title: Paracetamol-induced fixed drug eruption at an unusual site.
abstract: BACKGROUND
  Paracetamol (acetaminophen) is a widely used analgesic/antipyretic drug for which hypersensitivity reactions appear to be increasingly frequent.
  
  
  OBJECTIVE
  We report the case of a woman who experienced several delayed selective reactions induced by paracetamol: fixed drug eruptions (FDEs) with typical features but an unusual distribution (hard palate and a maculopapular rash.
  
  
  METHODS
  Skin tests: prick, intradermal and patch tests as well as a single-blind oral challenge test (OCT) were performed.
  
  
  RESULTS
  Skin tests were negative. The OCT was necessary to confirm the diagnosis. Interestingly, the challenge test elicited an FDE-type lesion instead of a maculopapular rash.
  
  
  CONCLUSIONS
  Our findings could reflect 2 different clinical patterns of delayed allergic reactions, or, more probably, the initial phase of a unique clinical entity that was stopped by the corticosteroids prescribed during the challenge. However, we were unable to confirm these hypotheses. The uncommon anatomical site of the lesions (hard palate) is noteworthy. Some relevant patents are also summarized in this paper.
authors.affiliation: Allergy Department, Hospital Central de la Cruz Roja, Avda Reina Victoria 22, 28003 Madrid, Spain. projasperecarmengomez.tras@gmail.com
authors.forename: Carmen
authors.initials: C
authors.lastname: Gómez-Traseira
authors.forename: Patricia
authors.initials: P
authors.lastname: Rojas-Pérez-Ezquerra
authors.forename: Leticia
authors.initials: L
authors.lastname: Sánchez-Morillas
authors.forename: Rosario
authors.initials: R
authors.lastname: González-Mendiola
authors.forename: María
authors.initials: M
authors.lastname: Rubio-Pérez
authors.forename: Alicia
authors.initials: A
authors.lastname: Moral-Morales
authors.forename: José
authors.initials: J
authors.lastname: Juliolaguna-Martinez
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage / Q000009:adverse effects*; D000284:Administration, Oral; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D003875:Drug Eruptions / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D005260:Female; D006801:Humans; D006968:Hypersensitivity, Delayed; D007114:Immunization; D008875:Middle Aged; D010159:Palate / Q000276:immunology / Q000473:pathology*; D010330:Patents as Topic; D012882:Skin Tests
chemical_list: D000305:Adrenal Cortex Hormones; D000082:Acetaminophen