Generalized reactions during skin testing with clindamycin in drug hypersensitivity: a report of 3 cases and review of the literature.
BACKGROUND
The diagnostic approach to drug hypersensitivity includes a detailed medical history, clinical examination, and skin testing and/or oral challenge with a culprit or alternative drug, depending on the type of reaction and the suspected drugs. Although skin testing is considered to be rather safe, cutaneous and systemic, including fatal, reactions have been described.


OBJECTIVES
To report 3 cases with generalized delayed reactions after skin testing with clindamycin, and to review the existing literature.


METHODS
Thorough clinical examination, blood tests and prick, intradermal and patch tests were performed in 3 patients.


RESULTS
All patients experienced generalized maculopapular exanthema after intradermal and patch testing with clindamycin and amoxicillin in the first patient, and clindamycin alone in the second and third patient. None of the patients showed immediate reactions to skin tests, while positive intradermal reactions after 24 h to amoxicillin and clindamycin were observed in the first patient, and positive intradermal reactions after 24 h to clindamycin were observed in the second and third patients.


CONCLUSIONS
Skin testing with clindamycin in the diagnosis of drug hypersensitivity carries some risk of adverse reactions. A stepwise and individual diagnostic work-up, considering potential risk factors, and testing in a specialized centre with emergency equipment available is highly recommended.
['Papakonstantinou|Eleni|E|', 'Müller|Sabine|S|', 'Röhrbein|Jan H|JH|', 'Wieczorek|Dorothea|D|', 'Kapp|Alexander|A|', 'Jakob|Thilo|T|', 'Wedi|Bettina|B|http://orcid.org/0000-0002-9868-6308']
D000368:Aged D002981:Clindamycin D003875:Drug Eruptions D004342:Drug Hypersensitivity D005060:Europe D005260:Female D006801:Humans D015994:Incidence D008297:Male D008875:Middle Aged D010328:Patch Tests D061214:Patient Safety D018570:Risk Assessment
generalized reactions skin testing drug hypersensitivity