Current causes of fixed drug eruptions.
TL;DR: In a study of 44 patients with fixed drug eruptions presenting between 1964 and 1969, the commonest causes were found to be barbiturates, phenolphthalein, oxyphenbutazone, tetracyclines, chlordiazepoxide and acetylsalicylate.
Abstract: SUMMARY
In a study of 44 patients with fixed drug eruptions presenting between 1964 and 1969 (inclusive), the commonest causes were found to be barbiturates, phenolphthalein, oxyphenbutazone, tetracyclines, chlordiazepoxide and acetylsalicylate. Fixed drug eruptions due to oxyphenbutazone, chlordiazepoxide and isoaminile citrate seem not to have been reported previously.
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TL;DR: Sialochemistry is being applied to diseases of the salivary glands per se with no evidence of systemic involvement, systemic diseases in which salivARY glands are involved, and clinical situations in whichsalivary flow rate and chemistry are helpful in diagnosis or monitoring patient progress.
Abstract: During the past few years an increasing number of investigators in a variety of disciplines have become interested in the potential of saliva as a diagnostic tool. The increase in interest reflects (in part at least) the marked proliferation in information on salivary physiology and salivary chemistry. Sialochemistry is being applied to (1) diseases of the salivary glands per se with no evidence of systemic involvement, (2) systemic diseases in which salivary glands are involved, and (3) clinical situations in which salivary flow rate and chemistry are helpful in diagnosis or monitoring patient progress (Tables 1 and 2).
240 citations
TL;DR: Fixed drug eruption (FDE) is one of the most common cutaneous disorders encountered by the dermatologist and the diagnostic hallmark is its recurrence at previously affected sites.
Abstract: Background Drug eruptions are among the most common cutaneous disorders encountered by the dermatologist. Some drug eruptions, although trivial, may cause cosmetic embarrassment and fixed drug eruption (FDE) is one of them. The diagnostic hallmark is its recurrence at previously affected sites.
Objective We evaluated 450 FDE patients to determine the causative drugs.
Results The ratio of men to women was 1:1.1. The main presentation of FDE was circular hyperpigmented lesion. Less commonly FDE presented as: nonpigmenting erythema, urticaria, dermatitis, periorbital or generalized hypermelanosis. Occasionally FDE mimicked lichen planus, erythema multiforme, Stevens–Johnson syndrome, paronychia, cheilitis, psoriasis, housewife’s dermatitis, melasma, lichen planus actinicus, discoid lupus erythematosus, erythema annulare centrifugum, pemphigus vulgaris, chilblains, pityriasis rosea and vulval or perianal hypermelanosis. Cotrimoxazole was the most common cause of FDE. Other drugs incriminated were tetracycline, metamizole, phenylbutazone, paracetamol, acetylsalicylic acid, mefenamic acid, metronidazole, tinidazole, chlormezanone, amoxycillin, ampicillin, erythromycin, belladonna, griseofulvin, phenobarbitone, diclofenac sodium, indomethacin, ibuprofen, diflunisal, pyrantel pamoate, clindamycin, allopurinol, orphenadrine, and albendazole.
Conclusions Cotrimoxazole was the most common cause of FDE, whereas FDE with diclofenac sodium, pyrantel pamoate, clindamycin, and albendazole were reported for the first time. FDE may have multiform presentations.
236 citations
TL;DR: Fixed drug eruption is a distinctive variant of drug-induced dermatoses with characteristic recurrence at the same site of the skin or mucous membranes with characteristic pathogenetic mechanisms.
Abstract: • Fixed drug eruption (FDE) is a distinctive variant of drug-induced dermatoses with characteristic recurrence at the same site of the skin or mucous membranes. The clinical and laboratory features of FDE are reviewed herein and possible pathogenetic mechanisms are discussed. ( Arch Dermatol 1984;120:520-524)
194 citations
TL;DR: Drug reactions are a legacy of the remarkable strides made in the development of the pharmaceutical industry worldwide and the problem has been complicated by the introduction of combinations of two or more medicaments.
