Pyrazinamide


Synthetic pyrazine analogue of nicotinamide used in the treatment of tuberculosis.
 
Incidence
Uncommon.
 
Clinical manifestations
Mainly cutaneous: flushing, rash, urticaria.
 
Diagnostic methods
Cutaneous testing
 
Patch-tests: pyrazinamide 1% eth. and 10% eth. positive in one patient with a pruriginous rash.
 
Mechanisms
Undetermined.
 
Management
Desensitization if absolutely necessary: starting dose 5 mg. Increasing by 50 to 100% every 30 minutes up to the total dose.

References

  1. Shorr A.F, Trotta R.F, "Pyrazinamide hypersensitivity", Chest , 1996 ; 109 (3): 855-6
  2. Goday J, Aguirre A, Diaz-Perez J.L, " A positive patch test in a pyrazinamide drug eruption", Contact Dermatitis, 1990 ; 22 (3): 181-2
  3. Soyez F, Surpas P, Vestri R, Philip-Joet F, Arnaud A, "Réaction inhabituelle au pirilène", Rev. fr. Allergol., 1988 ; 28: 1.

As in all diagnostic testing, the diagnosis is made by the physican based on both test results and the patient history.