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Nonpigmented fixed drug eruption induced by esomeprazole
Paulo Morais1, Teresa Baudrier, Alberto Mota
1Department of Dermatovenereology, Hospital S. João, E.P.E., Porto, Portugal. paulomoraiscardoso@gmail.com
Cutaneous and Ocular Toxicology
|May 18, 2010
Summary
A woman experienced a rare skin reaction, a nonpigmented fixed drug eruption, after taking esomeprazole (a proton-pump inhibitor). Prompt diagnosis and drug withdrawal led to rapid healing, highlighting the need for clinical awareness.
Area of Science:
- Dermatology
- Clinical Pharmacology
Background:
- Proton-pump inhibitors (PPIs) like esomeprazole are widely used for acid-related gastrointestinal disorders.
- Cutaneous adverse reactions to PPIs are reported, but specific reactions to esomeprazole are less common.
Observation:
- A 56-year-old woman presented with a distinctive spongiotic dermatitis after initiating esomeprazole therapy.
- The eruption resolved upon corticosteroid treatment and esomeprazole withdrawal.
- Delayed positive patch testing and oral provocation confirmed esomeprazole as the causative agent.
Findings:
- The patient was diagnosed with a nonpigmented fixed drug eruption (FDE) linked to esomeprazole.
- Skin biopsy revealed spongiotic dermatitis with a lymphocytic infiltrate.
- Diagnostic confirmation involved delayed patch testing and oral challenge.
Implications:
- This case underscores the potential for rare cutaneous reactions to esomeprazole.
- Increased clinical vigilance is necessary for diagnosing drug-induced eruptions to proton-pump inhibitors.
- Understanding FDE mechanisms is crucial for managing adverse drug reactions.
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