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Fixed-drug eruption presenting as an acute paronychia
The British Journal of Dermatology
|December 1, 1991
Summary
Fixed-drug eruption caused by cefalexine can manifest as acute paronychia. Skin biopsies revealed intense ICAM-1 expression, indicating a specific inflammatory response to the drug.
Area of Science:
- Dermatology
- Pharmacology
- Immunology
Background:
- Fixed-drug eruption (FDE) is a specific type of adverse drug reaction.
- Cephalexin, a common antibiotic, can rarely trigger FDE.
- Paronychia, an inflammation of the nail fold, is an unusual presentation of FDE.
Observation:
- A patient presented with acute paronychia.
- The paronychia was attributed to a fixed-drug eruption.
- The patient had a history of exposure to cefalexine.
Findings:
- A subsequent challenge with a single dose of cefalexine was administered.
- A biopsy of the affected skin was performed 20 days later.
- The biopsy demonstrated intense intercellular adhesion molecule-1 (ICAM-1) expression in the skin.
Implications:
- This case highlights an unusual presentation of cefalexine-induced FDE.
- Intense ICAM-1 expression suggests a role for cell adhesion molecules in the pathogenesis of this reaction.
- Understanding the immunologic mechanisms of FDE can guide future diagnosis and management.