scholarly journals Doxycycline induced fixed drug eruption: a case report

2018 ◽  
Vol 7 (11) ◽  
pp. 2264
Author(s):  
Isswariya Anandan ◽  
Nitya Selvaraj ◽  
Suganya Ganesan ◽  
Meher Ali Rajamohammad ◽  
Nalinidevi Jayabalan
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Drug Eruption ◽  
Skin Lesions ◽  
Severity Assessment ◽  
Fixed Drug Eruption ◽  
Skin Reactions ◽  
Dermatological Examination ◽  
Causative Drug ◽  
Fixed Drug

Fixed drug eruption (FDE) is an adverse drug reaction seen with various groups of drugs are antibiotics such as trimethoprim -sulphamethoxazle, pencillin, tetracyclines, non steroidal anti- inflammatory drugs like ibuprofen, aspirin etc. Doxycycline belongs to tetracycline groups of antibiotics. We herein present the case of Doxycycline induced fixed drug eruption. A 35-year - old man presented to our hospital, with a 2-day history of itching and hyperpigmentation over the chest. Patient developed skin lesion 2 days after and he started taking Doxycycline 100 mg twice a day for skin infections. Dermatological examination revealed multiple well defined hyperpigmented patches seen over the anterior aspect of the chest. Doxycycline was discontinued immediately, and the skin lesions resolved spontaneously within 2 weeks. Causality assessment by using Naranjo adverse drug reaction probability scale and WHO Uppsala monitoring scale categorize the reaction as Doxycycline was the probable cause for the adverse drug reaction. Severity assessment by using modified Hartwig and Siegel ADR severity assessment scale labelled the reaction as mild-level 2. The causative drug or drugs and cross reactants should be avoided in future to prevent recurrence of similar skin reactions.

scholarly journals A clinical study of morphological patterns of cutaneous adverse drug reaction and its causality assessment in tertiary care hospital of central India

2020 ◽  
Vol 9 (10) ◽  
pp. 1528
Author(s):  
Tanaji R. Shende ◽  
Riyaz A. Siddiqui
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Adverse Drug Reactions ◽  
Drug Eruption ◽  
Causality Assessment ◽  
Age Group ◽  
Drug Reactions ◽  
Fixed Drug Eruption ◽  
Fixed Drug ◽  
Cutaneous Adverse Drug Reaction

Background: Adverse reactions to drugs are as old as drug. Cutaneous adverse drug reactions are the most common type of drug reaction. Most cutaneous adverse drug reactions are important as they are frequently the reason for discontinuation of drug therapy. Looking to this matter the study was undertaken.Method: It was an observational study conducted at NKP Salve Institute of Medical Science & Research Centre, Nagpur Maharashtra. A total number of 80 patients having cutaneous adverse drug reaction were evaluated. All the patients were assessed for cutaneous adverse drug reaction during the study period and the information was carefully recorded in standard Adverse drug reaction (ADR) form and Naranjo’s algorithm was used for causality assessment of adverse drug reaction.Result: The maximum study subjects were in the age group of 41-50 years (32-50%) followed by the age group of 31-40 years (25%) followed by other age groups. In study group male to female ratio was 11.5:8.5. Majority of cutaneous adverse drug reactions comprise of fixed drug eruption which is 45%. Most of the cutaneous ADR’s were caused by antibiotics (42.5%) followed by Non-steroidal anti-inflammatory drugs (NSAIDS) (20%). The study subjects were in probable causality assessment of Naranjo’s scale i.e. 82.5% followed by definite in (12.5%) and possible (5%).Conclusion: The fixed drug eruption was the most common cutaneous adverse drug reaction and most of these drugs eruptions were caused by antimicrobial agents. The study provided the base line information about the prevalence of cutaneous adverse drug reaction and their morphological distribution amongst different age group, gender and the causative drug.

A Case Report of Tadalafil-Associated Fixed Drug Eruption

2017 ◽  
Vol 31 (6) ◽  
pp. 678-681 ◽  
Author(s):  
Ada W. Chiu ◽  
Robert Stenstrom
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Case Report ◽  
Drug Eruption ◽  
Case Reports ◽  
Good Evidence ◽  
Medical Attention ◽  
Medication History ◽  
Fixed Drug Eruption ◽  
Fixed Drug

Tadalafil is a drug approved for use in erectile dysfunction, but increasingly being used recreationally. There have only been scant case reports on tadalafil causing fixed drug eruption (FDE). Patients who use tadalafil recreationally are less likely to seek medical attention and the diagnosis can often be missed, given the difficulty in diagnosis. However, clinical examination together with a detailed medication history can provide clinicians with good evidence of the association without invasive biopsies. We discuss a 37-year-old male who developed FDE after 2 separate exposures to tadalafil used for recreational purpose. The scar from the first reaction served as a landmark for the second exposure. His lesions resolved 2 days after the initial presentation. The Naranjo adverse drug reaction probability scale (score = 9) indicates a definite adverse drug reaction to tadalafil. We hope to raise awareness of this drug reaction with this case report.

