title: Drug related clinical pattern in fixed drug eruption.
abstract: Fixed drug eruption (FDE) represents a frequent type of drug eruption in Turkey. The aim of this open study is to analyze the clinical features with special emphasize on drug related pattern in our case series. Sixty-four cases with established FDE by oral provocation were clinically evaluated. Cotrimoxazole, a combination of sulfamethoxazole and trimethoprim, was the most common offender for FDE (75%), followed by naproxen sodium (12.5%), dipyrone (9.5%), dimenhydrinate (1.5%) and paracetamol (1.5%). Sensitivity to more than one drug was not observed. Cotrimoxazole-induced FDE was mainly located on male genitalia. Naproxen predominantly affected lips and face whereas dipyrone mainly caused FDE on trunk and extremities. Statistical analysis revealed a significant difference only for dipyrone versus cotrimoxazole over trunk and extremities (p = 0.03). Familial occurrence, symmetrical and asymmetrical nonpigmenting FDE, linear FDE, solitary plaque on the cheek, and "wandering" FDE were unusual findings of cotrimoxazole-induced FDE. Cotrimoxazole was the leading etiological agent in our series. Cotrimoxazole-induced FDE had some rarely or previously unreported features, but a significant relation between drugs and involved areas or clinical pattern could not be established.
authors.affiliation: Department of Dermatology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey. ebayazit@istanbul.edu.tr
authors.forename: E
authors.initials: E
authors.lastname: Ozkaya-Bayazit
authors.forename: H
authors.initials: H
authors.lastname: Bayazit
authors.forename: G
authors.initials: G
authors.lastname: Ozarmagan
mesh_terms: D000082:Acetaminophen / Q000009:adverse effects; D000293:Adolescent; D000328:Adult; D000368:Aged; D018712:Analgesics, Non-Narcotic / Q000009:adverse effects*; D000890:Anti-Infective Agents / Q000009:adverse effects*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D002648:Child; D004111:Dimenhydrinate / Q000009:adverse effects; D004177:Dipyrone / Q000009:adverse effects; D004338:Drug Combinations; D003875:Drug Eruptions / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006634:Histamine H1 Antagonists / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000187:drug effects / Q000473:pathology; D009288:Naproxen / Q000009:adverse effects; D011446:Prospective Studies; D012867:Skin / Q000187:drug effects* / Q000473:pathology; D013420:Sulfamethoxazole / Q000009:adverse effects; D014295:Trimethoprim / Q000008:administration & dosage; D014421:Turkey / Q000453:epidemiology
chemical_list: D018712:Analgesics, Non-Narcotic; D000890:Anti-Infective Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D004338:Drug Combinations; D006634:Histamine H1 Antagonists; D000082:Acetaminophen; D009288:Naproxen; D004177:Dipyrone; D014295:Trimethoprim; D004111:Dimenhydrinate; D013420:Sulfamethoxazole