org/10.29021/spdv.75.2.770oai:ojs.revista.spdv.com.pt:article/770Journal of the Portuguese Society of Dermatology and Venereology; Vol 75 No 2 (2017): Abril - Junho; 155-162Revista da Sociedade Portuguesa de Dermatologia e Venereologia; v. 75 n. 2 (2017): Abril - Junho; 155-1622182-24092182-2395reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://revista.spdv.com.pt/index.php/spdv/article/view/770https://doi.org/10.29021/spdv.75.2.770https://revista.spdv.com.pt/index.php/spdv/article/view/770/494Pinho, AndréSantiago, LuísGonçalo, Margaridainfo:eu-repo/semantics/openAccess2022-10-06T12:35:03Zoai:ojs.revista.spdv.com.pt:article/770Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:11:02.408887Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Non-Immediate Cutaneous Hypersensitivity Drug Reactions: Are Positive Patch Tests Long-Lasting? Reações Cutâneas de Hipersensibilidade Retardada a Medicamentos: Serão os Testes Epicutâneos Positivos Persistentes? |
title |
Non-Immediate Cutaneous Hypersensitivity Drug Reactions: Are Positive Patch Tests Long-Lasting? |
spellingShingle |
Non-Immediate Cutaneous Hypersensitivity Drug Reactions: Are Positive Patch Tests Long-Lasting? Pinho, André beta-Lactams Carbamazepine Clindamycin Drug Eruptions Drug Hypersensitivity Hypersensitivity Delayed/ chemically induced Patch Tests beta-Lactâmicos Carbamazepina Clindamicina Erupção por Medicamentos Hipersensibilidade a Medicamentos Hipersensibilidade Retardada/induzida quimicamente Testes Epicutâneos |
title_short |
Non-Immediate Cutaneous Hypersensitivity Drug Reactions: Are Positive Patch Tests Long-Lasting? |
title_full |
Non-Immediate Cutaneous Hypersensitivity Drug Reactions: Are Positive Patch Tests Long-Lasting? |
title_fullStr |
Non-Immediate Cutaneous Hypersensitivity Drug Reactions: Are Positive Patch Tests Long-Lasting? |
title_full_unstemmed |
Non-Immediate Cutaneous Hypersensitivity Drug Reactions: Are Positive Patch Tests Long-Lasting? |
title_sort |
Non-Immediate Cutaneous Hypersensitivity Drug Reactions: Are Positive Patch Tests Long-Lasting? |
author |
Pinho, André |
author_facet |
Pinho, André Santiago, Luís Gonçalo, Margarida |
author_role |
author |
author2 |
Santiago, Luís Gonçalo, Margarida |
author2_role |
author author |
dc.contributor.author.fl_str_mv |
Pinho, André Santiago, Luís Gonçalo, Margarida |
dc.subject.por.fl_str_mv |
beta-Lactams Carbamazepine Clindamycin Drug Eruptions Drug Hypersensitivity Hypersensitivity Delayed/ chemically induced Patch Tests beta-Lactâmicos Carbamazepina Clindamicina Erupção por Medicamentos Hipersensibilidade a Medicamentos Hipersensibilidade Retardada/induzida quimicamente Testes Epicutâneos |
topic |
beta-Lactams Carbamazepine Clindamycin Drug Eruptions Drug Hypersensitivity Hypersensitivity Delayed/ chemically induced Patch Tests beta-Lactâmicos Carbamazepina Clindamicina Erupção por Medicamentos Hipersensibilidade a Medicamentos Hipersensibilidade Retardada/induzida quimicamente Testes Epicutâneos |
description |
Introduction: Like in allergic contact dermatitis, in non-immediate (NI) cutaneous adverse drug reactions (CADR) delayed hypersensitivity to antibiotics and anticonvulsants is considered to be lifelong. Although in allergic contact dermatitis patch tests remain positive for several years, this has seldom been assessed in the setting of NI-CADR to systemic drugs.Objective: To evaluate the long term behaviour of positive patch test reactions in NI-CADR to beta-lactams, clindamycin and carbamazepine. Methods: The drugs associated with the largest number of positive patch test reactions (beta-lactams, clindamycin and carbamazepin) were selected and 64 patients with history of NI-CADR to these drugs and relevant positive reactions were invited to repeat patch tests, at least 2 years thereafter. New patch test reactions were compared with the original ones.Results: In the 23 patients included in the study (10 males/ 13 females, median age 51 years) there were 44 positive reactions at the first patch tests and 40 (91.1%) of these remained positive after a median interval of 6.5 years (min. 2.0 – max. 30.7 years). Concerning beta-lactams, 17/19 reactions persisted positive for aminopenicillins (amoxicillin or ampicillin), 8/8 for isoxazolyl penicillins (flucloxacillin or dicloxacillin), 3/3 for benzylpenicillin, 1/1 for cefoxitin and 1/1 with piperacillin. Reactions with clindamycin remained positive in 5/7 cases. All five patch tests repeated with carbamazepine were positive. In 62.5% of the tests the same intensity of reaction was observed and was not affected by the time interval between tests, gender or age at performing patch tests.Conclusion: In NI-CADR to several antibiotics and carbamazepine, most of the patch test reactions remained positive after several years. |
publishDate |
2017 |
dc.date.none.fl_str_mv |
2017-07-20T00:00:00Z |
dc.type.driver.fl_str_mv |
journal article info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.29021/spdv.75.2.770 oai:ojs.revista.spdv.com.pt:article/770 |
url |
https://doi.org/10.29021/spdv.75.2.770 |
identifier_str_mv |
oai:ojs.revista.spdv.com.pt:article/770 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://revista.spdv.com.pt/index.php/spdv/article/view/770 https://doi.org/10.29021/spdv.75.2.770 https://revista.spdv.com.pt/index.php/spdv/article/view/770/494 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Dermatologia e Venereologia |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Dermatologia e Venereologia |
dc.source.none.fl_str_mv |
Journal of the Portuguese Society of Dermatology and Venereology; Vol 75 No 2 (2017): Abril - Junho; 155-162 Revista da Sociedade Portuguesa de Dermatologia e Venereologia; v. 75 n. 2 (2017): Abril - Junho; 155-162 2182-2409 2182-2395 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799130566665175040 |