scholarly journals Pathophysiology of Skin Resident Memory T Cells

2021 ◽  
Vol 11 ◽  
Author(s):  
Yoshiki Tokura ◽  
Pawit Phadungsaksawasdi ◽  
Kazuo Kurihara ◽  
Toshiharu Fujiyama ◽  
Tetsuya Honda
Keyword(s):  
Drug Eruption ◽  
Transforming Growth Factor ◽  
Skin Lesions ◽  
Microbial Pathogens ◽  
Delayed Type Hypersensitivity ◽  
Effector Memory ◽  
Lymphoid Tissues ◽  
Fixed Drug Eruption ◽  
Surveillance Network ◽  
Fixed Drug

Tissue resident memory T (TRM) cells reside in peripheral, non-lymphoid tissues such as the skin, where they act as alarm-sensor cells or cytotoxic cells. Physiologically, skin TRM cells persist for a long term and can be reactivated upon reinfection with the same antigen, thus serving as peripheral sentinels in the immune surveillance network. CD8+CD69+CD103+ TRM cells are the well-characterized subtype that develops in the epidermis. The local mediators such as interleukin (IL)-15 and transforming growth factor (TGF)-β are required for the formation of long-lived TRM cell population in skin. Skin TRM cells engage virus-infected cells, proliferate in situ in response to local antigens and do not migrate out of the epidermis. Secondary TRM cell populations are derived from pre-existing TRM cells and newly recruited TRM precursors from the circulation. In addition to microbial pathogens, topical application of chemical allergen to skin causes delayed-type hypersensitivity and amplifies the number of antigen-specific CD8+ TRM cells at challenged site. Skin TRM cells are also involved in the pathological conditions, including vitiligo, psoriasis, fixed drug eruption and cutaneous T-cell lymphoma (CTCL). The functions of these TRM cells seem to be different, depending on each pathology. Psoriasis plaques are seen in a recurrent manner especially at the originally affected sites. Upon stimulation of the skin of psoriasis patients, the CD8+CD103+CD49a- TRM cells in the epidermis seem to be reactivated and initiate IL-17A production. Meanwhile, autoreactive CD8+CD103+CD49a+ TRM cells secreting interferon-γ are present in lesional vitiligo skin. Fixed drug eruption is another disease where skin TRM cells evoke its characteristic clinical appearance upon administration of a causative drug. Intraepidermal CD8+ TRM cells with an effector-memory phenotype resident in the skin lesions of fixed drug eruption play a major contributing role in the development of localized tissue damage. CTCL develops primarily in the skin by a clonal expansion of a transformed TRM cells. CD8+ CTCL with the pagetoid epidermotropic histology is considered to originate from epidermal CD8+ TRM cells. This review will discuss the current understanding of skin TRM biology and their contribution to skin homeostasis and diseases.

scholarly journals Clinical Features and Drug Characteristics of Patients with Generalized Fixed Drug Eruption in the West of Iran (2005–2014)

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Hossein Kavoussi ◽  
Mansour Rezaei ◽  
Katayoun Derakhshandeh ◽  
Alireza Moradi ◽  
Ali Ebrahimi ◽  
...  
Keyword(s):  
Clinical Features ◽  
Drug Eruption ◽  
Cross Sectional Study ◽  
Fixed Drug Eruption ◽  
The West ◽  
Cross Sectional ◽  
Drug Eruptions ◽  
Causative Drug ◽  
Fixed Drug ◽  
Antibiotic Group

Background.Generalized fixed drug eruption is a specific variant of fixed drug eruption with multifocal lesions. Diagnosis of this drug reaction is straightforward, but occasionally recognition of the causative drug is not possible. This study was aimed at evaluating the clinical features and culprit drugs in generalized fixed drug eruptions in the west of Iran.Method.This cross-sectional study was carried out on 30 patients with criteria of generalized fixed drug eruption over 9 years. Demographic, clinical, and drug intake information were collected.Results.Out of 30 patients (17 females and 13 males) with the mean age of26.67±10.21years, 28 (93.3%) and 2 (6.7%) cases had plaque and bullous clinical presentation, respectively. Upper limbs were the most common (90%) site of involvement. The antibiotic group, especially cotrimoxazole (26.1%), was reported to be the most common offending drug, but the causative drug was not determined in 7 (23.3%) patients.Conclusion.Many cases of generalized fixed drug eruption firstly presented as limited lesions and led to generalized lesion due to repeated intake of the causative drug. No causative drug was found in some patients, which might be associated with concurrent intake of several drugs, multiple FDE, and peculiarity of the patch test.

scholarly journals Fixed Drug Eruption Associated with Nonsteroidal Anti-Inflammatory Drugs for Menstrual Pain: A Case Report

2022 ◽  
pp. 6-11
Author(s):  
Risa Shimizu ◽  
Fumihiko Tsushima ◽  
Ruri Komiya ◽  
Yuko Yamagata ◽  
Hiroyuki Harada
Keyword(s):  
Drug Eruption ◽  
Repeated Administration ◽  
Menstrual Pain ◽  
Fixed Drug Eruption ◽  
Causative Drug ◽  
Fixed Drug ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Simplex Virus ◽  
Rule Out

