Intradermal Tests for Diagnosis of Drug Allergy are not Affected by a Topical Anesthetic Patch

• Type: Article in International Scientific Journal
• Date: 2014

Authors

Couto, M (Author) FMUP; Silva, D (Author) FMUP; Ferreira, A (Author) Other; Cernadas, JR (Author) Other

Journal

Title: Allergy, Asthma and Immunology Research

Vol. 6

Pages: 458-462

ISSN: 2092-7355

Publisher: Soonchunhyang University

Indexing

ISI Web of Knowledge - 2 Citations

Scopus - 2 Citations

Other information

Authenticus ID: P-009-TH5

DOI: 10.4168/aair.2014.6.5.458

Abstract (EN): The use of topical anesthesia to perform intradermal tests (IDTs) for drug allergy diagnosis was never investigated. We aimed to determine the effects of a topical anesthetic patch containing prilocaine-lidocaine on wheal size of IDT with drugs. Patients who had positive IDT as part of their investigation process of suspected drug hypersensitivity were selected. IDT were performed according to guidelines. Anesthetic patch (AP) was placed and the same prior positive IDT, as well as positive histamine skin prick test (SPT) and negative (saline IDT) controls, were performed in the anesthetized area. Patients with negative IDT were also included to check for false positives with AP. Increase in wheals after 20 minutes both with and without AP was recorded and compared. 45 IDT were performed (36 patients), of which 37 have been previously positive (14 antibiotics, 10 general anesthetics, 6 non-steroidal anti-inflammatory drugs, 3 iodinated contrasts, 3 anti-Hi-histamines and 1 ranitidine). Mean histamine SPT size without the AP was 4.7 mm [95%CI (4.4-5.1)], and 4.6 mm [95%CI (4.2-5.0)] with anesthesia. Mean wheal increase in IDT for drugs without the anesthesia was 4.5 mm [95%CI (3.3-5.7)] and with anesthesia was 4.3 mm [95%CI (2.8-5.8)]. No statistical significant differences were observed between skin tests with or without AP for histamine SPT (P=0.089), IDT with saline (P=0.750), and IDT with drugs (P=0.995). None of the patients with negative IDT showed positivity with the AP, or vice-versa. The use of an AP containing prilocaine-lidocaine does not interfere with IDT to diagnose drug allergy, and no false positive tests were found.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 5