Clinical Features of Fixed Drug Eruption at a Tertiary Hospital in Korea

Abstract

PurposeFixed drug eruption (FDE) is characterized by a well-defined erythematous patch, plaque, or bullous eruption that recurs at the same site as the result of systemic exposure to a causative drug, and resolves with or without hyperpigmentation. This study was carried out to identify the common causative drugs and clinical features of FDE in Korea.MethodsWe reviewed electronic medical records of all patients diagnosed with FDE from January 2000 to December 2010 at a tertiary hospital in Korea.ResultsA total of 134 cases were diagnosed as FDE. The mean age was 35.9 years (range, 0-82 years) and 69 (51.5%) of the patients were male. The mean duration from the first event to attending hospital was 1.9 years (range, 1-20 years). The mean number of recurrences was 2.6 (1-10), and 72.6% of patients sought medical care after experiencing symptoms twice or more. Four patients (3.1%) needed hospitalization. The most common sites were the upper extremities (47.7%), followed by the lower extremities, face, abdomen, chest, buttocks and perineum. Clear documentation on the causative drugs was available for 38 patients (28.4%), and among these, non-steroidal anti-inflammatory drugs (NSAIDs) and acetaminophen accounted for 71.1% of cases, and antibiotics accounted for 15.8%. Eighty patients (59.7%) underwent active treatment for FDE, and topical steroids were most frequently prescribed (43.3%), with systemic steroids used in 11.2% of patients.ConclusionsNSAIDs and acetaminophen were the main causative agents of FDE, however, the causative agents were not assessed in 25% of patients.

Clinical features, culprit drugs, and allergology workup in 41 cases of fixed drug eruption

“…The largest one by Mahboob and Haroon included 450 patients . Contrary to most reports, our study showed a slight female predominance. Similar results were also reported by Brahimi et al and Andrade et al In addition, we found that more than half of our patients were aged between 20 and 50 years, which is in accordance with some published data that confirm that FDE is frequent in young adults …”

“…Paracetamol intake, but not age or gender, was identified to be associated with a significant risk of bullous FDE onset. Several studies reported that FDE may preferentially involve certain anatomical sites such as the limbs, trunk, genitalia, or lips The upper limbs are the common site for FDE in our study, which corroborates the findings of Kavoussi et al and Jung et al In addition, a possible association between the offending drug and the localization was reported previously . In the current study, NSAID‐induced FDE was mostly localized on the extremities.…”

“…This type of FDE may appear after repeated exposures to the offending drug . About one‐third of our patients presented with a bullous FDE which is in accordance with many reports . For example, Jung et al noted a bullous lesions in 19 of 52 patients (36.5%) with FDE.…”

“…About one‐third of our patients presented with a bullous FDE which is in accordance with many reports . For example, Jung et al noted a bullous lesions in 19 of 52 patients (36.5%) with FDE. Conversely, Kavoussi et al found that only 6.7% of their patients developed a bullous eruption.…”

“…To date, only few cohort studies on FDE have been published and all of them were descriptive. [1][2][3][4][5][6][7][8][9][10][11][12][13][14] Thus, the aim of this study was to assess the epidemiological, clinical, and chronological characteristics of FDE, indicate the implicated drugs, and determine the degree of association between intake of the drug and specific clinical features.…”