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Fixed drug eruption due to clarithromycin
Y Hamamoto1, A Ohmura, E Kinoshita
1Department of Dermatology, Yamaguchi University School of Medicine, Ube Yamaguchi, Japan.
Abstract:
Clarithromycin is one of the macrolide antibiotics used for cutaneous and respiratory system infections. Only a few cases of adverse cutaneous reactions to this drug have been reported. Here we report a rare case of clarithromycin-induced fixed drug eruption which could be reproduced by a peroral provocation test, whereas patch tests on both unaffected and residual pigmented skin yielded negative results. All cutaneous lesions that recurred due to the challenge test developed the same pigmentation after a short course of intravenous corticosteroid.
Insights
A rare case of clarithromycin-induced fixed drug eruption is presented. The reaction was confirmed by oral challenge, but not by patch testing, highlighting a unique diagnostic challenge for this antibiotic.
Area of Science:
- Dermatology
- Pharmacology
- Infectious Diseases
Background:
- Clarithromycin, a macrolide antibiotic, is widely used for bacterial infections.
- Adverse cutaneous reactions to clarithromycin are infrequently reported.
- Fixed drug eruptions (FDEs) are a type of adverse drug reaction characterized by recurrent lesions at the same site.
Observation:
- This report details a rare case of fixed drug eruption caused by clarithromycin.
- The patient experienced recurrent skin lesions upon oral administration of clarithromycin.
- Diagnostic evaluation included peroral provocation testing and patch testing.
Findings:
- Peroral provocation with clarithromycin successfully reproduced the fixed drug eruption.
- Patch tests, performed on both unaffected and previously affected pigmented skin, yielded negative results.
- Cutaneous lesions from the challenge test showed similar pigmentation after corticosteroid treatment.
Implications:
- This case underscores the importance of considering FDEs even with rare reported instances.
- The negative patch test results suggest limitations in standard diagnostic methods for certain drug-induced FDEs.
- Oral provocation remains a valuable, albeit invasive, tool for diagnosing challenging drug eruptions.