Fixed drug eruption induced by trimethoprim-sulfamethoxazole: evidence for a link to HLA-A30 B13 Cw6 haplotype.
BACKGROUND
Recent reports indicated a significant association between fixed drug eruption (FDE) and HLA class I antigens. A strong correlation was found between B22 antigen and feprazone-induced FDE.


OBJECTIVE
Our aim was to investigate the association between HLA class I antigens and FDE in Turkey, a country where feprazone is not on the market and trimethoprim-sulfamethoxazole is most often the offending drug.


METHODS
HLA class I typing was performed by lymphocytotoxicity assay in 67 unrelated patients with FDE, all established by oral provocation. The frequencies are compared with those of 2378 control subjects.


RESULTS
Significantly higher (P <.001) frequencies of the A30 antigen and A30 B13 Cw6 haplotype were found in 42 patients with FDE induced by trimethoprim-sulfamethoxazole. HLA-B55 (split of B22) was present exclusively in trimethoprim-sulfamethoxazole-induced FDE, and in higher frequency than in control subjects.


CONCLUSIONS
To our knowledge, ours is the first report indicating a link between A30 B13 Cw6 haplotype and trimethoprim-sulfamethoxazole-induced FDE. In addition, HLA-B22 was increased in patients with FDE caused by a drug other than feprazone.
Ozkaya-Bayazit
E
E
Department of Dermatology, Istanbul Medical Faculty, Istanbul University, 34750 Istanbul, Turkey.
Akar
U
U
D000293:Adolescent; D000328:Adult; D000368:Aged; D000890:Anti-Infective Agents / Q000009:adverse effects* / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D003875:Drug Eruptions / Q000276:immunology*; D005260:Female; D015234:HLA-A Antigens / Q000032:analysis / Q000096:biosynthesis*; D006239:Haplotypes; D006650:Histocompatibility Testing; D006801:Humans; D008297:Male; D008875:Middle Aged; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000009:adverse effects* / Q000276:immunology
D000890:Anti-Infective Agents; D015234:HLA-A Antigens; C069526:HLA-A*30 antigen; D015662:Trimethoprim, Sulfamethoxazole Drug Combination