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J Allergy Clin Immunol 2019 Jan 17;143(1):66-73. Epub 2018 Dec 17.

Dermatology and Allergy Department, Tenon Hospital, Medecine Sorbonne University, Paris, France; Assistance publique-hopitaux de Paris, Paris, France.

Controversies exist with regard to in vivo approaches to delayed immunologically mediated adverse drug reactions, such as exanthem (maculopapular eruption), drug reaction with eosinophilia and systemic symptoms, acute generalized exanthematous pustulosis, Stevens-Johnson syndrome/toxic epidermal necrolysis, and fixed drug eruptions. In particular, widespread differences exist between regions and practice on the availability and use of intradermal and patch testing, the standard drug concentrations used, the use of additional drugs in intradermal and patch testing to help determine cross-reactivity, the timing of testing in relation to the occurrence of the adverse drug reaction, the use of testing in specific phenotypes, and the use of oral challenge in conjunction with delayed intradermal and patch testing to ascertain drug tolerance. It was noted that there have been advances in the science of delayed T cell-mediated reactions that have shed light on immunopathogenesis and provided a mechanism of preprescription screening in the case of HLA-B*57:01 and abacavir hypersensitivity and HLA-B*15:02 and carbamazepine Stevens-Johnson syndrome/toxic epidermal necrolysis in Southeast Asian subjects. Read More

Indian J Pharmacol 2018 Jul-Aug;50(4):192-196

Department of Pharmacology and Dermatology, SCB Medical College, Cuttack, Odisha, India.

Objectives: To identify the association of cutaneous adverse drug reactions (CADRs) with use of fixed-dose combinations (FDCs) and to compare the occurrence of preventable CADRs between self-medication and prescribed medication of FDCs.

Patients And Methods: All cases of suspected CADRs with the use of FDCs were collected, and causality assessment was carried out using the WHO UMC scale. The burden of CADRs on self-medication and prescribed medication was found out. Read More

J Allergy Clin Immunol Pract 2018 Dec 1. Epub 2018 Dec 1.

Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, Mass; Department of Medicine, Harvard Medical School, Boston, Mass. Electronic address:

Background: Hypersensitivity reactions (HSRs) are immunologic responses to drugs. Identification of HSRs documented in the electronic health record (EHR) is important for patient safety.

Objective: To examine HSR epidemiology using longitudinal EHR data from a large United States health care system. Read More

An Bras Dermatol 2018 Nov/Dec;93(6):874-877

Department of Pathology, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.

Autoimmune progesterone dermatitis is an uncommon, poorly recognized and under-diagnosed catamenial dermatosis associated with hypersensitivity reactions to progestagens. Most cases manifest as urticaria, eczema or erythema multiforme-like. A 26-year-old woman developed violaceous plaques on the groin and abdomen, 4 days after a spontaneous abortion resolved with uterine curettage. Read More

Indian J Ophthalmol 2018 Nov;66(11):1627-1629

Department of Pediatrics, Dr Shroff's Charity Eye Hospital, New Delhi, India.

Fixed drug eruption (FDE) is a type of drug-induced cutaneous disorder that characteristically presents with recurrence of similar lesion at the same skin or mucosal site as a result of systemic exposure to a drug. Paracetamol is commonly prescribed analgesic-antipyretic agent in all age group of patients. FDE due to paracetamol is not very common but it is well reported in literature for all age groups. Read More

Am Fam Physician 2018 Sep;98(5):283-291

Thomas Jefferson University Hospital, Philadelphia, PA, USA.

Annular lesions can present in a variety of diseases. Knowledge of the physical appearance and history of presentation of these skin findings can help in the diagnosis. A pruritic, annular, erythematous patch that grows centrifugally should prompt evaluation for tinea corporis. Read More

J Med Case Rep 2018 Sep 11;12(1):254. Epub 2018 Sep 11.

School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia.

Background: Cutaneous adverse reactions to medications are extremely common and display characteristic clinical morphology. A fixed drug eruption is a cutaneous adverse drug reaction due to type IV or delayed cell-mediated hypersensitivity. Ivermectin, a broad-spectrum anti-parasitic compound, has been an essential component of public health campaigns targeting the control of two devastating neglected tropical diseases: onchocerciasis (river blindness) and lymphatic filariasis. Read More

Dermatol Online J 2018 08 23;24(6). Epub 2018 Aug 23.

Department of Dermatology, Dr Ram Manohar Lohia Hospital, New Delhi.

