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Fluconazole-Induced Fixed Drug Eruption With Cross-Reactivity to Clotrimazole-Confirmation With Patch Testing.

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Fixed drug eruption (FDE) to fluconazole is rare but underdiagnosed, especially in women treated for vaginal candidiasis. This case highlights a novel cross-reactivity between fluconazole and clotrimazole, emphasizing the need for patch testing.

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Area of Science:

  • Dermatology
  • Pharmacology
  • Mycology

Background:

  • Fixed drug eruption (FDE) to fluconazole is uncommon but potentially underdiagnosed.
  • Women with vaginal candidiasis are most affected, often experiencing multiple episodes before diagnosis.

Purpose of the Study:

  • To report a case of fixed drug eruption to fluconazole in a young woman.
  • To investigate potential cross-reactivity with other azole antifungal agents.

Main Methods:

  • Clinical presentation of recurrent rash after fluconazole ingestion.
  • Lesional skin biopsies for histopathological confirmation.
  • Patch testing with fluconazole and clotrimazole.

Main Results:

  • A 29-year-old female experienced recurrent, localized blistering rash on her right hand after fluconazole use for vaginal candidiasis.
  • Skin biopsies were consistent with FDE.
  • Patch tests confirmed FDE to fluconazole and revealed cross-reactivity with clotrimazole.

Conclusions:

  • Fixed drug eruption to fluconazole should be considered in women with recurrent rashes after treatment for vaginal candidiasis.
  • Patch testing is crucial for identifying FDE and assessing cross-reactivity with other azole antifungals.
  • This case presents a novel finding of cross-reactivity between fluconazole and clotrimazole.