Ketoconazole is a synthetic imidazole-derivative antifungal agent used in the treatment of systemic and subcutaneous mycosis; also effective in the treatment of dermatophytosis and superficial mycosis.
Very low (4 cases published).
Pruritus, rash, urticaria, facial angioedema.
Skin-prick tests with 1, 10, 20, 40 mg/ ml positive with a concentration of 10 mg/ ml in a patient with allergic reaction to ketoconazole.
No specific IgE found.
Histamine release test was positive in the same patient.
Oral challenge: 25 mg, 50 mg, 100 mg, 200 mg positive in the same patient following a cumulative dose of 75 mg.
IgE-mediated hypersensitivity is likely.
Cross-reactivity with other azole derivatives is possible, but not demonstrated.