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[Multilocular fixed drug reaction simulating intertrigo in a diabetic patient]
1Abteilung für Umweltdermatologie und Venerologie, Universitätsklinik für Dermatologie und Venerologie Graz.
Deutsche Medizinische Wochenschrift (1946)
|December 1, 2000
Summary
A patient developed inguinal rash during antibiotic treatment for H. pylori. Tests confirmed a fixed drug reaction to amoxicillin, not a fungal infection, highlighting the importance of considering drug reactions in antibiotic-associated rashes.
Area of Science:
- Dermatology
- Infectious Diseases
- Clinical Immunology
Background:
- Helicobacter pylori infection is commonly treated with antibiotic regimens.
- Gastric ulcers are a frequent indication for such treatments.
- Cutaneous adverse drug reactions can complicate antibiotic therapy.
Observation:
- A 57-year-old male with diabetes and hypertension developed inguinal pruritus and erythema on amoxicillin, clarithromycin, and pantoprazole.
- The patient presented with bright red, well-circumscribed erythema in the inguinal region and inner thighs.
- Initial suspicion of Candida intertrigo was made based on clinical presentation.
Findings:
- Bacteriological and mycological tests were unremarkable.
- Immunological tests, including specific IgE assays, were negative for common penicillin allergies.
- Epifocal epicutaneous testing with amoxicillin and ampicillin yielded a positive reaction, confirming a fixed drug reaction.
Implications:
- Intertriginous changes during antibiotic therapy may indicate a drug reaction rather than a common fungal infection.
- Fixed drug reactions are prognostically significant and require careful management.
- Patients experiencing such reactions should be identified and advised regarding future antibiotic use, such as receiving an "allergic to penicillin" card.