Immediate pressure urticaria

out with good tolerance. The basic structure of macrolides is characterized by a lactonic cycle with 2 osidic chains. They are classified by the number of carbon atoms in the cycle. For example: 14-membered macrolides such as erythromycin, roxithromycin, and clarithromycin; 15-membered macrolides such as azithromycin; and 16-membered macrolides such as midecamycin (7). Whether these differences in chemical structure form the basis of the different cross-reactivities among macrolides is largely unknown. However, we have documented the use of topical provocation tests and a controlled oral challenge in the first reported case of FDE caused by a macrolide showing cross-reactivity with other antibiotics from the same group. Thus, it seems reasonable to perform patch testing with macrolides that have different numbers of carbon atoms in patients with FDE due to this specific antibiotic group.

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