Antikonvülzan Ilaç Kullanan Hastalarda Ilaç Yama Testlerinin Deʇerlendirilmesi

Objective: Incidence of serious adverse cutaneous drug reaction (ACDR) with anticonvulsant drugs is predicted as 2%. It is known that 20% of serious ACDR develope as a result of aromatic anticonvulsant drugs. Patcht tests can be used for the diagnosis of ACDR caused by aromatic anticonvulsant drugs. In this study, we aimed to predict ACDR rates of patients using anticonvulsant drugs by the application of drug patch tests performed before and after the commence of the treatment.

Results: Two patients had positive reactions with drug patch tests. A 54 year-old female patient was positive with 30% phenytoin in vaseline on 72nd hour, she had a pruritic eruption after the commence of treatment. The pruritus ceased with withdrawal of drug, she was treated with systemic antihistamines. A 41 year-old female patient had positive reaction with %30 phenytoin in vaseline on 48th hour. She was evaluated with a diagnosis of maculopapular drug eruption due to the histopathological examination made from the pruritic erythematous maculopapular lesions which started on 28th day of treatment. The patient had full recovery by withdrawal of drug and given systemic antihistamines and topical steroid treatments.

Conclusion: The studies concerning drug reactions and drug patch tests reveal that results are variable according to type of drug reactions occured. Our study is a crucial step and a preliminary study for the identification of specifity and predictivity of drug patch tests in respect to the positive drug patch test results correlating with ACDRs observed.

Material and Methods: 38 patients with prescribed phenytoin,carbamazepine and oxcarbazepin who accepted epicutaneous drug patch test applications were prospectively recruited for this study. Drug patch tests were applied with diluted preparations of drugs with 15% and 30% concentrations in water and vaseline seperately on 1st day and 21st day of treatment on right upper back of patients. Evaluations were made on 48th, 72th and 96th hours.