Recurrent fixed drug eruption caused by citiolone.
Citiolone (N-acetylhomocysteinethiolactone) is a thiolic-derived medication frequently used in Spain and in other countries as a mucolytic agent for the treatment of certain hepatic disorders. Mucolytic drugs have rarely been implicated in the fixed drug eruption etiology. We report on a patient who presented several episodes of fixed exanthema related to citiolone intake. The patch test with citiolone (10% in dimethyl sulfoxide) was negative. The diagnosis was confirmed by a positive controlled oral challenge test. Other mucolytic thiolic-derivatives (N-acetylcysteine) were tolerated by the patient, thus crossreactivity between these drugs seems to be unlikely.
de Barrio
M
M
Sección de Alergia, Hospital General Gregorio Marañón, Madrid, Spain.
Tornero
P
P
Prieto
A
A
Sainza
T
T
Zubeldia
J M
JM
Herrero
T
T
D000111:Acetylcysteine / Q000009:adverse effects; D000328:Adult; D003429:Cross Reactions; D003875:Drug Eruptions / Q000175:diagnosis / Q000209:etiology*; D005100:Expectorants / Q000009:adverse effects*; D006801:Humans; D008297:Male; D010328:Patch Tests; D012008:Recurrence; D016037:Single-Blind Method; D013876:Thiophenes / Q000008:administration & dosage / Q000009:adverse effects*
D005100:Expectorants; D013876:Thiophenes; C000486:citiolone; D000111:Acetylcysteine