A case of entecavir-associated bullous
fixed drug eruption and a review of literature.
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Fixed drug eruption is very rare with ondansetron usage.
Fixed drug eruption: a disease mediated by self-inflicted responses of intraepidermal T cells.
The most common morphological types of the ACDRs were maculopapular rash (25%),
fixed drug eruptions (23%) and urticarial wheals (22%).
Patients 1
Fixed drug eruption Antimalarial, Fluroquinolones 2 Acneform eruption 7 Systemic Steroids 3 SJ syndrome 6 Isoniazid, phenytoin, Carbamazepine, Septran 4 Melasma 5 Oral contraceptive pills 5 Angioedema 4 Penicillin, Salicylates 6 Erythema 4 Sulfonamides multiformae 7 Urticaria 3 NSAIDs,ACE inhibitors 8 Drug induced 3 Chloroquine Erythroderma 9 Maculopapular 3 Ampicillin, Chloroquine exanthema 10 Pellagrous 3 Isoniazid dermatitis 11 Hypertrichosis 2 Systemic Steroid 12 Stria 2 Systemic Steroid 13 Hyperpigmentation 1 Clofazamine 14 Bullous FDR 1 Metronidazole 15 Phototoxic reaction 1 Hydroxychloroquine
[2]
Fixed drug eruptions (FDE) is characterized by development of one or more annular or oval, sharply demarcated erythematous plaques or blisters as a result of systemic exposure to a drug, which usually leaves a residual hyperpigmentation.
They were also reassured of the relative safety of provocation tests in
fixed drug eruption. They were motivated to undergo provocation tests.
Fixed drug eruption (FDE ) was first described by Brocq in 1894 in association with antipyrine therapy.1 Since then numerous cases have been reported across the globe, some in association with drugs2 and others in association with food ingredients.3 FDE is characterized by erythematous patch with dark center which may progress to form blister.
One case (1.51%) each of drug induced lichenoid reaction,
fixed drug eruption, follicular lichen planus, bullous lichen planus, lichen striatus, & lichenoid tattoo reaction.
Conclusion Frequency distribution of the offending drugs and the adverse reactions revealed that cephradine was responsible for maculopapular rash, sulphonamides for Stevens-Johnson syndrome, indigenous medicines for exfoliative dermatitis, NSAIDs for urticaria and paracetamol for
fixed drug eruption.
In our case, the clinical findings and the temporal association with the drug intake and the patient's history established Azithromycin to be the culprit in causing the
Fixed Drug Eruption. Oral rechallenge and patch testing with azithromycin was refused by the patient and the lesions were also subsided.
(16) Intraepidermal CD8+ T cells with an effector-memory phenotype resident in
fixed drug eruption lesions have a major part to play in the development of localized tissue damage.
