Clinical features, culprit drugs, and allergology workup in 41 cases of fixed drug eruption. (7th August 2019)

• Record Type: Journal Article
• Authors: Ben Fadhel, Najah; Chaabane, Amel; Ammar, Helmi; Ben Romdhane, Haifa; Soua, Yosra; Chadli, Zohra; Zili, Jameleddine; Boughattas, Naceur A.; Ben Fredj, Nadia; Aouam, Karim
• Is Part Of: Contact dermatitis. Volume 81:Number 5(2019)
• Page Start: 336
• Page End: 340
• Publication Date: 2019-08-07
• Subjects: epidemiology -- fixed drug eruption -- oral rechallenge -- patch test; Contact dermatitis -- Periodicals; 616.51
• DOI: 10.1111/cod.13351
• Languages: English
• ISSNs: 0105-1873

Abstract

Abstract: Background: Fixed drug eruption (FDE) represents a drug‐related cutaneous reaction. Many drugs been associated with this clinical entity, with continually evolving documentation of implicated agents and clinical presentations. A bullous form can occur although it is rare. Objectives: To assess the epidemiological and clinical characteristics of FDE. Methods: We retrospectively analysed all FDE cases who presented to the Clinical Pharmacology Department at the University Hospital, Monastir, Tunisia, for allergy workup. Results: The mean age of the 41 confirmed FDE cases was 43.8 ± 15.5 years. The time between first lesion onset and FDE diagnosis was less than 1 month for 13 patients (31.7%). Fifteen patients had bullous lesions. The upper limbs were the most common location (65.9% of cases). The patch tests were positive in 27 cases; a provocation test yielded a positive response in the four cases tested. Nonsteroidal anti‐inflammatory drugs (NSAIDs) were involved in 51.2%, antibiotics in 24.4%, and other analgesics in 19.5%. The most common offending drug was mefenamic acid in 24.4% of cases. Bullous lesions were significantly associated with paracetamol intake ( P = .014; odds ratio 16.7; 95% confidence interval: 1.76‐158). Conclusions: NSAIDs and antibiotics were the most implicated in inducing FDE; paracetamol was associated with bullous lesions.