fixed drug reaction


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fixed drug reaction

Dermatology  An idiopathic skin eruption more common in blacks, which often recurs at the same place, every time a particular drug or a related congener is administered; FDRs may also occur with chemically unrelated drugs or disappear with repeated administration of the same drug Clinical Sharply circumscribed edematous red-brown or purplish plaque that may be surmounted by a bulla, most often located on the extremities, the hands, and glans penis which with time, becomes lichenified, scaly, ±accompanied by hypermelanosis Agents causing FDR phenazone, barbiturates, sulfonamides, quinine, tetracycline, oxyphenbutazone, chlordiazepoxide, food dyes, toothpaste, mothballs
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A patient with a fixed drug reaction often has a single lesion, and the lesion will occur in the same location every time the patient is exposed to the drug.
If the eruption has occurred before, that factor suggests that a diagnosis of erythema multiforme or fixed drug reaction may be more likely than TEN.
The most common type of offending drugs causing the drug reactions are sulfonamides in 8 (40%) cases followed by NSAIDs in 6 (30%) quinolones 3 (15%) metronidazole in 2 (10%) cases and anticonvulsants in 1(5%) case similar to the study finding of Patel et al.9 where majority of causative drugs in fixed drug reaction were co-trimoxazole 26 (29.5%) and NSAIDs 20 (22.8%) in number.
The differential diagnosis included Behcet's disease, cicatricial pemphigoid, a fixed drug reaction, and allergic contact dermatitis.
* A fixed drug reaction is an allergic reaction to a particular medication that occurs at the same location whenever that medication is taken.
6 52 F Ciprofloxacin, Mefenamic Fixed drug reaction acid, Acetaminophen, affecting multiple Diclofenac sodium, sites with oral Cefadroxyl erosions 7 42 F Diclofenac sodium, Urticaria Ampicillin, Cetirizine.
It is especially important to rule out herpes simplex, varicella, bullous tinea, bullous fixed drug reaction, bullous drug eruption, and staphylococcal scalded skin syndrome.
Again, more than 75% of drug reactions present with dermal manifestations (urticaria, angioedema, fixed drug reactions).
Fixed Drug Reactions. Following a primary episode of allergic skin/mucosal eruption induced by a drug-specific T cell-mediated hypersensitivity immune reaction in response to exposure to a systemic drug, reexposure to the same or to a chemically closely related drug may induce a recurrent eruption at the same site.
Fixed drug reactions have been reported for indomethacin, aspirin, mefenamic acid, diclofenac, piroxicam and paracetamol.

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