藥物皮膚測試可以重現(xiàn)對(duì)藥物的延遲超敏反應(yīng)，并導(dǎo)致患者適度地再次接觸有問題的藥物。
藥物斑貼試驗(yàn)(DPTs)和點(diǎn)刺試驗(yàn)可以用任何一種藥物的商業(yè)化形式進(jìn)行。在非嚴(yán)重延遲非Ige介導(dǎo)的藥物反應(yīng)中，有延遲讀數(shù)的皮內(nèi)試驗(yàn)(IDT)具有更大的價(jià)值，但其技術(shù)缺乏標(biāo)準(zhǔn)化。
藥物皮膚測試陰性并不排除藥物的責(zé)任，藥物必須在非嚴(yán)重的情況下重新檢測。
藥物斑貼試驗(yàn)DPTs適用于黃斑丘疹、屈曲性疹，也適用于固定的藥疹。最好的適應(yīng)癥是急性全身性膿皰病或伴有嗜酸性粒細(xì)胞增多和全身癥狀的藥物反應(yīng)。他們應(yīng)該謹(jǐn)慎地執(zhí)行，遵循嚴(yán)格的指導(dǎo)方針。
點(diǎn)刺試驗(yàn)的數(shù)值很低。在對(duì)藥物的非嚴(yán)重遲發(fā)反應(yīng)中，皮內(nèi)延遲讀數(shù)測試是最敏感的皮膚測試，尤其是-內(nèi)酰胺類抗生素、放射對(duì)比劑、肝素以及一些生物制劑。
斑貼試驗(yàn)檢測的價(jià)值因涉及藥物和非立即不良反應(yīng)的不同而不同。在DRESS應(yīng)用中，藥物斑貼試驗(yàn)DPTs在卡馬西平或質(zhì)子泵抑制劑的檢測中有很好的價(jià)值，但在別嘌呤醇或薩拉佐匹林的檢測中仍然為陰性。
在毒性表皮壞死松解術(shù)中，藥物斑貼試驗(yàn)DPTs是安全的，但只有9%到23%的報(bào)告病例呈陽性。
Skin Testing and Patch Testing in Non-IgE-Mediated Drug Allergy
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First Online: 17 April 2014
Drug skin tests can reproduce delayed hypersensitivity to drugs and entail a moderate reexposure of patients to offending drugs. Drug patch tests (DPTs) and prick tests can be done with any commercialized form of a drug. In non-severe delayed non-IgE-mediated reactions to drugs, intradermal tests (IDT) with delayed readings have a greater value, but their techniques lack standardization. A negative drug skin test does not exclude the responsibility of a drug, and the drug must be rechallenged in non-severe cases. DPTs are useful in maculopapular rashes, flexural exanthemas, and if done in situ, also in fixed drug eruption. Their best indication is in acute generalized exanthematous pustulosis or drug reaction with eosinophilia and systemic symptoms (DRESS). They should be carried out cautiously, following strict guidelines. Prick tests have a low value but they can sometimes be positive on delayed readings. In non-severe delayed reactions to drugs, intradermal tests with delayed readings are the most sensitive skin tests especially for beta-lactam antibiotics, radiocontrast media, heparins but also some biological agents. The value of patch testing varies according to the implicated drug and the non-immediate adverse drug reaction. In DRESS, DPTs have a good value in testing carbamazepine or proton pump inhibitors but remain negative in testing with allopurinol or salazopyrin. In toxic epidermal necrolysis, DPTs are safe but positive in only 9 to 23 % of the reported cases.