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Acta Medica Portuguesa May 2023
Topics: Humans; Anti-Inflammatory Agents, Non-Steroidal; Drug Eruptions
PubMed: 35225773
DOI: 10.20344/amp.16519 -
Dermatology Online Journal Apr 2018Fixed drug eruption (FDE) is an adverse drug reaction characterized by the development of well-circumscribed, round, dusky erythematous macules and plaques on cutaneous... (Review)
Review
Fixed drug eruption (FDE) is an adverse drug reaction characterized by the development of well-circumscribed, round, dusky erythematous macules and plaques on cutaneous or mucosal surfaces. The reaction occurs on the same mucosal or cutaneous site with subsequent exposures to the offending drug. Although FDE usually manifests as a single lesion, in rare instances, more than one lesion may arise and this is referred to as a generalized eruption. Herein, we present a 31year-old man with history of cystic fibrosis who developed a generalized fixed drug eruption to piperacillin/tazobactam (Zosyn, Pfizer). We discuss our patient's course and review causes and outcomes of generalized fixed drug eruptions in the literature.
Topics: Adult; Anti-Bacterial Agents; Anti-Inflammatory Agents; Drug Eruptions; Humans; Male; Penicillanic Acid; Piperacillin; Piperacillin, Tazobactam Drug Combination; Triamcinolone
PubMed: 29906010
DOI: No ID Found -
Clinical Reviews in Allergy & Immunology Jun 2022Confirming drug imputability is an important step in the management of cutaneous adverse drug reactions (CADR). Re-challenge is inconvenient and in many cases life... (Review)
Review
Confirming drug imputability is an important step in the management of cutaneous adverse drug reactions (CADR). Re-challenge is inconvenient and in many cases life threatening. We review the literature on ideal patch testing technique for specific CADRs. Testing should be performed approximately 3 months after the resolution of the eruption using standard patch testing techniques. Commercially available patch test preparations are available for a minority of drugs, so in most cases, testing should be performed with the drug at various recommended concentrations and in different vehicles. Testing to all known excipients, such as dyes, vehicles and preservatives is also important. Immunosuppressive medications should be discontinued or down titrated to the lowest tolerable dose to decrease the risk of false negative reactions. We provide an overview of expert recommendations and extant evidence on the utility of patch testing for identifying the culprit drug in common CADRs and for specific drug or drug classes. Overall, there appears to be significant variability in the patch test positivity of different drugs, which is likely the result of factors intrinsic to the drug such as dermal absorption (as a function of lipophilicity and molecular size) and whether the drug itself or a downstream metabolite is implicated in the immune reaction. Drugs with high patch test positivity rates include beta-lactam antibiotics, aromatic anticonvulsants, phenytoin, and corticosteroids, among others. Patch testing positivity varies both as a function of the drug and type of CADR. The sum of the evidence suggests that patch testing in the setting of morbilliform eruptions, fixed drug eruption, acute generalized exanthematous pustulosis, and possibly also drug-induced hypersensitivity syndrome, photoallergic and eczematous reactions may be worthwhile, although utility of testing may vary on the specific drug in question for the eruption. It appears to be of limited utility and is not recommended in the setting of other complex CADR, such as SJS/TEN and leukocytoclastic vasculitis.
Topics: Anticonvulsants; Drug Eruptions; Drug Hypersensitivity; Exanthema; Humans; Hypersensitivity, Delayed; Patch Tests
PubMed: 35113364
DOI: 10.1007/s12016-022-08924-2 -
International Journal of... 2022Tuberculosis is one of the leading causes of death from infectious diseases in adults worldwide. Drug hypersensitivity in tuberculosis is an important problem affecting...
Tuberculosis is one of the leading causes of death from infectious diseases in adults worldwide. Drug hypersensitivity in tuberculosis is an important problem affecting the treatment process. Although treatment is started with isoniazid, rifampicin, ethambutol, and pyrazinamide in drug-sensitive tuberculosis patients, it may not always be continued in this way. When hypersensitivity develops under antituberculosis treatment, type 4 hypersensitivity is the most common, and maculopapular drug eruption develops as a subgroup. Lichenoid drug eruption is very rare. We present our case who was diagnosed with pulmonary tuberculosis, who developed lichenoid drug eruption while receiving treatment, and whose treatment was completed by giving the new regimen with successful desensitization.