Fixed drug eruption is a delayed type hypersensitivity reaction to a drug seen most frequently with antibiotics such as tetracyclines, sulfonamides, and NSAIDs such as naproxen and ibuprofen. Although H1-antihistamines rarely elicit cutaneous adverse effects, there have been a few reports in the literature implicating them in causing fixed drug eruption, particularly the piperazine derivatives (hydroxyzine, cetirizine, levocetirizine), and loratadine. However, cutaneous drug reactions with the alkylamine derivatives like pheniramine maleate are extremely uncommon and fixed drug eruptions have not been reported with any of the alkylamine antihistamines to date. Read More

Dermatol Online J 2018 Jun 15;24(6). Epub 2018 Jun 15.

Department of Dermatology, Dr. BC Roy Post Graduate Institute of Pediatric Sciences, Kolkata.

Sunitinib is an oral multi-targeted tyrosine kinase inhibitor. It has been approved for the treatment of gastro-intestinal stromal tumor and advanced renal cell carcinoma. Fixed drug eruption related to sunitinib is a rare cutaneous adverse drug reaction. Read More

Curr Drug Saf 2019 ;14(1):72-76

Department of Microbiology, Government Medical College, Amritsar 110002, India.

Background: Fixed drug eruption is a clinical entity occurring at the same site each time the drug is administered. They are usually found on lips, genitalia, abdomen, and legs but can occur at any location. The eruptions usually occur within hours of administration of the drug and resolves spontaneously. Read More

Indian J Dermatol 2018 Jul-Aug;63(4):332-337

Department of Pharmacology and Toxicology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.

Background: A fixed-drug eruption (FDE) is a unique cutaneous adverse drug effect in the form of recurrent lesions at the same site after re-exposure to the offending agent.

Aim: The aim of the study was to identify changes in trends in fixed drug eruptions with regard to causative drug or patient risk factors.

Methods: Cases of FDEs encountered between March 2014 to May 2017 during routine pharmacovigilance activities were analyzed. Read More

Curr Drug Saf 2018 ;13(3):224-225

Department of Dermatology, Venereology & Leprology, All India Institute of Medical Sciences, GE Rd, Tatibandh, Raipur, Chhattisgarh, India.

Background: Aceclofenac is a phenylacetic acid derivative belongs to the group of nonsteroidal anti-inflammatory drug. It is commonly used in the treatment of pain and various inflammatory disorders. It is well tolerated, with most adverse events being minor and reversible and affecting mainly the GI system. Read More

An Bras Dermatol 2018 Jun;93(3):470-472

Emergency Unit, Hospital Copa D'Or, Rio de Janeiro, RJ, Brazil.

Acta Clin Belg 2018 Jun 18:1-3. Epub 2018 Jun 18.

d Department of Public Health, Faculty of Medicine , Yıldırım Beyazıt University , Ankara , Turkey.

Background Fixed drug eruptions (FDE) are characterized by recurrent, usually solitary erythematous or dark red macular, plaque or bullous lesions, all at the same site. Among the first choices for antidotal treatment in mercury exposure, 2,3-dimercapto-1-propanesulfonic acid (DMPS) is generally a drug with a low incidence of side effects. FDE due to DMPS was not detected in our literature research and so we aimed to present this rare case. Read More

Dermatol Online J 2018 Apr 15;24(4). Epub 2018 Apr 15.

University of California Davis, Sacramento, California.

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. Read More

BMJ Case Rep 2018 Jun 4;2018. Epub 2018 Jun 4.

Department of General Medicine, Shri Sathya Sai Medical College and Research Institute, Kanchipuram, Tamil Nadu, India.

Ciprofloxacin, a very common antibiotic used in our day-to-day practice can cause adverse cutaneous reactions in 1-2% of patients. Photosensitivity, urticaria and maculopapular rash are the usual skin reactions. Fixed drug eruption (FDE) is an uncommon side effect of ciprofloxacin. Read More

J Cutan Med Surg 2018 Nov/Dec;22(6):621-623. Epub 2018 May 13.

4 Division of Clinical Dermatology and Cutaneous Science, Department of Medicine, Dalhousie University, Halifax, NS, Canada.

Background: Dasatinib is a tyrosine kinase inhibitor indicated for the treatment of chronic myeloid leukemia (CML). Skin rashes are common, occurring in about a quarter of patients treated, and are generally mild. The commonest rash is a keratosis pilaris-like eruption. Read More

Med J Malaysia 2018 Apr;73(2):73-77

Hospital Pulau Pinang, Dermatology Department, Jalan Residensi, Georgetown, Penang, Malaysia.

