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Updated: Sep 23, 2026

Trans-vivo Delayed Type Hypersensitivity Assay for Antigen Specific Regulation
Published on: May 2, 2013
Acute generalized exanthematous pustulosis due to sulfamethoxazol with positive lymphocyte transformation test (LTT)
Mark David Anliker1, Brunello Wüthrich
1Allergy Unit, Department of Dermatology, University Hospital of Zürich, Zürich, Switzerland. markanliker@hotmail.com
Abstract:
We studied an acute generalized exanthematous pustulosis (AGEP) due to sulfamethoxazol in a 48-year-old woman with unusual findings in allergy testing. The histological picture provided evidence for a pustular drug eruption and leukocytoclastic vasculitis. Skin testing with sulfamethoxazol was negative for immediate-type reaction (scratch test) and delayed-type reaction (epicutaneous testing). A lymphocyte transformation test (LTT) showed a significant lymphocyte stimulation (stimulation index 5.04/2.61) toward sulfamethoxazol (200/100 mg/ml) by measuring the rate of built-in tritium-thymidine in the DNS of the patients lymphocytes, implicating a drug-specific hypersensibility of lymphocytes; we could be dealing with a combined type III and IV reaction by Coombs and Gell in this case. LTT may play a possible role in the determination of drug allergy in AGEP despite negative skin testing.
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