title: Alcohol-induced rash caused by topical tacrolimus.
abstract: BACKGROUND
  Topical treatment with tacrolimus may be complicated by ingestion-related flushing caused by consuming small amounts of alcohol, a reaction that can be mistaken for food allergy.
  
  
  OBJECTIVE
  To increase awareness of a drug interaction with alcohol that can mimic food allergy.
  
  
  METHODS
  We describe 3 patients who used topical tacrolimus, 2 with an atopic history and 1 without, who presented with a flushing reaction after ingesting alcohol.
  
  
  RESULTS
  Cessation of topical tacrolimus use resolves the alcohol-related skin reaction.
  
  
  CONCLUSIONS
  A careful history, including consideration of alcohol use, should be obtained in patients who use topical tacrolimus and present with new skin complaints, because these factors may be evidence of an avoidable drug interaction and not worsening of atopic disease or a food allergy.
authors.affiliation: Department of Clinical Immunology, The Mount Sinai School of Medicine, New York, New York, USA. Adina.Knight@mssm.edu
authors.forename: Adina Kay
authors.initials: AK
authors.lastname: Knight
authors.forename: Mitchell
authors.initials: M
authors.lastname: Boxer
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Chandler
mesh_terms: D000328:Adult; D003876:Dermatitis, Atopic / Q000188:drug therapy; D000431:Ethanol / Q000009:adverse effects*; D005076:Exanthema / Q000139:chemically induced*; D005260:Female; D005512:Food Hypersensitivity / Q000209:etiology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D016559:Tacrolimus / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D007166:Immunosuppressive Agents; D000431:Ethanol; D016559:Tacrolimus