Introduction: Severe cutaneous adverse drug reactions (SCARs) are not uncommon and potentially lifethreatening. Our objective is to study the patient characteristics, the pattern of implicated drugs and treatment outcome among patients with SCARs.

Methods: A 10-year retrospective analysis of SCARs cases in Penang General Hospital was carried out from January 2006 to December 2015. Read More

Int Arch Allergy Immunol 2018 3;176(2):106-114. Epub 2018 Apr 3.

Background: Acetaminophen is the most commonly used antipyretic in children. However, there are limited data assessing hypersensitivity reactions related to acetaminophen usage.

Objectives: To conduct a systematic review to characterize reported reactions to acetaminophen in adults and children, and perform a meta-analysis to assess the prevalence of acetaminophen hypersensitivity in children with a suspected acetaminophen allergy. Read More

BMJ Case Rep 2018 Mar 17;2018. Epub 2018 Mar 17.

Interventional Cardiology, University of Arizona College of Medicine Phoenix, Phoenix, Arizona, USA.

Pediatr Allergy Immunol 2018 08 24;29(5):569-570. Epub 2018 Apr 24.

Plate-Forme Transversale d'Allergologie, Centre Hospitalo-Universitaire de Nantes, Nantes, France.

Therapie 2018 Oct 15;73(5):433-435. Epub 2018 Feb 15.

Dermatology department, Habib Thameur hospital, rue El Messelekh, 2004 Tunis, Tunisia.

Ann Dermatol Venereol 2018 Mar 24;145(3):210-213. Epub 2018 Feb 24.

Service de dermatologie et allergologie, Sorbonne université, faculté de médecine sorbonne université, AP-HP, service de dermatologie et allergologie, hôpital Tenon, 75020 Paris, France.

Dermatol Online J 2017 Jul 15;23(7). Epub 2017 Jul 15.

Baylor College of Medicine, Department of Dermatology, Houston, Texas.

Fixed drug eruption (FDE) is defined as sharply demarcated erythematous patches or plaques that occur secondary to systemic exposure to a causative medication. Eruptions are deemed "fixed" because upon repeated exposure they recur at previously affected sites. Generalized bullous fixed drug eruption (GBFDE) is a rare FDE variant occurring in patients with a previous history of FDE. Read More

Contact Dermatitis 2018 Jul 15;79(1):34-35. Epub 2018 Feb 15.

Department of Dermatology, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain.

J Immunol Res 2017 27;2017:1503709. Epub 2017 Dec 27.

Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.

Severe cutaneous adverse reaction (SCAR) is life-threatening. It consists of Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN), drug reaction with eosinophilia and systemic symptoms (DRESS), acute generalized exanthematous pustulosis (AGEP), and generalized bullous fixed drug eruptions (GBFDE). In the past years, emerging studies have provided better understandings regarding the pathogenesis of these diseases. Read More

Rev Mal Respir 2018 Jan 9;35(1):69-73. Epub 2018 Feb 9.

Clinique de pneumologie, centre hospitalier national universitaire de FANN (CHNUF), avenue Cheikh-ANTA-DIOP, BP 5035, Dakar, Sénégal.

Introduction: The Drug Reaction with Eosinophilia and Systemic Symptom (DRESS) is a severe drug-induced reaction.

Case Report: We report the case of a 35-year-old man treated by RHEZ for a first episode of a smear positive pulmonary tuberculosis and who developed a DRESS syndrome due to pyrazinamide after twenty days of treatment, associated with a viral reactivation to Human Herpes Virus 6 (HHV6). He had a skin eruption, liver involvement and hypereosinophilia. Read More

J Cutan Med Surg 2018 May/Jun;22(3):359-361. Epub 2018 Feb 3.

2 Department of Dermatology & Skin Science, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.

Ann Afr Med 2018 Jan-Mar;17(1):40-42

Dermatology Unit, Department of Medicine, Barau Dikko Teaching Hospital, Kaduna, Nigeria.