Fixed drug eruption (FDE) is a type of drug reaction in which cutaneous or mucocutaneous lesions recur at the same site due to repeated administration of the causative drug. The most reported FDE-inducing drugs are nonsteroidal anti-inflammatory drugs (NSAIDs). We report a case of FDE associated with the use of NSAIDs for menstrual pain. A 33-year-old woman was referred to our department with blisters and soreness on her lips, tongue, and labial mucosa. The results of blood examination helped rule out herpes simplex virus infection, pemphigus, and pemphigoid. An FDE was suspected because these symptoms coincided with the use of NSAIDs for menstrual pain. Thus, the patient was advised not to use these NSAIDs but to use acetaminophen instead. No recurrence has been observed since the patient began avoiding these NSAIDs.

scholarly journals Ofloxacin/ tinidazole induced fixed drug eruption- a case report

2021 ◽  
Vol 2 (1) ◽  
pp. 36-38
Author(s):  
Monika Kapoor
Keyword(s):  
Adverse Drug Reaction ◽  
Case Report ◽  
Drug Eruption ◽  
Fixed Drug Eruption ◽  
Drug Induced ◽  
Drug Eruptions ◽  
Fixed Drug ◽  
Causative Agents ◽  
Inflammatory Drugs ◽  
Cutaneous Adverse Drug Reaction

Introduction: An immunological cutaneous adverse drug reaction is distinguished as sharply defined lesions with red rashes and sharp borders, erythematous lesions with or without blisters developing within an hour or in a few cases within a week after drug administration is termed as fixed drug eruptions (FDE). FDE is one of the major forms of drug-induced dermatosis. Various class of drugs that are causative agents for FDE includes antibiotics, anticonvulsants, antivirals, and Non-steroidal anti-inflammatory drugs (NSAID). FDE is easily recognized and differentiated from other drug eruptions since it does not occur voluntarily or during infection. Case report: This case report is to spotlight the case of a 52-year-old male patient who was undergoing treatment for acute gastroenteritis and suffered from FDE due to administration of IV Ofloxacin.

scholarly journals A Review of Fixed Drug Eruption with a Special Focus on Generalized Bullous Fixed Drug Eruption

Medicina ◽  
2021 ◽  
Vol 57 (9) ◽  
pp. 925
Author(s):  
Hannah J. Anderson ◽  
Jason B. Lee
Keyword(s):  
Drug Eruption ◽  
The Body ◽  
Stevens Johnson Syndrome ◽  
Special Focus ◽  
Fixed Drug Eruption ◽  
Causative Drug ◽  
Johnson Syndrome ◽  
Fixed Drug ◽  
Specific Medication ◽  
Cutaneous Adverse Drug Reaction

Fixed drug eruption (FDE) is a cutaneous adverse drug reaction characterized by the onset of rash at a fixed location on the body each time a specific medication is ingested. With each recurrence, the eruption can involve additional sites. Lesions can have overlying vesicles and/or bullae, and when they cover a significant percentage of body surface area, the eruption is referred to as generalized bullous fixed drug eruption (GBFDE). Due to the widespread skin denudation that can be seen in this condition, GBFDE may be confused clinically with Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN). While treatments described for GBFDE include supportive care, topical and/or systemic steroids, and, recently, cyclosporine, the mainstay of management involves identifying and discontinuing the causative drug. This review article will provide an overview of FDE with an emphasis on its generalized bullous variant.

Relapsing generalized bullous fixed drug eruption: a severe and avoidable cutaneous drug reaction. Three case reports

Therapies ◽  
2021 ◽  
Author(s):  
Clément Braesch ◽  
Amandine Weill ◽  
Olivier Gaudin ◽  
Bénédicte Lebrun-Vignes ◽  
Charlotte Bernigaud ◽  
...  
Keyword(s):  
Drug Reaction ◽  
Drug Eruption ◽  
Case Reports ◽  
Fixed Drug Eruption ◽  
Fixed Drug ◽  
Cutaneous Drug Reaction

scholarly journals Fixed drug eruption associated with fixed combination of fluoroquinolone-nitroimidazole

2021 ◽  
Vol 10 (5) ◽  
pp. 576
Author(s):  
R. Meenakshi ◽  
S. Nitya ◽  
S. Kiruthika ◽  
M. Shanthi
Keyword(s):  
Adverse Drug Reaction ◽  
Adverse Reaction ◽  
Drug Eruption ◽  
Fixed Combination ◽  
Fixed Drug Eruption ◽  
Combination Drug ◽  
Drug Eruptions ◽  
Fixed Drug ◽  
Erythematous Plaques ◽  
Cutaneous Adverse Drug Reaction

Fixed drug eruptions (FDE) are cutaneous adverse drug reaction characterized by well demarcated erythematous plaques which on removal of the offending agent resolves with residual hyperpigmentation patches at the site. FDE to nitroimidazoles and fluoroquinolones have nevertheless been infrequently reported. Awareness about the adverse reaction to the fluoroquinolone-nitroimidazole combination drug and also the likelihood of recurrence with same or similar drugs and the possible cross reaction is eminent. Hereby we report one such case of FDE to ciprofloxacin/tinidazole combination.

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