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Current Allergy and Asthma Reports
Published in: Current Allergy and Asthma Reports 4/2017

01-04-2017 | Allergic Skin Diseases (L Fonacier, Section Editor)

Non-immediate Cutaneous Reactions to Beta-Lactams: Approach to Diagnosis

Authors: Antonino Romano, Rocco Luigi Valluzzi, Cristiano Caruso, Michela Maggioletti, Francesco Gaeta

Published in: Current Allergy and Asthma Reports | Issue 4/2017

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Abstract

Non-immediate cutaneous reactions (i.e., occurring at least 1 h after the initial drug administration), particularly maculopapular exanthemas and urticarial eruptions, are common during beta-lactam treatments. A T cell-mediated pathogenic mechanism has been demonstrated in some cutaneous reactions, such as maculopapular exanthema, fixed drug eruption, acute generalized exanthematous pustulosis, and drug-induced hypersensitivity syndrome. In the diagnostic work-up, patch testing is useful, together with delayed-reading intradermal testing. Patch tests are a simple and safe diagnostic tool, which in the case of severe reactions should be used as the first line of investigation. However, patch tests are less sensitive than intradermal tests, which are preferable in subjects with mild reactions. Lymphocyte transformation or activation tests and enzyme-linked immunosorbent spot assays can be used as complementary tests. In selected cases of mild or moderate reactions, displaying negative results in the aforesaid allergy tests, a graded challenge with the implicated beta-lactam can be performed.
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Metadata
Title
Non-immediate Cutaneous Reactions to Beta-Lactams: Approach to Diagnosis
Authors
Antonino Romano
Rocco Luigi Valluzzi
Cristiano Caruso
Michela Maggioletti
Francesco Gaeta
Publication date
01-04-2017
Publisher
Springer US
Published in
Current Allergy and Asthma Reports / Issue 4/2017
Print ISSN: 1529-7322
Electronic ISSN: 1534-6315
DOI
https://doi.org/10.1007/s11882-017-0691-4

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