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A case of fixed drug eruption due to doxycycline and erythromycin present in food

Won-Suk Lim1, Do-Hun Kim, Sang-Yun Jin

  • 1Department of Dermatology, Dongguk University Ilsan Hospital, College of Medicine, Dongguk University, Goyang, Korea.

Allergy, Asthma & Immunology Research
|September 5, 2013
PubMed

Insights

Fixed drug eruption (FDE) can be triggered by antibiotics in food. This case highlights doxycycline and erythromycin in pork and fish causing FDE, even after cooking.

Area of Science:

  • Dermatology
  • Toxicology
  • Food Science

Background:

  • Fixed drug eruption (FDE) is a common cutaneous reaction to medications.
  • Identifying the causative agent can be challenging, especially when patients deny drug intake.

Purpose of the Study:

  • To report the first case of FDE caused by antibiotics consumed through food.
  • To investigate the link between dietary antibiotic residues and FDE.

Main Methods:

  • Clinical diagnosis of FDE based on characteristic skin lesions.
  • Patient history including dietary habits and suspected food triggers.
  • Oral provocation testing with suspected antibiotics (doxycycline, erythromycin).

Main Results:

  • A 57-year-old female presented with recurrent, well-demarcated erythematous patches.
  • Patient denied oral medication but reported FDE onset after consuming pork and/or fish.
  • Oral provocation tests confirmed doxycycline and erythromycin as causative agents.

Conclusions:

  • Antibiotics like doxycycline and erythromycin, used in livestock and aquaculture, can cause FDE when present in food.
  • The thermostability of these antibiotics means cooking does not eliminate the risk.
  • Dietary history is crucial for diagnosing FDE when drug ingestion is denied.
Keywords:
Fixed drug eruptiondoxycyclineerythromycinfoodresidual antibiotics

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