title: Bucillamine-induced toxic epidermal necrolysis and fixed drug eruption.
abstract: We report two cases of bucillamine-induced bullous reactions with keratinocyte necrosis. The first patient, a 27-year-old woman, developed toxic epidermal necrolysis (TEN) over her whole body after taking bucillamine 300 mg/day for seven days. The second patient, a 63-year-old woman, developed several bullous erythemas on the mucous membranes and legs after taking bucillamine for more than two years. The fixed drug eruptions were diagnosed based on a provocation test in addition to clinical and histopathologic findings. These cases highlight the importance of considering fixed drug eruption as well as TEN in the differential diagnosis of bucillamine-induced bullous drug eruption.
authors.affiliation: Department of Dermatology, Nara Medical University School of Medicine, Nara, Japan.
authors.forename: Atsuko
authors.initials: A
authors.lastname: Izumi
authors.forename: Sachiko
authors.initials: S
authors.lastname: Katsumi
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Kobayashi
authors.forename: Hironori
authors.initials: H
authors.lastname: Niizeki
authors.forename: Hideo
authors.initials: H
authors.lastname: Asada
authors.forename: Sachiko
authors.initials: S
authors.lastname: Miyagawa
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000188:drug therapy; D001707:Biopsy, Needle; D003545:Cysteine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D003875:Drug Eruptions / Q000209:etiology* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008134:Long-Term Care; D008875:Middle Aged; D018570:Risk Assessment; D012720:Severity of Illness Index; D013262:Stevens-Johnson Syndrome / Q000209:etiology* / Q000473:pathology*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D003545:Cysteine; C026535:bucillamine