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Fixed drug eruption caused by sulfaguanidine
J Arias1, M Fernández-Rivas, M Martinez
1Allergy Section, Hospital Virgen del Valle, Toledo, Spain.
Dermatology (Basel, Switzerland)
|January 1, 1994
Summary
A patient experienced a fixed drug eruption (FDE) from sulfaguanidine, a previously unreported cause. Subsequent oral provocations with other sulfonamides were tolerated, indicating specific drug sensitivity.
Area of Science:
- Dermatology
- Pharmacology
Background:
- Fixed drug eruption (FDE) is a specific type of adverse drug reaction characterized by recurrent, well-demarcated lesions at the same site(s) upon re-exposure to the causative agent.
- Sulfonamides are a class of drugs with various therapeutic uses, but their potential to cause FDE is well-documented for some agents.
Observation:
- A case report details a patient who developed a fixed drug eruption (FDE) after administration of sulfaguanidine.
- This represents the first documented instance of sulfaguanidine causing FDE.
Findings:
- Diagnostic confirmation was achieved through a positive oral provocation test with sulfaguanidine, leading to the recurrence of the characteristic FDE lesion.
- A biopsy of the affected lesion further supported the diagnosis of FDE.
- The patient was subsequently challenged with other sulfonamides, specifically sulfamethoxazole and sulfadiazine, which were well-tolerated, suggesting a specific hypersensitivity to sulfaguanidine.
Implications:
- This case expands the known spectrum of drugs capable of inducing fixed drug eruptions.
- It highlights the importance of considering less common sulfonamides, such as sulfaguanidine, in the differential diagnosis of FDE.
- The findings underscore the need for careful drug history and potential cross-reactivity assessment in patients presenting with FDE.