S-Carboxymethyl-L-cysteine-induced Fixed Drug Eruption

Carbocisteine‐induced Stevens–Johnson syndrome confirmed by inadvertent re‐exposure

“…However, it may rarely induce cutaneous adverse reactions such as maculopapular rash and fixed drug eruption (FDE). 4,5 To our knowledge, this is the first case report of SJS after carbocisteine ingestion confirmed by oral re-administration. Recently, in a disproportionality analysis on drug-induced SJS from the World Health Organization pharmacovigilance database, carbocisteine had a strong signal as a causative drug, in spite of no relevant cases reported on PubMed to date.…”

Maculopapular rash to S‐carboxymethylcysteine‐lysine (carbocisteine)

“…Thiodiglycolic acid is an S‐CMC metabolite formed only during the night; it has been assumed to be responsible for the FDE associated with S‐CMC, 2 but it is not known if it could also be responsible for a maculopapular rash. We do not know either if the results of the patch tests in our patient would have been different if we had performed them at night and also with the metabolite.…”

“…The chemical name of carbocisteine is S‐(carboxymethyl)‐1‐cysteine (S‐CMC) 1 . It is a mucoregulatory drug 2 used to treat chronic obstructive pulmonary disease (COPD) 1 . Although S‐CMC is used for treatment of patients in all ages, from infants to elderly, few cutaneous reactions to this drug have been reported; the most frequent are delayed allergic skin reactions such as fixed drug eruption (FDE) 2‐4 …”