What is a fixed drug eruption?
Fixed drug eruption (FDE) is a distinctive type of cutaneous drug reaction that characteristically recurs in the same locations upon re-exposure to the offending drug.
What is the most common drug induced cutaneous reaction?
Exanthematous drug eruptions, also known as maculopapular drug eruptions, are the most common cutaneous skin reactions and represent approximately 95% of all cutaneous drug eruptions.
What is bullous fixed drug eruption?
Background: Bullous fixed drug eruption (BFDE) is a rare and particular adverse drug reaction characterized by localized or generalized blisters and erosions, which can be confused with Stevens-Johnson syndrome, toxic epidermal necrolysis, major erythema multiforme and autoimmune bullous dermatosis.
What are the most common types of drugs that can result in drug eruption?
Examples of common drugs causing drug eruptions are antibiotics and other antimicrobial drugs, sulfa drugs, nonsteroidal anti-inflammatory drugs (NSAIDs), biopharmaceuticals, chemotherapy agents, anticonvulsants and psychotropic drugs.
How is a fixed drug eruption diagnosed?
FDE commonly occurs on the genitals, lips, trunk, and hands. Although the lesions are distinctive, the diagnosis of FDE often is missed because it shares none of the characteristics of more common morbilliform drug rashes. The diagnosis can be confirmed by histopathologic examination of a small punch biopsy specimen.
Which antibiotics cause fixed eruptions?
Fixed drug eruption (FDE) is a common cutaneous drug eruption. We are the first to report a case of polysensitive FDE to both trimethoprim-sulfamethoxazole (TMP-SMX) and doxycycline. Diagnosis of FDE is largely clinical, and it is important to establish a good medication history to identify the causative agent.
What medications cause fixed eruption?
The major categories of causative agents of fixed drug eruption include antibiotics, antiepileptics, nonsteroidal anti-inflammatory agents, sildenafil, and phenothiazines, although numerous other agents and certain foods such as cashews and licorice have also been reported as causative agents.
Which drugs can induce all four types of hypersensitivity reactions?
Antibiotics (particularly beta-lactams) and anticonvulsants are the most common triggering drugs, accounting for three-quarters of all cases of hypersensitivity (e7).
What is the difference between bullous pemphigoid and pemphigus vulgaris?
Lesions between the two diseases look different. Pemphigus vulgaris lesions have flaccid bullae, erosions, and flexural vegetations or growths, and bullous pemphigoid has urticated plaques, tense bullae, and some milia.
How is fixed drug eruption diagnosed?
Do fixed drug eruptions disappear?
Fixed drug eruptions (FDE) are a distinct type of drug eruptions that appear as pruritic, well circumscribed, round or oval-shaped, erythematous macules or edematous plaques, and characteristically recur at the same sites upon re-exposure to the offending drug. They usually resolve spontaneously with hyperpigmentation.
How do you treat FDE?
Treatment for fixed drug eruptions (FDEs) otherwise is symptomatic. Systemic antihistamines and topical corticosteroids may be all that are required. In cases in which infection is suspected, antibiotics and proper wound care are advised.
How long does it take for a fixed drug eruption to go away?
The FDEs were treated by discontinuing the offending drug, topical corticosteroids, and oral antihistamines. More than half (50.4%) of the patients recovered within 10 days, while in 14 patients, the lesions took between 11 and 30 days to resolve.
Why do fixed drug eruptions happen?
Fixed drug eruption is usually due to oral medications, with antimicrobials and non-steroidal anti-inflammatory drugs (NSAID) being the most common culprits. Less common drug exposures may be topical or intravaginal.
What is the difference between Type 2 and 3 hypersensitivity?
Type 2 hypersensitivity reactions may occur in response to host cells (i.e. autoimmune) or to non-self cells, as occurs in blood transfusion reactions. Type 2 is distinguished from Type 3 by the location of the antigens – in Type 2, the antigens are cell bound, whereas in Type 3 the antigens are soluble.
Is fixed drug eruption an allergy?
Fixed drug eruption is a distinctive cutaneous allergic reaction that characteristically recurs at the same site(s) on re-exposure to the medication or other chemical agent.
What are the histologic features of pemphigus vulgaris?
Histology of pemphigus vulgaris
Early lesions of pemphigus vulgaris show suprabasal epidermal acantholysis, clefting and blister formation. The blister cavity may contain inflammatory cells including eosinophils and rounded acantholytic cells with intensely eosinophilic cytoplasm and a perinuclear halo.
How can you tell the difference between pemphigus and pemphigoid?
Pemphigus is characterized by shallow ulcers or fragile blisters that break open quickly. Pemphigoid presents with stronger or “tense” blisters that don’t open easily. Those with pemphigoid are also more likely to have hot, red and itchy hive spots.
How long can a fixed drug eruption last?
How can we get rid of fixed drug eruptions?
The main goal of treatment is to identify the causative agent and avoid it. Treatment for fixed drug eruptions (FDEs) otherwise is symptomatic. Systemic antihistamines and topical corticosteroids may be all that are required. In cases in which infection is suspected, antibiotics and proper wound care are advised.
What are the 4 types of hypersensitivity reactions?
The four types of hypersensitivity are:
- Type I: reaction mediated by IgE antibodies.
- Type II: cytotoxic reaction mediated by IgG or IgM antibodies.
- Type III: reaction mediated by immune complexes.
- Type IV: delayed reaction mediated by cellular response.
What is an example of type 3 hypersensitivity?
Examples of type III hypersensitivity reactions include drug-induced serum sickness, farmer’s lung and systemic lupus erythematosus.
What foods cause fixed eruptions?
What is the difference between pemphigus vulgaris and bullous pemphigoid?
What is the difference between pemphigus vulgaris and pemphigus foliaceus?
Pemphigus vulgaris usually presents with widespread mucocutaneous blisters and erosions. Cutaneous blistering in pemphigus foliaceus tends to occur in a seborrheic distribution. Blistering in pemphigus foliaceus is more superficial compared with pemphigus vulgaris.