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Acetaminophen-induced cellulitis-like fixed drug eruption

Neila Fathallah1, Chaker Ben Salem, Raoudha Slim

  • 1Department of Clinical Pharmacology, Faculty of Medicine of Sousse, Sousse, Tunisia.

Indian Journal of Dermatology
|July 1, 2011
PubMed

Insights

Acetaminophen can cause severe skin reactions like fixed drug eruption, even in elderly patients. Prompt drug withdrawal is crucial for managing these rare but serious adverse effects.

Area of Science:

  • Dermatology
  • Pharmacology

Background:

  • Acetaminophen is a common analgesic with rare but severe adverse reactions.
  • Fixed drug eruption (FDE) is a type of adverse drug reaction characterized by recurrent skin lesions upon re-exposure to the causative agent.

Purpose of the Study:

  • To report a case of generalized bullous fixed drug eruption (GBFDE) induced by acetaminophen.
  • To highlight the potential for acetaminophen to cause FDE and its varied clinical presentations.

Main Methods:

  • A case study of an 89-year-old male patient presenting with a progressive skin eruption after acetaminophen ingestion.
  • Clinical observation, diagnostic evaluation, and assessment of drug causality using the Naranjo probability scale.

Main Results:

  • The patient developed an edematous, erythematous plaque that evolved into flaccid vesicles and blisters.
  • Initial suspicion of cellulitis was incorrect; symptoms improved significantly after acetaminophen discontinuation.
  • The Naranjo scale indicated probable causality between acetaminophen and the observed GBFDE.

Conclusions:

  • Acetaminophen can induce generalized bullous fixed drug eruption, a severe adverse reaction.
  • Clinicians must consider acetaminophen as a potential cause of FDE, recognizing its diverse clinical manifestations.
  • Early diagnosis and withdrawal of acetaminophen are essential for effective management of this condition.
Keywords:
Acetaminophencellulitisgeneralized bullous fixed drug eruption

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