title: Positive patch test reactions to gentamicin show sensitization to aminoglycosides from topical therapies, bone cements, and from systemic medication.
abstract: BACKGROUND
  A history of prolonged use of topical antimicrobials is common among patients with positive patch test reactions to gentamicin and to aminoglycosides.
  
  
  OBJECTIVE
  The aim of this study was to show sources of gentamicin sensitization in patients with positive patch test reactions to gentamicin.
  
  
  METHODS
  About 7814 patients were patch tested with a baseline patch test series and 620 of them were further tested with gentamicin. The clinical histories, concurrent contact sensitivities, and sources of sensitization are analysed among these patients.
  
  
  RESULTS
  Positive patch test reactions to gentamicin were seen in 29/620 patients, most of whom (18/29) also reacted to neomycin and to kanamycin (7/29). Mean age of the gentamicin-positive patients was 62 years, but three young operating room nurses with hand dermatitis had a history of gentamicin exposure from bone cement. Among the 11/29 neomycin-negative patients, a history of exposure to different aminoglycosides was apparent, and one patient had a history of systemic netilmicin-medication-associated exanthema.
  
  
  CONCLUSIONS
  Positive patch test reactions to gentamicin reflect sensitization to different aminoglycosides for which gentamicin seems to represent a sensitive indicator. Gentamicin sensitization may result from occupational exposure to gentamicin containing bone cements or from systemic medication with aminoglycosides.
authors.affiliation: Department of Dermatology, Turku University Hospital, Allergy Unit, PO Box 52, 20521 Turku, Finland. jussi.liippo@tyks.fi
authors.forename: Jussi
authors.initials: J
authors.lastname: Liippo
authors.forename: Kaija
authors.initials: K
authors.lastname: Lammintausta
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000617:Aminoglycosides / Q000276:immunology* / Q000627:therapeutic use; D001843:Bone Cements; D015331:Cohort Studies; D004333:Drug Administration Routes; D003875:Drug Eruptions / Q000175:diagnosis* / Q000453:epidemiology* / Q000276:immunology; D005260:Female; D005839:Gentamicins / Q000276:immunology* / Q000627:therapeutic use; D006801:Humans; D007114:Immunization; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010328:Patch Tests; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D017678:Sex Distribution; D055815:Young Adult
chemical_list: D000617:Aminoglycosides; D001843:Bone Cements; D005839:Gentamicins