engleski

Occupational airborne allergic contact dermatitis to azithromycin: A case report

Occupational allergy to antibiotics is seldom reported. We present a case of airborne allergic contact dermatitis in worker employed in synthesis of azithromycin. Sensitization to azythromycin is not reported so far, but due to its macrolide structure contact sensitization potency may be expected. A 32-year old pharmaceutical worker employed for 13 years in synthesis of antibiotics came to allergology unit with forearm and face skin symptoms. For the last 3 years he worked on loading reactors in three different stages of azythromycin chemical synthesis and was exposed to airborne powdered chemicals. As personal protection he wore working coverall and gloves. Skin symptoms persisted for a year and were presented in form of erythema, pruritus, vesicles and peeling of the nose, face and forearms. He had no history of previous respiratory or skin allergy. Patch test with Europaen standard series of contact allergens including latex allergen (ALK-Abello, Denmark) was negative at 48 and 72 hours. Prick test with common inhalatory allergens was negative and total serum IgE was within normal range (55 kU/L). Patch test with pure azythromycin was positive at 48 and 72 hours (erythema and vesicles occurred). To exclude irritative and nonspecific skin reactions, patch test with pure azythromycin was done in control group of 5 nonatopic volunteers and was negative in all control subjects at 48 and 72 hours. Workplace challenge confirmed the concordance between skin symptoms and occupational exposure. A week of workplace exposure resulted in progressive worsening of skin symptoms which were reduced after cessation of workplace exposure. Patch test and workplace challenge are reliable methods in the diagnosis of work-related contact dermatitis induced by azythromycin.

drug sensitization; occupational contact dermatitis; prick test; patch test; azythromycin sensitization; antibiotics sensitivity

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