Localized pustulosis induced by betalactams.
Localized forms of pustular drug eruptions related to antibiotics are uncommon and their mechanism is still unknown. We describe herein a patient who developed numerous pin-head pustules without erythema in the peribuccal area after ingestion of ceftibuten and amoxicillin. The relationship with these drugs was confirmed by single-blind oral challenges. The following tests were performed: prick and intradermal tests with benzylpenicilloyl polylysine, minor determinant mixture, benzylpenicillin and amoxicillin; patch tests were also carried out with benzylpenicillin, amoxicillin, cloxacillin, cefuroxime, ceftriaxone, cefazolin, ceftibuten and cefaclor. All cutaneous tests were negative. Controlled single-blind challenge tests were performed with amoxicillin, cefadroxil, ceftibuten, cefuroxime, cefaclor, erythromycin and ciprofloxacin. All betalactam antibiotics tested gave a positive reaction, with good tolerance of other antibiotics; this would appear to indicate a specific mechanism of hypersensitivity and not an unspecific reaction to wide spectrum antibiotics.
Allergy Service, Jiménez Díaz Foundation, Universidad Autónoma de Madrid, Spain.
A
A
Novalbos
C
C
Bombín
E
E
Figueredo
M
M
Lluch
J
J
Sastre
D000328:Adult; D000077722:Ceftibuten; D002511:Cephalosporins / Q000009:adverse effects* / Q000627:therapeutic use; D004342:Drug Hypersensitivity / Q000209:etiology; D005076:Exanthema / Q000139:chemically induced*; D005148:Facial Dermatoses / Q000139:chemically induced*; D005260:Female; D006801:Humans; D008413:Mastitis / Q000188:drug therapy
D002511:Cephalosporins; D000077722:Ceftibuten