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Generalized reactions during skin testing with clindamycin in drug hypersensitivity: a report of 3 cases and review of the literature
Author(s) -
Papakonstantinou Eleni,
Müller Sabine,
Röhrbein Jan H.,
Wieczorek Dorothea,
Kapp Alexander,
Jakob Thilo,
Wedi Bettina
Publication year - 2018
Publication title -
contact dermatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.524
H-Index - 96
eISSN - 1600-0536
pISSN - 0105-1873
DOI - 10.1111/cod.12956
Subject(s) - medicine , clindamycin , dermatology , hypersensitivity reaction , delayed hypersensitivity , skin patch , acute generalized exanthematous pustulosis , patch testing , culprit , physical examination , antibiotics , surgery , allergy , contact dermatitis , immunology , antigen , biology , myocardial infarction , microbiology and biotechnology
Summary Background The diagnostic approach to drug hypersensitivity includes a detailed medical history, clinical examination, and skin testing and/or oral challenge with a culprit or alternative drug, depending on the type of reaction and the suspected drugs. Although skin testing is considered to be rather safe, cutaneous and systemic, including fatal, reactions have been described. Objectives To report 3 cases with generalized delayed reactions after skin testing with clindamycin, and to review the existing literature. Methods Thorough clinical examination, blood tests and prick, intradermal and patch tests were performed in 3 patients. Results All patients experienced generalized maculopapular exanthema after intradermal and patch testing with clindamycin and amoxicillin in the first patient, and clindamycin alone in the second and third patient. None of the patients showed immediate reactions to skin tests, while positive intradermal reactions after 24 h to amoxicillin and clindamycin were observed in the first patient, and positive intradermal reactions after 24 h to clindamycin were observed in the second and third patients. Conclusions Skin testing with clindamycin in the diagnosis of drug hypersensitivity carries some risk of adverse reactions. A stepwise and individual diagnostic work‐up, considering potential risk factors, and testing in a specialized centre with emergency equipment available is highly recommended.