对复方新诺明非即刻过敏的斑贴试验：有用吗？

IF 4.8 1区医学 Q2 ALLERGY Contact Dermatitis Pub Date : 2024-09-04 DOI:10.1111/cod.14692

João Nuno Soares, João Pedro Teixeira, Ana Carolina Figueiredo, André Castro Pinho, Margarida Gonçalo

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引用次数: 0

摘要

背景：现有文献对使用复方新诺明（CTX）进行斑贴试验（PT）在药物过敏性研究中的敏感性提出了质疑：患者/材料/方法：回顾性分析（2000-2022 年）根据 ESCD 指南对 CTX 非即刻皮肤药物不良反应疑似患者进行的 PT 与抗生素系列（包括 CTX 10% pet (Chemotechnique Diagnostics©)）检测。一些患者还接受了由 Bactrim DS® 片剂制成的 10% Pet 或水 CTX 内部制剂以及 10% Pet 三甲氧苄啶（Laboratórios Edol©）的测试：结果：共纳入 64 名患者（48 名女性/16 名男性；平均年龄 47 ± 18 岁），其中大多数人患有斑丘疹性红斑（51 人，占 80%）。值得注意的是，CTX 是 24 名患者的唯一疑似病例。对Chemotechnique或Bactrim DS®片剂中10%的CTX或10%的pet进行斑贴试验，均未出现阳性反应。一名患者只对三甲氧苄氨嘧啶有 1+ 反应。两名患者仅对 Bactrim DS® 片剂的 D2 水溶液粉末有微弱反应（1+），但由于反应在 24 或 48 小时内完全消失，因此被解释为刺激性非特异性反应：这些研究结果表明，斑贴试验可能缺乏足够的灵敏度来诊断 CTX 引起的非即刻性 CADR。因此，临床医生在解释 CTX 斑贴试验结果时应谨慎。

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Patch testing in non-immediate hypersensitivity to cotrimoxazole: Is it useful?

Background

Existing literature has questioned the sensitivity of patch testing (PT) with cotrimoxazole (CTX) in the study of drug hypersensitivity.

Objectives

Assess the sensitivity of PT with CTX in non-immediate cutaneous adverse drug reactions (CADR).

Patients/Materials/Methods

Retrospective analysis (2000–2022) of PT with an antibiotic series including CTX 10% pet (Chemotechnique Diagnostics©) performed according to ESCD guidelines in patients with suspected non-immediate CADR reactions to CTX. Some patients were additionally tested with in-house preparations of CTX from Bactrim DS® tablets at 10% in pet or water and trimethoprim 10% pet (Laboratórios Edol©).

Results

Sixty-four patients (48F/16M; mean age 47 ± 18) were included, mostly with maculopapular exanthema (51, 80%). Notably, CTX was sole suspect in 24 patients. There was no positive reaction to CTX at 10% from Chemotechnique or Bactrim DS® tablets prepared at 10% pet for patch testing. One patient reacted exclusively to trimethoprim with 1+ reaction. Two patients had a faint reaction (1+) only with the powder of Bactrim DS® tablets in water at D2, but as the reactions faded completely in 24 or 48 h, they were interpreted as irritant non-specific reactions.

Conclusion

These findings suggest that patch testing may lack sufficient sensitivity to diagnose CTX-induced non-immediate CADR. Therefore, clinicians should be cautious interpreting CTX patch test results.

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来源期刊

Contact Dermatitis 医学-过敏

CiteScore

4.60

自引率

30.90%

发文量

227

审稿时长

4-8 weeks

期刊介绍： Contact Dermatitis is designed primarily as a journal for clinicians who are interested in various aspects of environmental dermatitis. This includes both allergic and irritant (toxic) types of contact dermatitis, occupational (industrial) dermatitis and consumers" dermatitis from such products as cosmetics and toiletries. The journal aims at promoting and maintaining communication among dermatologists, industrial physicians, allergists and clinical immunologists, as well as chemists and research workers involved in industry and the production of consumer goods. Papers are invited on clinical observations, diagnosis and methods of investigation of patients, therapeutic measures, organisation and legislation relating to the control of occupational and consumers".