ÖzetFiks ilaç erüpsiyonu, neden olan ilaçlar›n tekrar eden al›mlar› sonucunda ayn› bölgelerde, genellikle soliter eritematöz parlak ya da koyu k›rm›z› makül, ödematöz plak ya da büllöz lezyonlar ile karakterizedir. Yüzden fazla ilaç suçlanmakla birlikte özellikle tetrasiklinler, sülfonamidler, sulfonlar, penisilinler, barbütiratlar, fenolfitolein, pirazolonlar, aspirin, oral kontraseptifler ve nonsteroid antiinflamatuvar ilaçlar sorumlu tutulmaktad›r. Alerjik rinit, ekzema, ast›m, ürtiker gibi pek çok hastal›¤›n tedavisinde yayg›n flekilde kullan›lan setirizin, hidroksizin, loratadin, levosetrizin gibi antihistaminiklere karfl› da fiks ilaç erüpsiyon geliflimi bildirilmifltir. Sorumlu ajan›n ortaya ç›kar›lmas›nda deri yama testi, intradermal testler, deri prick testi ya da oral uyar› testleri kullan›labilmektedir. K›rk üç yafl›nda erkek hasta alerjik rinit nedeniyle setirizin al›m›ndan yar›m saat sonras›nda ayak s›rtlar›ndan bafllayarak tüm vücuda da¤›lan kafl›nt›l› yer yer su kabarc›klar› içeren k›zar›kl›klar ile baflvurdu. Döküntüleri bafllad›ktan sonra hidroksizin kullan›m›yla lezyonlar›nda art›fl oldu¤unu belirten hastan›n öyküsünde 1 y›l önce de setirizin al›m›ndan sonra benzer yak›nmalar›n›n daha hafif bir flekilde oldu¤u ö¤renildi. Deri bak›s›nda vücutta yayg›n eritemli, keskin s›n›rl›, yer yer büllöz makül ve plaklar gözlendi. Lezyonlar›n gerilemesinden dört ay sonra sekiz farkl› antihistaminikle yap›lan deri yama testinde setirizin, levosetirizin ve hidroksizine karfl› pozitiflik saptand›. (Türkderm 2011; 45: 49-52) Anahtar Kelimeler: Fiks ilaç erüpsiyonu, setirizin, levosetirizin, hidroksizin SummaryFixed drug eruption (FDE) is characterized by solitary erythematous macules, edematous plaques and bullous lesions that occur at the same place with recurrent exposure to a drug. Though more than 100 drugs have been implicated in leading to FDE, this side effect is more commonly caused by tetracyclines, sulfonamides, sulfone, penicillins, pyrazolones, barbiturates, phenolphthalein, pirazones, aspirin, oral contraceptives and nonsteroidal anti-inflammatory drugs. FDE occurrence has been reported in association with cetrizine, hydroxyzine, loratadine and levocetirizine, which are widely used in the treatment of allergic diseases, such as allergic rhinitis, eczema, asthma, urticaria. Patch, intradermal skin, prick tests or oral challenge test can be performed to identify the agent responsible for FDE. A 43-year-old male patient attended our outpatient clinic with itchy and erythematous rashes with sporadic blisters, starting from dorsum of his feet and spreading to other parts of his body, following oral intake of cetirizine for allergic rhinitis. He described that his eruptions exacerbated with hydoxyzin. Patient's history revealed that he had slightly suffered from the same cutaneous reactions one year ago, after oral administration of cetirizine. On physical examination, multiple, round, erythematoviolaceous, well-defined macules and plaques, with central blisters localized on the trunk, arms and legs wer...
ÖzetReaktif perforan kollajenoz, yapısal olarak değişikliğe uğramış kollajen liflerinin epidermisteki hücrelerin arasından geçerek dışa atıldığı nadir bir hastalıktır. Kollajenoma perforans verrüsiforme olarak da bilinir. Diabetes mellitus ve kronik böbrek yetmezliği başta olmak üzere, hiperparatiroidizm, hipotiroidizm, lenfoma, malignite, nörodermatit, karaciğer hastalıkları, atopik dermatit, uyuz, AIDS (acquired immune deficiency syndrome), pulmoner fibrozis, herpes zoster enfeksiyonu ile de görülebilir. Kliniğimizde izlediğimiz diabetes mellitusu ve kronik böbrek yetmezliği olan kazanılmış reaktif perforan kollajenoz olgusunu literatür ışığında burada sunmaktayız. Anahtar kelimeler: Böbrek yetmezliği; diabetes mellitus; reaktif perforan kollajenoz AbstractReactive perforating collagenosis is a rare disease of elimination of altered collagen through the epidermis. Its synonym is collagenoma perforans verruciforme. The disease exists especially with diabetes mellitus and chronic renal failure and also with hyperparathyroidism, hypothyroidism, lymphoma, malignancy, neurodermatitis, liver disease, atopic dermatitis, scabies, acquired immune deficiency syndrome, pulmonary fibrosis and herpes zoster infection. In the review of literature, we present a case with acquired reactive perforating collagenosis associated with diabetes mellitus and renal failure.
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