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Fixed drug eruption following metronidazole therapy and the use of topical provocation testing in diagnosis

K A Short1, L C Fuller, J R Salisbury

  • 1Departments of Dermatology and Histopathology, King's College Hospital, London, UK. kshort@doctors.org.uk

Clinical and Experimental Dermatology
|October 10, 2002
PubMed

Insights

Fixed drug eruption (FDE) is a rare reaction to metronidazole. Topical provocation testing successfully diagnosed metronidazole-induced FDE, confirming its utility in clinical practice.

Area of Science:

  • Dermatology
  • Pharmacology

Background:

  • Fixed drug eruption (FDE) is a specific type of adverse drug reaction.
  • Metronidazole, an antibiotic and antiprotozoal agent, is infrequently implicated in FDE.
  • Diagnosis of FDE often relies on identifying the causative agent.

Observation:

  • A case of fixed drug eruption (FDE) attributed to metronidazole is presented.
  • The patient exhibited characteristic FDE lesions upon re-exposure to the drug.
  • Topical provocation testing was employed to elicit the FDE reaction.

Findings:

  • Topical provocation testing successfully reproduced the clinical and histological features of metronidazole-induced FDE.
  • This diagnostic method confirmed metronidazole as the causative agent in the described case.
  • The findings align with existing literature suggesting metronidazole as a rare cause of FDE.

Implications:

  • Topical provocation testing is a valuable diagnostic tool for fixed drug eruption (FDE).
  • This method can potentially serve as a first-line investigation for FDE diagnosis.
  • Utilizing topical testing may prevent the need for more invasive oral provocation, thus avoiding adverse events.

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