Alcohol-induced rash caused by topical tacrolimus.
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.
Knight
Adina Kay
AK
Department of Clinical Immunology, The Mount Sinai School of Medicine, New York, New York, USA. Adina.Knight@mssm.edu
Boxer
Mitchell
M
Chandler
Michael J
MJ
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
D007166:Immunosuppressive Agents; D000431:Ethanol; D016559:Tacrolimus