Anaphylaxis and toxic epidermal necrolysis or Stevens–Johnson syndrome after nonmucosal topical drug application: fact or fiction?

Sachs, B.; Fischer-Barth, Wilma; Erdmann, Stephan; Seebeck, Jörg

doi:10.1111/j.1398-9995.2007.01398.x

Cited by 23 publications

(7 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patch tests are relatively safe; they rarely reinstitute drug eruption or worsen an active eruption. No recurrence of severe CADRs such as toxic epidermal necrolysis (TEN) has ever been documented with their use . Their safety was confirmed in drug reaction with eosinophilia and systemic symptoms (DRESS) and in Stevens–Johnson syndrome (SJS)/TEN from carbamazepine .…”

Section: Introductionmentioning

confidence: 99%

The use of patch tests in the diagnosis of delayed hypersensitivity drug eruptions

2016

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

The use of patch tests in the diagnosis of delayed hypersensitivity drug eruptions

2016

View full text Add to dashboard Cite

show abstract

“…A large number of topical medications can induce EM and EM‐like eruptions, including antibiotics, nonsteroidal anti‐inflammatory drugs, corticosteroids, promethazine, balsam of Peru, econazole, pyrrolnitrin, vitamin E, nitroglycerin patch, ethylenediamine, mephenesin, and scopolamine ophthalmic drops. Serious systemic reactions (Stevens–Johnson syndrome/toxic epidermal necrolysis, anaphylaxis) following non‐mucosal topical drug application seems to be extremely rare.…”

mentioning

confidence: 99%

Erythema multiforme induced by imiquimod 5% cream

et al. 2014

View full text Add to dashboard Cite

CorrespondenceErythema multiforme induced by imiquimod 5% cream Erythema multiforme (EM) is an acute self-limited immune-mediated reaction manifested by target skin lesions with mucous membrane involvement. Topical medication is considered a rare cause of EM and EM-like eruptions 1 . We report one patient with EM due to systemic reaction to imiquimod 5% cream.A 70-year-old man with a medical history of hypertension presented with multiple actinic keratoses on the scalp and nose. He was instructed to apply imiquimod cream 5% three times per week to his multiple actinic keratoses. A progressive local cutaneous reaction was observed at the application site of imiquimod accompanied by an intense flu-like syndrome during this treatment. On the third week of treatment, he also developed a symmetrically distributed eruption, with erythematous round maculopapules and bullae on the elbows, knees, palms, and soles (Fig. 1). Oral and ocular mucosae were not affected. A skin punch biopsy showed keratinocyte necrosis and intraepidermal vesiculation affecting the epidermis, accompanied by an inflammatory lymphohistiocytic infiltrate in the papillary dermis, all such findings being consistent with EM (Fig. 2). Treatment was discontinued, and the eruption resolved within two weeks. In this case, other well established causes of EM were ruled out; in particular, no evidence of herpes simplex infection and no past history of similar infection were observed, and no other drugs were introduced at that time. It was therefore assumed that the imiquimod induced the EM.A large number of topical medications 2,3 can induce EM and EM-like eruptions, including antibiotics, 4 nonsteroidal anti-inflammatory drugs, 5,6 corticosteroids, promethazine, balsam of Peru, econazole, pyrrolnitrin, vitamin E, nitroglycerin patch, ethylenediamine, mephenesin, and scopolamine ophthalmic drops. Serious systemic reactions

show abstract

“…NACDG antigens such as neomycin and bacitracin still represent the second (8.7%) and fourth (8.3%) most common allergens, respectively, in North America during the same period 17 . Moreover, almost half of all anaphylactic reactions were attributed to topical antibiotics 25 . Erythema and pruritus observed in the fusidic acid group may be the symptoms of irritant or allergic contact dermatitis, which warrant further evaluations, including a patch test.…”

Section: Discussionmentioning

confidence: 99%

Retrospective Clinical Trial of Fusidic Acid versus Petrolatum in the Postprocedure Care of Clean Dermatologic Procedures

et al. 2015

View full text Add to dashboard Cite

BackgroundClean dermatologic procedures create wounds with a low risk of infection (usually up to 5%). Whether the use of topical antibiotics is advocated, with regard to its efficacy and safety issues such as antibiotic resistance and sensitizing potential, is controversial. Fusidic acid, a topical antibiotic against gram-positive bacteria, is a rare sensitizer and commonly used in postprocedure care in Korea.ObjectiveThis is a retrospective study aimed at comparing the efficacy and safety between fusidic acid and petrolatum for the postprocedure care of clean dermatologic procedures.MethodsPatients were treated with either fusidic acid or petrolatum ointment, applied on the wound created during clean dermatologic procedures such as biopsy of the punch, incisional, excisional, and shave types. The efficacy, adverse events, and subjective level of satisfaction were retrieved from medical records.ResultsA total of 414 patients with a total of 429 wounds were enrolled. The overall rate of adverse events was 0.9%, and the rates of adverse events in the fusidic acid group and the petrolatum group were 1.4% and 0.5%, respectively (p=0.370). There was no wound discharge, pain, tenderness, swelling, induration, or dehiscence in both groups. The patients' self-assessment of the wound was not significantly different between the two treatment groups.ConclusionOur findings support the hypothesis that the routine prophylactic use of topical antibiotics is not indicated for clean dermatologic procedures. We recommend the use of petrolatum in the postoperative care of clean dermatologic procedures because of its equivalent efficacy and superior safety profiles.

show abstract

Anaphylaxis and toxic epidermal necrolysis or Stevens–Johnson syndrome after nonmucosal topical drug application: fact or fiction?

Abstract: Anaphylaxis does occur after non-mucosal topical drug administration. Application of drugs to skin wounds or to skin with impaired barrier function may pose a risk factor for its occurrence. TEN or SJS following non-mucosal topical drug application seems to be extremely rare.

Cited by 23 publications

References 50 publications

The use of patch tests in the diagnosis of delayed hypersensitivity drug eruptions

The use of patch tests in the diagnosis of delayed hypersensitivity drug eruptions

Erythema multiforme induced by imiquimod 5% cream

Retrospective Clinical Trial of Fusidic Acid versus Petrolatum in the Postprocedure Care of Clean Dermatologic Procedures

Contact Info

Product

Resources

About