title: Value of patch tests in clindamycin-related drug eruptions.
abstract: BACKGROUND
  Patch tests help to confirm the aetiology of the cutaneous adverse drug reactions involving delayed hypersensitivity mechanisms, but the results vary with the pattern of skin reaction and the culprit drug.
  
  
  OBJECTIVE
  To analyse the results of patch tests in patients with cutaneous adverse drug reactions imputable to clindamycin and assess their contribution to the diagnosis.
  
  
  METHODS
  Between 2005 and 2009, we studied patients with delayed cutaneous adverse drug reactions following administration of clindamycin, usually associated with other drugs. After resolution of the cutaneous adverse drug reaction, patch tests were performed with a series of antibiotics, including pure clindamycin 10% in petrolatum.
  
  
  RESULTS
  We studied 30 patients (23 females and 7 males) aged 33-86 years (mean 59.97 years) with generalized maculopapular exanthema where clindamycin was among the highly suspected drugs. Two patients had a previous positive involuntary rechallenge. Patch tests with clindamycin were positive in 9 of 30 patients (30%). More than 50 control patients patch tested with clindamycin were negative.
  
  
  CONCLUSIONS
  We considered the positive patch tests results with clindamycin, in the 9 patients with maculopapular exantema, to be specific, versus the negative results observed in the control group. Although the sensitivity is low (30%), they confirmed the responsibility of this antibiotic in cutaneous adverse drug reactions in which, with only chronological criteria, it was not possible to conclude on the culprit drug.
authors.affiliation: Department of Dermatology, Coimbra University Hospital, 3000-075 Coimbra, Portugal. neidepereira@sapo.pt
authors.forename: Neide
authors.initials: N
authors.lastname: Pereira
authors.forename: Maria Miguel
authors.initials: MM
authors.lastname: Canelas
authors.forename: Felicidade
authors.initials: F
authors.lastname: Santiago
authors.forename: Maria Manuel
authors.initials: MM
authors.lastname: Brites
authors.forename: Margarida
authors.initials: M
authors.lastname: Gonçalo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D002981:Clindamycin / Q000009:adverse effects*; D003875:Drug Eruptions / Q000175:diagnosis*; D005076:Exanthema / Q000139:chemically induced / Q000175:diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010328:Patch Tests; D012680:Sensitivity and Specificity
chemical_list: D000900:Anti-Bacterial Agents; D002981:Clindamycin