Topics: Adult; Humans; Antitubercular Agents; Pyrazinamide; Isoniazid; Tuberculosis; Drug Eruptions
PubMed: 36510939
DOI: 10.4103/ijmy.ijmy_151_22 -
Nihon Ronen Igakkai Zasshi. Japanese... 2023
Topics: Humans; Aged; Skin Diseases; Drug Eruptions; Skin
PubMed: 38171750
DOI: 10.3143/geriatrics.60.345 -
Dermatology Online Journal Jul 2020Terbinafine is an antifungal agent used in the treatment of hair, nail, and skin dermatophyte infections. Skin side effects to terbinafine are not common. Lichenoid drug... (Review)
Review
Terbinafine is an antifungal agent used in the treatment of hair, nail, and skin dermatophyte infections. Skin side effects to terbinafine are not common. Lichenoid drug eruption is a medication-related adverse cutaneous event; the lesion morphology and pathology mimic lichen planus. A woman with onychomycosis developed a lichenoid drug eruption one week after starting terbinafine. The features of her dermatosis and the characteristics of two additional men who also experienced terbinafine-induced lichenoid drug eruption are discussed. They were receiving a daily terbinafine dosage of either 125mg or 250mg to treat onychomycosis or tinea cruris. The lichenoid drug eruption presented as diffuse or symmetric lesions within one to two weeks after starting terbinafine treatment. The extremities, chest, abdomen, and/or trunk were common sites. Less frequent locations were the lips, nails, palms, soles, and suprapubic region; lesions did not occur on the oral or genital mucosa. The eruption resolved after discontinuation of the medication (with or without treatment using topical corticosteroids, systemic corticosteroids, or both). In addition, more frequently occurring terbinafine-associated cutaneous adverse events (such as urticaria, erythematous eruptions, pruritus, acute generalized exanthematous pustulosis, subacute cutaneous lupus erythematosus, and papulosquamous conditions) are reviewed.
Topics: Aged; Antifungal Agents; Biopsy; Drug Eruptions; Female; Humans; Lichenoid Eruptions; Male; Onychomycosis; Skin; Terbinafine
PubMed: 32898398
DOI: No ID Found -
Acta Bio-medica : Atenei Parmensis Jan 2019Adverse reactions to drugs are not frequent in childhood. Cutaneous reactions are the most frequent in this age group. Mild cutaneous reactions are immediate or delayed... (Review)
Review
Adverse reactions to drugs are not frequent in childhood. Cutaneous reactions are the most frequent in this age group. Mild cutaneous reactions are immediate or delayed adverse reactions that do not seriously compromise the clinical condition of children. The patients usually early improve and recover the state of health. Although it is difficult to define the prevalence accurately, we could affirm that the rate adverse reaction to drugs are often over estimated by both the families and the physicians. Therefore, children may be prone to loss of school days and inappropriate or sub-optimal treatments. However, the identification of a true adverse reaction to drugs allows adequate treatment and alert to further exposure to harmful drugs.
Topics: Drug Eruptions; Exanthema; Humans; Photosensitivity Disorders; Urticaria
PubMed: 30830060
DOI: 10.23750/abm.v90i3-S.8159 -
Indian Journal of Dermatology,... 2023
Topics: Humans; Drug Eruptions
PubMed: 36332090
DOI: 10.25259/IJDVL_502_2021 -
Contact Dermatitis Jul 2022
Topics: COVID-19; COVID-19 Vaccines; Dermatitis, Allergic Contact; Drug Eruptions; Exanthema; Humans
PubMed: 35243643
DOI: 10.1111/cod.14092 -
Symmetrical drug-related intertriginous and flexural exanthema-like eruption after COVID-19 vaccine.Journal of the European Academy of... Aug 2022
Topics: COVID-19; COVID-19 Vaccines; Drug Eruptions; Exanthema; Humans
PubMed: 35344627
DOI: 10.1111/jdv.18108