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Anaphylactic shock and contact urticaria after the patch test with professional allergens
Allergie Und Immunologie
|January 1, 1976
Summary
Anaphylactic complications can occur after patch testing with penicillin G, aminophenazone, and promethazine hydrochloride. These reactions are linked to rapid skin penetration of haptens, necessitating careful testing and observation.
Area of Science:
- Allergy and Immunology
- Dermatology
- Pharmacology
Background:
- Patch testing is a common diagnostic tool for allergic contact dermatitis.
- Certain medications, like penicillin G, aminophenazone, and promethazine hydrochloride, can cause hypersensitivity reactions.
- Understanding the mechanisms of drug-induced anaphylaxis is crucial for patient safety.
Purpose of the Study:
- To report anaphylactic complications in medical professionals following patch testing.
- To investigate the immunological basis of these reactions.
- To recommend prophylactic measures for patch testing.
Main Methods:
- Case report of 3 patients experiencing anaphylaxis post-patch testing.
- Evaluation of IgE-mediated allergy mechanisms.
- Mast cell degranulation tests and serum IgE level measurements.
Main Results:
- Positive mast cell degranulation in tested patients.
- Elevated serum IgE in one patient, but not in tissue.
- Anaphylaxis linked to rapid epidermal penetration of low molecular weight, soluble haptens.
Conclusions:
- The study highlights the risk of anaphylaxis from specific drug patch tests.
- Rapid hapten penetration is a key factor in IgE-mediated allergic reactions.
- Open patch testing in a clinical setting with immediate monitoring and treatment availability is recommended.