Skin Allergy to Azole Antifungal Agents for Systemic Use: A Review of the Literature.

IF 4.2 Q3 Pharmacology, Toxicology and Pharmaceutics
G. Calogiuri, L. H. Garvey, E. Nettis, P. Romita, E. Di Leo, R. Caruso, L. Butani, C. Foti
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引用次数: 10

Abstract

BACKGROUND Antifungal azoles are the first-line agents used to treat topical and, above all, systemic mycosis. The latter could be life-threating infections in immunocompromised patients. Chemotherapeutic antibiotics, including antifungal azoles, may induce hypersensitivity reactions; however, such immunologic adverse reactions have not been as well defined and carefully investigated. OBJECTIVE To provide an update on the evaluation and diagnosis of skin allergy to azole antifungal agents. METHODS This is a systematic review performed on PubMed and Google Schoolbarusing the key term "allergy, hypersensitivity, anaphylaxis, immediate-type reaction, delayed-type reaction, ketoconazole, fluconazole, posaconazole, voriconazole, itravuconazole, triazoles, imidazoles, antifungals, antimycotics"The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, reviews and case reports. RESULTS One hundred twenty-four articles matched our search terms. The most common adverse events reported were T-cell mediateddelayed-type hypersensitivity reactions, such as fixed drug eruptions,localized, generalized and exhantematous dermatitis, Steven Johnson syndrome, toxic epidermal necrolysis and acute generalizedexhanthematouspustulosis. Rarely a drug rash, eosinophilia systemic symptoms has been described Also immediate-type reactions such as urticaria-angioedema or anaphylaxis have been reported following administration of antifungal imidazoles, although not so frequently. CONCLUSION Despite their widespread use, triazoles seem to induce rare cutaneous hypersensitivity reactions, but the pathomechanisms, risk factors, diagnostic and management strategies, including skin tests and challenge tests, are little known and poorly investigated.
皮肤对全身使用的唑类抗真菌药物过敏:文献综述。
背景:抗真菌唑类药物是用于治疗局部和系统性真菌病的一线药物。后者可能是免疫功能低下患者的危及生命的感染。化疗抗生素,包括抗真菌唑类药物,可能会引起过敏反应;然而,这些免疫不良反应还没有被很好地定义和仔细地调查。目的探讨皮肤对唑类抗真菌药物过敏的诊断和评价。方法以“过敏、超敏反应、过敏反应、立即型反应、延迟型反应、酮康唑、氟康唑、泊沙康唑、伏立康唑、伊曲康唑、三唑类、咪唑类、抗真菌类、抗真菌类药物”为关键词,对PubMed和谷歌schoolbars进行系统综述。检索策略包括meta分析、随机对照试验、临床试验、观察性研究、综述和病例报告。结果124篇文章符合我们的搜索条件。最常见的不良反应是t细胞介导的延迟型超敏反应,如固定药疹、局部、全身性和外伤性皮炎、史蒂文·约翰逊综合征、中毒性表皮坏死松解和急性全身性外伤性口疱病。很少有药物皮疹,嗜酸性粒细胞增多的全体性症状也有报道,如荨麻疹-血管性水肿或过敏反应,在使用抗真菌咪唑后,尽管不常见。结论尽管三唑类药物被广泛使用,但其诱发皮肤过敏反应的机制、危险因素、诊断和治疗策略(包括皮肤试验和激发试验)知之甚少,研究也很少。
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来源期刊
CiteScore
3.90
自引率
0.00%
发文量
0
期刊介绍: Recent Patents on Inflammation & Allergy Drug Discovery publishes review articles by experts on recent patents in the field of inflammation and allergy drug discovery e.g. on novel bioactive compounds, analogs and targets. A selection of important and recent patents in the field is also included in the journal. The journal is essential reading for all researchers involved in inflammation and allergy drug design and discovery.
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