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首页> 外文期刊>Clinical and Translational Allergy >Patch testing in drug cutaneous adverse reactions: value of the extemporaneous preparations
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Patch testing in drug cutaneous adverse reactions: value of the extemporaneous preparations

机译：药物皮肤不良反应的斑贴试验：即用制剂的价值

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BackgroundPatch testing (PT) is a part of tools used for the etiologicaldiagnosis of a cutaneous adverse reaction (CADR).Positivity of PT is observed in above 30 to 50 % ofexplored cases. Recommended procedure is based ondilution in petroleum or in water at 30 % for the finishedproduct or at 10 % for the active ingredient. Chemotechniquelaboratory supplies, in the form of ready for usesyringes, around 30 active ingredients. Other medicinesmust be thus prepared by a hospital pharmacy, accordingto the strict protocol. Thus, preparations are not availablein all the test centers and some patients can not beexplored. We led a forward-looking study comparing theextemporaneous tests, easily practicable, compared withthe recommended procedures. Patients and methods Theprogrammed tests were performed at the same time withChemotechnique products or pharmaceutical preparationsand with tablets brought by the patients, crushedmanually with a pestle in order to transform in powderand then mixed in petroleum. The used chambers wereQ or IQ chambers ( Chemotechnique ) and the readingsrealized at 48 and 96 hours.Results70 patients (25 men/ 45 women) were included. Sevenwere tested with 2 different molecules, thus 77 doubletests were performed. Tested substances included usualCADR inducers such as allopurinol (n=9), amoxicillin(n=25), tetrazepam (n=7), pristinamycin (n=10) and 16others molecules. CADR tested included maculopapularrash (MPR; n=27), Drug Reaction with Eosinophilia andSystemic Symptoms (DRESS; n=9), Acute GeneralizedExanthematous Pustulosis (AGEP; n=12), Fixed DrugReaction (FDE; n=5), Linear IgA Dermatosis (n=2),Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis(n=15), erytroderma (n=3) and eczematous rash (n=2).All the tests were coherent: 20 positive tests and 57negative with the 2 techniques. As usually observed inliterature with recommended patch testing, the positivetests were observed preferentially with some ingredients(amoxicillin, tetrazepam, pristinamycin) and converselythere was no positive tests with allopurinol, ibuprofenand piroxicam. As well, patch testing was more frequentlypositive with some kinds of CADR (AGEP andMPR), confirming reliability of the tests.ConclusionFor the patients that could not consult easily in centershaving access to the pharmaceutical preparations butnevertheless expert in CADR, the extemporaneous preparationsconstitute a possible alternative.
机译：背景斑贴试验（PT）是用于皮肤不良反应（CADR）病因诊断的工具的一部分。在超过30％到50％的病例中观察到PT的阳性。推荐的程序基于最终产品中30％或活性成分10％在石油或水中的稀释度。化学技术实验室用品，以即用型注射器形式提供，约有30种有效成分。因此，必须根据严格的协议，由医院药房制备其他药物。因此，并非所有测试中心都提供准备工作，因此无法探索某些患者。我们进行了一项前瞻性研究，将临时测试与推荐的程序进行了比较，比较容易。患者和方法用化学技术产品或药物制剂以及患者带来的片剂同时进行程序测试，然后用杵将其手动压碎，以制成粉末，然后与石油混合。使用的腔室为Q或IQ腔室（Chemotechnique），读数分别在48和96小时出现。结果包括70例患者（25名男性/ 45名女性）。用2个不同的分子测试了Seven，因此进行了77次重复测试。被测物质包括常见的CADR诱导剂，如别嘌醇（n = 9），阿莫西林（n = 25），四西p（n = 7），普ristinamycin（n = 10）和16others分子。测试的CADR包括斑丘疹（MPR; n = 27），与嗜酸性粒细胞增多症和全身症状的药物反应（DRESS; n = 9），急性全身发疹性脓疱病（AGEP; n = 12），固定药物反应（FDE; n = 5），线性IgA皮肤病（n = 2），Stevens-Johnson综合征/中毒性表皮坏死症（n = 15），红皮病（n = 3）和湿疹（n = 2）。所有测试均一致：20项阳性测试和57项阴性（两种技术） 。正如通常通过推荐的斑贴试验所观察到的文盲情况一样，优先使用某些成分（阿莫西林，四西p，普ristinamycin）观察到阳性试验，而别嘌呤醇，布洛芬和吡罗昔康则没有阳性试验。同样，对于某些类型的CADR（AGEP和MPR），斑块测试的阳性率更高，从而证实了测试的可靠性。结论对于无法轻易咨询中心途径使用药物制剂但仍是CADR专家的患者，临时制剂是一个可能的选择。

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