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Occupational allergic contact dermatitis from azithromycin in pharmaceutical workers: a case series
Author(s) -
MilkovićKraus Sanja,
Macan Jelena,
KanceljakMacan Božica
Publication year - 2007
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/j.1600-0536.2007.00999.x
Subject(s) - azithromycin , medicine , dermatology , patch test , allergic contact dermatitis , contact dermatitis , sensitization , asymptomatic , allergy , surgery , immunology , antibiotics , microbiology and biotechnology , biology
Background: Reports on hypersensitivity reactions to azithromycin associated with therapy or occupational exposure have been rare. Objectives: A case series describing clinical characteristics, diagnostic pathways and risk factors in occupational allergic contact dermatitis (ACD) caused by azithromycin in pharmaceutical workers is presented. Patients/Methods: 7 out of 21 pharmaceutical workers exposed to powdered intermediate and final substances in azithromycin synthesis were referred with workplace‐related skin and respiratory symptoms. They all underwent diagnostic procedure involving medical history and examination, patch testing with standard allergens and azithromycin, prick testing with inhalatory allergens and total immunoglobulin E measurement. Results: Airborne ACD caused by azithromycin was established in 4 examined workers with positive patch test to azithromycin. 2 workers additionally had positive patch test to intermediate substances. Occupation‐related symptoms of urticaria, rhinoconjunctivitis, laryngitis and/or dyspnoea were described in additional 2 workers without clearly positive patch test to azithromycin. 2 atopic workers had a shorter asymptomatic period between the beginning of the exposure to azithromycin and occurrence of skin symptoms than non‐atopics (2–3 months versus 1–3 years, respectively). Conclusions: Our results suggest that daily manipulation with powdered azithromycin and intermediates is a main route of sensitization. Besides contact sensitization, other possible workplace‐related azithromycin hypersensitivity reactions are indicated.