Sparfloxacin, a synthetic, second generation, broad spectrum aminodifluoroquinolone antibiotic, has excellent penetration into respiratory tissues and has good activity against Gram-positive, Gram-negative, and atypical bacteria. Although it is indicated for the treatment of adult community-acquired pneumonia and acute exacerbation of chronic bronchitis, its use has been limited by phototoxicity which is more common with it than with other quinolones. We report a case of a 20-year-old Nigerian woman who developed a diffuse blue-black nail pigmentation of thumb and big toe nails, 2 weeks after completing therapy with sparfloxacin, and a recurrence of the pigmentation in the same nails 1 year after taking the drug again. Read More

Drug Saf Case Rep 2018 Jan 2;5(1). Epub 2018 Jan 2.

Division of Immunology and Allergic Diseases, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Millet Street, Capa, Istanbul, Turkey.

We present a rare case of generalized fixed drug eruption caused by fluconazole. A 45-year-old female patient was referred to our outpatient clinic because of suspicious drug eruptions that occurred 5 months earlier and resolved within a month. The patient had sequela of hyperpigmentation on her arms, legs, back, and abdomen after oral administration of the fourth dose of 150 mg of fluconazole once daily because of vaginal candidiasis. Read More

Ann Pathol 2018 Feb 24;38(1):7-19. Epub 2017 Dec 24.

Département de pathologie, hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France. Electronic address:

There are many different types of cutaneous adverse reactions. The most classical reactions are driven by T lymphocytes that specifically react towards a drug, with an individual genetic susceptibility linked to certain type I major histocompatibility complex alleles. These reactions are characterized by a wide variety of clinical and histopathological presentations, and a wide range of severity. Read More

Indian J Dermatol 2017 Nov-Dec;62(6):618-625

Department of Skin and VD, GMERS Medical College, Gotri, Vadodara, Gujarat, India.

Background: The epidemiological data based on intensive monitoring studies are limited for the cutaneous adverse drug reactions (CADRs) in terms of incidence. Most of earlier Indian studies focused only on types and causative drugs of CADRs.

Aim: The aim of this study is to analyze the CADRs with reference to the incidence, its subgroup analysis, causative drugs, and other clinical characteristics in Indian population. Read More

Acta Derm Venereol 2018 Mar;98(3):376-377

Department of Dermatology, University Hospital Jena, Erfurter Str. 35, DE-07743 Jena, Germany.

Br J Dermatol 2017 10;177(4):e164

Department of Dermatology and Venereology, İstanbul Medical Faculty, İstanbul University, 34093, Istanbul, Turkey.

Pediatr Allergy Immunol 2018 02 28;29(1):115-117. Epub 2017 Nov 28.

Université Paris Descartes, Paris, France.

Med Sante Trop 2017 Aug;27(3):296-300

CHU Brazzaville, 13 avenue Auxence-IKonga, Brazzaville, Congo.

To determine the frequency of diseases responsible for skin lesions of the male external genitalia. This descriptive retrospective study examined the medical records of patients older than 14 years treated for genital symptoms as outpatients at the Dermatology Department of Talangaï Hospital in Brazzaville in 2009-2011. Patients' sociodemographic, medical history, clinical, and laboratory data were collected on a standardized individual form. Read More

Contact Dermatitis 2017 Oct;77(4):261-262

Sección de Alergología Hospital Universitario Joan XXIII, 43005 Tarragona, Spain.

Indian J Psychol Med 2017 Jul-Aug;39(4):537-538

Department of Psychiatry, National Drug Dependence Treatment Centre (NDDTC), All India Institute of Medical Sciences (AIIMS), New Delhi, India.

Adverse cutaneous reactions are known to occur with psychotropic medications, which may lead to poor drug compliance. As compared to other group of psychotropics, there is relatively scarce literature on olanzapine-induced skin eruptions. We present a case of a 39-year-old man diagnosed with first episode mania and alcohol dependence syndrome who was started on tablet olanzapine which leads to fixed drug eruptions. Read More

Pediatr Allergy Immunol 2017 12 3;28(8):848-850. Epub 2017 Oct 3.

Pediatric Allergy & Clinical Immunology, CHU Sainte-Justine, University of Montreal, Montréal, QC, Canada.

Ann Dermatol 2017 Aug 21;29(4):479-482. Epub 2017 Jun 21.

Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea.

Autoimmune progesterone dermatitis is a rare cyclic premenstrual reaction to progesterone produced during the luteal phase of the menstrual cycle. The clinical symptoms of autoimmune progesterone dermatitis overlap with other forms of dermatosis such as erythema multiforme, eczema, fixed drug eruption, urticaria, and angioedema. We experienced 3 cases of autoimmune progesterone dermatitis. Read More

Dermatol Res Pract 2017 28;2017:6216193. Epub 2017 Jun 28.

Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.

Background: Prevalence and incidence of drug eruptions vary around the world and are influenced by some key factors including HIV infection.

Objective: This study aimed to find the peculiarities of drug eruptions in people living with HIV (PLHIV) and on antiretroviral therapy (ART).

Methods: This was a retrospective cross-sectional study including ART-taking PLHIV, aged 15+ years, followed up between January 2010 and December 2014 at the day-care unit of the Yaoundé Central Hospital, and who presented with drug eruptions after ART initiation. Read More

Contact Dermatitis 2017 Aug;77(2):123-126

Department of Dermatology, Keio University School of Medicine, Tokyo, 160-8582, Japan.

Hong Kong Med J 2017 Aug 7;23(4):395-403. Epub 2017 Jul 7.

Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Laichikok, Hong Kong.

Antipyretics are commonly prescribed drugs and hypersensitivity occurs at rates of 0.01% to 0.3%. Read More

Dermatol Online J 2017 Jun 15;23(6). Epub 2017 Jun 15.

Molecular Dermatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Autoimmune progesterone dermatitis (APD) is a rare disorder characterized by periodic skin lesions that erupt during the luteal phase of the menstrual cycle. Clinical manifestations of APD is caused by an unusual allergy to progesterone and has a wide range of clinical manifestations from eczema and urticaria to angioedema and erythema multiforme. A 46-year-old woman described recurrent, round erythematous plaques on the lower lip, both forearms and buttocks. Read More

Am J Dermatopathol 2017 Aug;39(8):622-624

*Department of Dermatology, University of Cincinnati, Cincinnati, OH; †Miraca Life Sciences Research Institute, Irving, TX; and ‡Department of Dermatology, University of Florida College of Medicine, Gainesville, FL.

Factitious dermatitis (FD) (dermatitis artefacta) is rare and often difficult to diagnose because of conflicting history and nonspecific clinical and histologic findings. It can present with varied clinical features including geometric ulcers, erosions, and less commonly bullae secondary to external trauma from chemicals, electric burns, heat, and suction. Herein, we describe a case of bullous FD due to thermal burn with histologic features demonstrating overlap with fixed drug eruption. Read More

Clin Exp Dermatol 2017 Jul 17;42(5):544-545. Epub 2017 May 17.

Department of Dermatology, Venerology and Allergology, 1a Kliniczna Street, Gdańsk, 80-402, Poland.

Expert Rev Clin Pharmacol 2017 Jul 28;10(7):717-725. Epub 2017 Apr 28.

b Department of Dermatology , University of California, San Diego , La Jolla , CA , USA.

Introduction: Dapsone is a sulfone drug used to treat infectious conditions and also numerous dermatologic diseases. Fixed drug eruption is a distinctive adverse cutaneous reaction associated with the initial administration and subsequent delivery of a specific agent. Areas covered: The authors preformed a literature search using the following keywords: dapsone, fixed drug eruption, and adverse cutaneous drug reaction. Read More

Sultan Qaboos Univ Med J 2017 Feb 30;17(1):e121-e122. Epub 2017 Mar 30.

Department of Medicine, Medical College Kolkata, Kolkata, India.

Therapie 2017 Oct 25;72(5):539-545. Epub 2017 Mar 25.

Centre régional de pharmacovigilance de Sfax, faculté de médecine de Sfax, avenue Majida-Boulila, 3029 Sfax, Tunisie.

Introduction: Antiepileptic drugs are widely used and are associated with numerous side effects including skin eruptions. Epicutaneous tests have been used with variable success in skin drug reactions. The purpose of this study was to evaluate the profitability of epicutaneous tests in delayed hypersensitivity reactions induced by antiepileptic drugs. Read More

Semin Diagn Pathol 2017 May 22;34(3):237-249. Epub 2017 Mar 22.

Department of Radiation Oncology, The Ohio State University, Columbus, OH, United States.

The terms 'lichenoid' and 'interface' dermatitis are often used interchangeably to describe an inflammatory pattern characterized histologically by damage to the basal keratinocytes in the epidermis. The mechanism of cell damage of such cells is now best understood as apoptosis, or programmed cell death. This inflammatory pattern of dermatoses, is also accompanied frequently by a band of lymphocytes and histiocytes in the superficial dermis, that often obscures the dermal-epidermal junction, hence the term 'lichenoid'. Read More