Fixed drug eruption by etoricoxib confirmed by patch test

Abstract

Non-steroidal, anti-inflammatory drugs, followed by antibiotics, are the main causes of fixed drug eruption. They provoke one or several round erythematous or bullous lesions that recur in the same place after taking the causative medication. A positive patch test on residual, lesional skin can replace satisfactorily oral reintroduction. We describe the case of a 74-year-old woman with numerous, rounded, erythematous lesions on the trunk and recurrent blistering on the fifth right-hand finger, which developed a few hours after taking etoricoxib. Lesional patch testing with etoricoxib was positive and reproduced the typical pattern of a fixed drug eruption upon histopathology. We emphasize the specific reactivity of the etoricoxib patch test, and the capacity to reproduce the histologic pattern of the reaction.

Bullous fixed drug eruption induced by etoricoxib, confirmed by patch testing, with tolerance to celecoxib

“…Etoricoxib is a cyclo‐oxygenase 2‐selective inhibitor, and is rarely described as the responsible drug in FDE. In cases of etoricoxib‐induced FDE, it is usually safe to use another coxib with a different chemical structure, although cross‐reactivity is possible …”

Celecoxib‐induced bullous fixed drug eruption: An unusual presentation

“…To our knowledge, only three clinical observations of celecoxib-induced FDE have been reported (PubMed database) 2,3 and three others with etoricoxib. 1,4 However, no one among these described patients exhibited with a bullous pattern.…”

“…Fixed drug eruption (FDE) is a drug reaction characterized by one or multiple erythematous lesions that recurs in a fixed site after taking the causative drug. 1 It can be associated with blister formation defining the bullous FDE (BFDE). Celecoxib, cyclo-oxygenase 2 selective inhibitor, is known to cause mild skin side effects 2 although has never been implicated in inducing BFDE.…”

“…We describe an original case of celecoxib‐induced BFDE, where the accountability of the latter drug was found to be definite (score = 10) according the Naranjo causality scale in view of the temporal relationship between drug intake and BFDE onset, the remission of the acute eruption after celecoxib withdrawal, the previous history of FDE after celecoxib intake, the histopathological findings, and the positive rechallenge to this drug. To our knowledge, only three clinical observations of celecoxib‐induced FDE have been reported (PubMed database) and three others with etoricoxib . However, no one among these described patients exhibited with a bullous pattern.…”

“…Fixed drug eruption (FDE) is a drug reaction characterized by one or multiple erythematous lesions that recurs in a fixed site after taking the causative drug . It can be associated with blister formation defining the bullous FDE (BFDE).…”