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Related Experiment Videos

Fixed drug eruption from amoxycillin

I Jiménez1, E Antón, I Picáns

  • 1Allergy Section, Marqués de Valdecilla Hospital, Santander, Spain.

Allergologia Et Immunopathologia
|December 12, 1997
PubMed
Summary

Fixed drug eruption on the genital mucosa caused by amoxicillin was observed. Oral challenge confirmed amoxicillin as the trigger, with no cross-reactivity to other beta-lactams like phenoxymethylpenicillin or cephalexin.

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Area of Science:

  • Dermatology
  • Allergology
  • Pharmacology

Background:

  • Fixed drug eruption (FDE) is a rare adverse drug reaction characterized by the recurrence of a skin lesion at the same site with re-exposure to the causative agent.
  • Amoxicillin, a widely used antibiotic, is occasionally implicated in FDE, though documented cases are scarce.

Observation:

  • A case of FDE localized to the genital mucosa (glans penis) induced by amoxicillin is presented.
  • Topical provocation with amoxicillin did not elicit a reaction.
  • Oral challenge with amoxicillin resulted in pruritic erythema on the glans penis approximately 6 hours post-ingestion.

Findings:

  • The patient tolerated phenoxymethylpenicillin, which shares a similar nuclear structure with amoxicillin, indicating no cross-reactivity.

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  • Cephadroxil, a cephalosporin with an identical side chain to amoxicillin, was also well-tolerated.
  • This case adds to the limited literature on amoxicillin-induced FDE, with only three prior reports identified.
  • Implications:

    • This case highlights the importance of considering amoxicillin as a potential cause of genital FDE.
    • Diagnostic strategies for FDE should include careful history taking and targeted drug challenges.
    • Understanding cross-reactivity patterns within beta-lactam antibiotics is crucial for safe prescribing in patients with penicillin allergies.