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Vol. 226, No. 4, 2013
Issue release date: September 2013
Dermatology 2013;226:347-352

Cutaneous Adverse Drug Reaction to Oral Acetazolamide and Skin Tests

Jachiet M. · Bellon N. · Assier H. · Amsler E. · Gaouar H. · Pecquet C. · Bourrain J.L. · Bégon E. · Chosidow O. · Francès C. · Ingen-Housz-Oro S. · Soria A.
aDepartment of Dermatology and Allergology, AP-HP, Hôpital Tenon, Paris, bDepartment of Dermatology, AP-HP, Hôpital Henri Mondor, Créteil, cDepartment of Dermatology, Hôpital A. Michallon, Grenoble, dDepartment of Dermatology, Hôpital René Dubos, Pontoise, and eUniversité Paris-Est Créteil Val de Marne, Créteil, France

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Background: Few cases of cutaneous adverse drug reactions (CADR) to oral acetazolamide, a non-antimicrobial sulfonamide, have been previously reported, and the interest of acetazolamide skin tests has never been studied. Objectives: We report a series of ten patients with oral acetazolamide CADR and skin tests. Patients and Methods: The files of ten patients with CADR secondary to oral acetazolamide prescribed for cataract surgery in most cases referred between 2001 and 2011 in four French dermatology and allergy departments were retrospectively reviewed. Skin tests with acetazolamide were performed in nine patients and twelve controls. Other sulfonamides were tested in five of ten patients. Results: Seven patients developed maculopapular exanthema and four had acute generalized exanthematous pustulosis. Patch tests were positive for 8/9 patients, prick tests for 2/4 and intradermal tests for 3/3. Patch and prick or intradermal test results were concordant in 2/3 positive subjects. Patch tests for other sulfonamides were negative, as were patch tests in controls. Conclusions: We report the largest series of CADR to oral acetazolamide (maculopapular exanthema or acute generalized exanthematous pustulosis). A drug eruption after cataract surgery should be investigated for accountability of acetazolamide. In view of this retrospective study, skin tests and particularly intradermal tests appear to be an important contribution to demonstrate accountability. © 2013 S. Karger AG, Basel

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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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