Eczematous‐like drug eruption induced by synergistins

Michel, Murielle; Dompmartin, Anne; Szczurko, C.; Castel, B.; Moreau, Axelle; Leroy, D.

doi:10.1111/j.1600-0536.1996.tb02135.x

Cited by 25 publications

(12 citation statements)

References 4 publications

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“…With our study, which has the largest published number of patients suffering from CADRs due to pristinamycin, who have been tested with the suspected drug, we confirm the value of patch tests with pristinamycin in investigating CADR due to this synergistin, as was suggested by previous reports in smaller series 2/3 (3), 2/2 (5), 9/11 (6) and 8/9 (7). 69% of the 29 patients had positive patch tests to pristinamycin.…”

Section: Discussionsupporting

confidence: 89%

Drug skin tests in cutaneous adverse drug reactions to pristinamycin: 29 cases with a study of cross‐reactions between synergistins

Barbaud

Tréchot²,

Weber-Muller

et al. 2004

Contact Dermatitis

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The present study was made to determine the value of drug skin tests in patients with cutaneous adverse drug reactions (CADRs) due to a synergistin (pristinamycin) and to determine the frequency of cross-reactions between synergistins. 29 patients were referred during the onset of the CADR due to pristinamycin: 18 with maculopapular rash, 9 erythrodermas, 1 angioedema and 1 Stevens-Johnson syndrome. They all had patch tests with pristinamycin and, in most cases, with other synergistins [virginiamycin and dalfopristin-quinupristin (DQ)], prick tests (10 cases) and intradermal tests (IDT) (5 cases). Skin tests with synergistins were positive in 27 cases, patch tests with pristinamycin in 20/29 cases (69%), prick tests with pristinamycin in 3/9 cases on immediate (1 case) or on delayed (2 cases) readings, and IDT with DQ in 4/5 cases. Cross-reactions between synergistins occurred in 9/22 with virginiamycin and in 7/8 cases with DQ. Skin tests with synergistins are useful in investigating CADR due to pristinamycin. Synergistins are composed of 2 chains (1 depsipeptide and 1 macrocyclic lactone) with many structural analogies between all synergistins. According to the chemical structures and our results, it seems advisable to avoid all synergistins in patients with CADR due to pristinamycin.

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Section: Discussionsupporting

confidence: 89%

Drug skin tests in cutaneous adverse drug reactions to pristinamycin: 29 cases with a study of cross‐reactions between synergistins

Barbaud

Tréchot²,

Weber-Muller

et al. 2004

Contact Dermatitis

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“…Similar immunohistological alterations were found in situ in biopsy specimens obtained from MPRs induced by amoxycillin and in biopsy specimens obtained from the same patients who had delayed positive results of their patch tests, prick tests and/or IDRs performed with amoxycillin. 12 Patch tests may also be useful in determining the culprit drug in some other clinical features of cutaneous ADRs-thought to be induced by a cellular delayed immune reaction 1-3 -such as AGEP, 13 erythrodermas 14,21,22 and generalized eczema. 14,21 Photopatch tests have an investigative value in drug photosensitivity.…”

Section: Discussionmentioning

confidence: 99%

The use of skin testing in the investigation of cutaneous adverse drug reactions

Barbaud¹,

Reichert-Pénétrat²,

Tréchot³

et al. 1998

Br J Dermatol

236

204

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Skin testing with the suspected compound has been reported to be helpful in determining the cause of cutaneous adverse drug reactions (ADRs), but the value and specificity of these tests need to be determined. In this study, 72 patients with presumed drug eruptions (27 maculopapular, 18 urticarial, seven erythrodermic, nine eczematous, four photosensitivity, three fixed drug eruptions, three with pruritus and one with acute generalized exanthematous pustulosis) were assessed. All had drug patch tests; 46 also had prick tests and 30 had intradermal tests (performed on hospitalized patients using a sterile solution of the suspected drug, diluted sequentially) with immediate and delayed readings. Among these patients, 52 (72%) had a positive skin test reaction, 43%, 24% and 67% in patch, prick and intradermal skin tests, respectively. The results of skin tests varied with the drug tested and with the clinical type of cutaneous ADR, as a significantly higher number of positive patch tests was observed in maculopapular rashes than in urticarial reactions (P = 0.001). This study supports the value of careful sequential drug skin testing in establishing the cause of cutaneous ADR. Guidelines are proposed for performing these tests, and these include the use of appropriate negative control patients to avoid false-positive results.

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“…The most frequent reports of positive drug patch tests are related to the following drugs: betalactam antibiotics (Romano et al, 2002), especially amoxicillin (Barbaud et al, 1998b(Barbaud et al, , 2000Van Ketel, 1987, 1989;Bruynzeel et al, 1985;Romano et al, 1993Romano et al, , 1995Barbaud et al, 1997;Vega et al, 1991;Felix and Comaish, 1974), cotrimoxazole (Klein et al, 1995), corticosteroids (Barbaud et al, 1998b;Dooms-Goossens, 1995;Bircher et al, 1996;Kilpio and Hannuksela, 2003), heparin derivatives (Barbaud et al, 1998b;Bircher et al, 1990;Moreau et al, 1996;Figarella et al, 2001), pristinamycin (Barbaud et al, 1998bMichel et al, 1996), carbamazepine (Barbaud et al, 1998b(Barbaud et al, , 2000Vaillant et al, 1989;Silva et al, 1982;Camarasa, 1985;Romaguera et al, 1989;Jones et al, 1994;Rodriguez-Mosquera et al, 1991;Alanko, 1993;Corazza et al, 1995;Puig et al, 1996), diltiazem (Barbaud et al, 1998a(Barbaud et al, , 1993Romano et al, 1992;Cholez et al, 2003), hydroxyzine (Barbaud et al, 1998b;Michel et al, 1997), pseudoephedrine …”

Section: The Clinical Significance Of Drug Patch Testsmentioning

confidence: 96%