Abstract: Drug reactions are a legacy of the remarkable strides made in the development of the pharmaceutical industry worldwide. The problem has been complicated by the introduction of combinations of two or more medicaments.^ It is imperative to know more about such drug reactions, which although trivial, may cause cosmetic changes.^ The fixed drug eruption is one of them. Although several facets of fixed drug eruption are still speculative, it is relatively easy to recognize its various expressions.^"* This peculiar drug reaction is characterized by an appearance of round or oval, apparently edematous plaques, which vary in size from that of a coin to that of a palm, and may affect any part of the skin and/or mucous membrane. The lesions are usually preceded and accompanied by itching or burning. Furthermore, their evolution is rather affirmative. Initially, they are dusky red macules with definite edematous and erythematous outline. Formation of bullae, desquamation, and crusting may also be their important accompaniment. The cardinal morphologic feature is pigmentation that varies from dusky slate to brownish black. The diagnostic hallmark is its recurrence at previously affected sites.^
136 citations
TL;DR: The drugs responsible for eighty‐six cases of fixed drug eruption have been identified, and in all but two were confirmed by challenge, and the main causative drugs were phenazones and barbiturates, which were the most frequent causative agents in the series.
Abstract: SUMMARY
The drugs responsible for eighty-six cases of fixed drug eruption have been identified, and in all but two were confirmed by challenge. The series included sixteen cases of generalized bullous fixed eruption, which resembles Lyell's syndrome. The main causative drugs were phenazones and barbiturates, both in the series as a whole and in the group of the most severe cases. The same drugs were the most frequent causative agents in a report from Finland 10 years ago.
124 citations
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TL;DR: The present study is based on 350 deeply pigmented patients suffering from fixed eruptions seen during the past 10 years, and provides data that may shed some light on the continuing problem of the localization of the eruptive elements.
Abstract: were subject to recurrent exacerbation on each subsequent administration of the inducing drug, interest in the subject has increased. Among the many and varied syndromes provoked by new drugs and food additives (Sternberg and Bierman, 1963), fixed eruptions are becoming increasingly common (Welsh, 1961; Welsh and Ede, 1961). The present study is based on 350 deeply pigmented patients suffering from fixed eruptions seen during the past 10 years (171 Congolese (Browne, 1959, 1960a, 1960b), 175 Nigerians, and 4 others), and provides data that may shed some light on the continuing problem of the localization of the eruptive elements.
63 citations
TL;DR: All cutaneous manifestations due to substances used as medicaments regardless of whether they are synthetic or derived from nature, orWhether they are pure chemicals or mixtures are included.
Abstract: In employing the term "drug eruptions" in this paper, we intend to use the expression in a purely etiologic sense; that is, we include all cutaneous manifestations due to substances used as medicaments regardless of whether they are synthetic or derived from nature, or whether they are pure chemicals or mixtures. For the purposes of our presentation we further disregard the manner of contact with the drug, whether it has been used internally or externally. We also embrace within our definition all the various clinical types, including eczematous eruptions (as from quinine or butesin picrate), fixed eruptions (as from phenolphthalein, antipyrine or arsphenamine) and acneform eruptions (as from iodine or bromine). While we realize that such a classification is arbitrary, we believe it logical, perhaps just as logical as the designation of syphilis for the variegated manifestations of syphilitic infection, or of tuberculosis for the polymorphous pictures caused
58 citations
TL;DR: Current issues of 13 "mass" magazines, each with a minimum circulation of one million copies per average issue, contain articles on drugs, such as: systemic antiinfectives, antibiotics, sulfonamides,uberculostatics, antihistamines, tranquilizers, and anorexigenics.
Abstract: Current issues of 13 "mass" magazines, each with a minimum circulation of one million copies per average issue, contain articles on drugs, such as: systemic antiinfectives (including antibiotics, sulfonamides,tuberculostatics), antihistamines, tranquilizers, and anorexigenics. From such information, millions of persons have gained impressions which they intend to discuss with their physicians. During 1959, as compared with 1949, purchases of drugs have shown an increase of almost 150%. out of 10 dentists are now prescribing drugs. More than 630 million prescriptions were filled by the nation's pharmacies during 1959, and additional, substantial increases have been predicted for 1960 (in figures now being compiled) and for 1961. 1 short, more people are going to be exposed to reactions from drugs, because more peoplee using more drugs. Only one type of reaction from drugs, the fixed eruption, is the subject of this report. Definition of the "Fixed Eruption" Soon after 1885 when antipyrine into use, observers began to
36 citations
Journal Article•
11 citations
TL;DR: This report deals with a fixed-drug eruption due to tetracycline, where the patient had an allergic reaction to the drug and needed to be admitted to hospital for treatment.
Abstract: This report deals with a fixed-drug eruption due to tetracycline. This type of allergic reaction to tetracycline is rare.
11 citations