Topical provocation in 27 cases of cotrimoxazole-inducedxed drug eruption (original) (raw)

Drugs Causing Fixed Drug Eruption: A Clinical Study

2011

Objectives: To identify the causative drugs of fixed drug eruption, and to assess drug-related body site distribution of fixed drug eruption. Methods: This study was conducted at Prince Rashid Hospital and Queen Alia Hospital during the period between January 2008 and June 2009. A total of 64 patients who attended the dermatology clinic with fixed drug eruption were asked about the offending drug. Results: Trimethoprim-sulphamethoxazole was the causative agent in 43 cases (70.3%), followed by Furosemide in 5 cases (7.8%), and Tetracyclines in 4 cases (6.3%). Other causative drugs included Diclofenac sodium 3 (4.7%), Ciprofloxacin 3 (4.7%), Ibuprofen 2 (3.1%), Metronidazole 2 (3.1%), Norfloxacin 1 (1.6%), and aspirin 1 (1.6%). The glans penis of the male genitalia was the most commonly involved site (58.0%), followed by the extremities (39.0%), the trunk (20.3%), and the lips (6.3%). The female genitalia (clitoris) was involved only in two patients (3.1%). Only one patient (1.6%) dev...

A prospective observational study on drug induced cutaneous eruptions in a tertiary care hospital

2018

Article History: Received 20 Sep 2017 Revised 05 Dec 2017 Accepted 11 Dec 2017 Aims: To study the clinical pattern of drug-induced cutaneous eruptions, associate the causality relationship between the suspected drug and the cutaneous reaction observed, also to assess the severity and the preventability criteria of cutaneous reaction. Subject & Methodology: A hospital-based Prospective, the Observational study was carried out in patients presenting to Department of Dermatology at Osmania General Hospital. Data collection form was designed according to the need of our study. Naranjo scale, Modified Hartwig and Siegal scale, Schumock and Thornton scale was used in the study to assess the causality, severity and the preventability criteria of the observed reactions respectively. After inclusion and exclusion criteria, 147 cases were enrolled in the study. Results: A total of 147 cutaneous eruptions were identified in which female predominance was observed. The most common clinical patte...

Specific site involvement in fixed drug eruption

Journal of the American Academy of Dermatology, 2003

A total of 105 patients with established fixed drug eruption (FDE) by oral provocation were evaluated with regard to a drug-related site involvement. Cotrimoxazole was the leading causative agent (63.8%), followed by naproxen sodium (23.8%), dipyrone (5.7%), oxicams (4.8%) and other rare causes (1.9%). Cotrimoxazole most frequently induced lesions on genital mucosa; naproxen and oxicams on lips; and dipyrone on trunk and extremities. Isolated FDE on male genitalia (n ϭ 16) was exclusively because of cotrimoxazole. A highly significant association could be established between naproxen and FDE on lips (chi-square ϭ 28.3; corrected P ϭ .000002). As this study represents the largest series of patients with naproxen-induced FDE, we would suggest that naproxen should be considered as an important potential cause of FDE on lips. (J

Clinical Profile of Severe Cutaneous Drug Eruptions in a Tertiary Care Hospital

Journal of College of Medical Sciences-Nepal, 2019

Background: An adverse cutaneous reaction caused by a drug is any undesirable change in the structure or function of the skin, its appendages or mucous membranes and it encompass all adverse events related to drug eruption, regardless of the etiology. Methods: This is a retrospective descriptive cross-sectional study done fom April 2017 to March 2019 at dermatology department of Kathmandu Medical College Teaching Hospital. Sample size was calculated as 42 with prevalance of severe cutaneous drug eruption as 3%. After the medication history was taken, all suspected causative drugs were discontinued. For the initial 5 to 7 days, all patients were treated with intravenous corticosteroids and oral antihistamines. Follow up after one week, 2 weeks and one month were suggested for assessment of outcomes. Results: Out of 42 patients, 22 (52.38%) were females and 20 (47.62%) males. Most were in age groups 16-39 & 46-60 counting to 14 (33.33%) in each group. Acute morbilliform eruption was ...

Desensitization to co-trimoxazole in a patient with fixed drug eruption

Journal of investigational allergology & clinical immunology, 2008

Although co-trimoxazole is a major cause of fixed drug eruption, there are no reports in the literature of desensitization protocols for co-trimoxazole in such patients. We present the case of an 85-year-old woman with a fixed drug eruption to co-trimoxazole. Since she needed co-trimoxazole therapy for treatment of infection of a prosthetic hip by Staphylococcus aureus, she underwent allergy testing with co-trimoxazole and its components sulfamethoxazole and trimethoprim. Allergy tests were all negative and a diagnosis of nonallergic hypersensitivity reaction to co-trimoxazole was made. Based on previous experience, we decided to attempt a desensitization protocol with co-trimoxazole. After 10 days, the patient could receive 800 mg of sulfamethoxazole and 160 mg of trimethoprim twice a day and no adverse reactions were observed. We suggest that desensitization protocols with co-trimoxazole be considered in patients with fixed drug eruption, especially when there are no alternative d...

Most Common Drug Eruptions by Pattern and Drug Class: A Review

Journal of Dermatology Research, 2024

Cutaneous drug reactions come in many different morphologies, distributions and severities ranging from pruritus and erythema to diffuse epidermal denudation requiring hospitalization. The wide variety of presentations and medications responsible make identification and elimination of the offending agent difficult. Here these authors present a review of the common morphologic drug eruptions and their offending drugs.

A study of cutaneous adverse drug eruptions in dermatologic practice

Cutaneous adverse drug reactions (CADR) are a major problem in drug therapy and is one of the leading causes of morbidity and mortality in health care. Objectives: 1) To study the diverse clinical spectrum of CADR. 2) To assess the causality and identify the offending drug. Materials and Methods: Present study was an 18 months prospective, hospital based study conducted, recording a total of 100 patients with various cutaneous ADR. The diagnosis of cutaneous drug reactions was made mainly based on detail history and correlation between the intake of probable offending drug and the onset of rash. Results: The most common type of CADR patterns recorded among the 100 cases in the present study were Maculopapular rash (30%), Fixed drug eruption & bullous variant (19%), Acute urticaria (18%), Acneiform eruptions (6%), Erythema multiforme & Stevens – Johnson syndrome (SJS) in (5%), Exfoliative dermatitis & Photosenstivity in (4%), Angioedema, Vasculitis & Hyperpigmentation in (2%), Toxic epidermal necrolysis (TEN), Drug hypersensitivity syndrome & Pruritus in (1%) each. The drugs most often implicated were Antimicrobials(40%), NSAIDs (30%), and Anticonvulsants (11%). Antimicrobials were implicated in (43.3%) of Maculopapular rash followed by NSAIDs (33.3%). Antimicrobials (52.6%) and NSAIDs (42.1%) in FDE. Urticarial reaction was caused mainly by NSAIDs (44.3%). Life threatening severe cutaneous adverse drug reactions (SCARs) such as SJS, TEN & Drug hypersensitivity syndrome (DHS) were seen 7% of total cases. Conclusion: Although it was a monocentric study, this study revealed a high frequency of cutaneous drug reactions with different clinical presentations, induced by frequently used antibiotics, analgesics and anticonvulsants as and when used giving an interesting data with respect to onset, severity and clinical presentation.