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Recurrent fixed drug eruption caused by citiolone

M de Barrio1, P Tornero, A Prieto

  • 1Sección de Alergia, Hospital General Gregorio Marañón, Madrid, Spain.

Journal of Investigational Allergology & Clinical Immunology
|May 1, 1997
PubMed
Summary

Citiolone, a mucolytic drug, can cause fixed drug eruptions, a rare side effect. A patient experienced recurring rashes linked to citiolone, confirmed by an oral challenge test.

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Area of Science:

  • Pharmacology
  • Dermatology
  • Toxicology

Background:

  • Citiolone (N-acetylhomocysteinethiolactone) is a thiolic derivative used as a mucolytic agent for hepatic disorders.
  • Mucolytic drugs are infrequently associated with fixed drug eruptions (FDE).

Observation:

  • A case report details a patient experiencing recurrent fixed exanthema episodes.
  • These eruptions were consistently linked to the intake of citiolone.

Findings:

  • Standard patch testing with citiolone yielded negative results.
  • Diagnosis of citiolone-induced FDE was confirmed through a positive controlled oral challenge test.
  • The patient tolerated N-acetylcysteine, another thiolic mucolytic, indicating unlikely cross-reactivity.

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Implications:

  • This case highlights citiolone as a potential, albeit rare, cause of fixed drug eruptions.
  • It underscores the importance of considering oral challenge tests for diagnosing drug-induced exanthemas when patch tests are negative.
  • The findings suggest that therapeutic alternatives like N-acetylcysteine may be safe for patients with citiolone-induced FDE.