Bullous Fixed Drug Eruption Induced by Intravaginal Metronidazole Ovules, With Positive Topical Provocation Test Findings

Hermida, María Daniela; Consalvo, Lorena; Lapadula, María M.; Giovanna, Patricia Della; Cabrera, Hugo

doi:10.1001/archdermatol.2010.419

Cited by 12 publications

(10 citation statements)

References 5 publications

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“…All other reported eruptions were induced by the oral administration of drugs. 9 Although the eruption can occur anywhere on the body, trunk, extremities, lips and genital regions are preferred locations. 1,2 Eruption in our case was of unusual and rare localisation.…”

Section: Discussionmentioning

confidence: 99%

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Fixed drug eruption induced by topical olopatadine ophthalmic solution

et al. 2012

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Fixed drug eruption (FDE) usually develops after oral administration and is described as a cutaneous reaction recurring at the same location each time the drug is taken. Olopatadine is both a H1 histamine receptor antagonist and a mast cell stabilizer, indicated for the treatment of allergic conjunctivitis. Here, we report a 14-year-old male patient who developed FDE localised on the lateral side of periorbital rim bilaterally, whilst applying olopatadine 0.1% ophthalmic solution for the treatment of allergic conjunctivitis. As far as we know, FDE due to olopatadine has not been previously reported in the literature. We deem it appropriate to report this case because FDE that results from the application of topical drugs is a rare event in the literature.

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Section: Discussionmentioning

confidence: 99%

“…All other reported eruptions were induced by the oral administration of drugs. 9…”

Section: Discussionmentioning

confidence: 99%

Fixed drug eruption induced by topical olopatadine ophthalmic solution

et al. 2012

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“…Topically, metronidazole is also used in the treatment of bacterial vaginosis, trichomoniasis, and occasionally in wound healing disorders of the skin. After intra-vaginal application as an ovule, drug reactions have been observed under the clinical picture of fixed-drug reaction [ 37 ] and SDRIFE (symmetrical drug-related intertriginous and flexural exanthema) [ 38 ]. Allergic CD on the face has been described in association with the use of metronidazole-containing topical preparations for the treatment of facial dermatoses such as rosacea and acneiform skin symptoms [ 39 ].…”

Section: Contact Allergies To Topical Antibioticsmentioning

confidence: 99%

Contact allergies to topical antibiotic applications

Kreft¹,

Wohlrab²

2022

ALS

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Despite limited evidence on clinical efficacy and increasing resistance problems, topical antibiotics are still used in everyday clinical practice. However, topical antiseptic agents such, as octenidine and polyhexanide, often have a broader efficacy spectrum. They also have a broader target tropism because of their non-specific cellular mechanisms of action. Repeated use of topical antibiotics also carries the risk of contact sensitization, which could limit potential subsequent use as systemic antibiotics. Contact allergy is a clinically relevant problem, particularly in patients with barrier-damaged skin, pre-existing dermatosis, or occupational exposure. It can be concluded that with the use of modern antiseptics, topical antibiotic therapy is rarely indicated and should be avoided, not only because of the risk of contact sensitization but also because of the unfavorable and potentially consequential resistance problem.

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“…Other Hypersensitivity Reactions Other case reports include allergic contact dermatitis [75], fixed drug eruption [76][77][78][79], serum sickness-like reaction [80], SJS/TEN [81,82], AGEP [83,84], SDRIFE [85], and a possible case of DRESS given fever and rash but no lab studies were done to assess internal organ involvement [86].…”

Section: Ige-mediated Reactionsmentioning

confidence: 99%

Immediate and Delayed Hypersensitivity Reactions to Antibiotics: Aminoglycosides, Clindamycin, Linezolid, and Metronidazole

Dilley

Geng

2021

Clinic Rev Allerg Immunol

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Hypersensitivity reactions including IgE-mediated and delayed cell-mediated reactions to aminoglycosides, clindamycin, linezolid, and metronidazole are rare. For aminoglycosides, allergic contact dermatitis is the most frequent reaction for which patch testing can be a useful step in evaluation. For clindamycin, delayed maculopapular exanthems are the most common reactions. There are case reports of clindamycin associated with drug rash with eosinophilia and systemic symptoms (DRESS), acute generalized exanthematous pustulosis (AGEP), acute febrile neutrophilic dermatosis, and symmetrical drug-related intertriginous and flexural exanthema (SDRIFE). For linezolid, cases of hypersensitivity were exceedingly rare and included urticaria, angioedema, anaphylaxis, delayed rashes, and DRESS. For metronidazole, only rare cases were found across a broad spectrum of reactions including allergic contact dermatitis, fixed drug eruption, angioedema, anaphylaxis, serum sickness-like reaction, SJS/TEN, AGEP, SDRIFE, and a possible case of DRESS. IgE-mediated reactions and anaphylaxis to these types of antibiotics are uncommon, and reports of skin testing concentrations and desensitization protocols are largely limited to case reports and series. Non-irritating skin testing concentrations have been reported for gentamycin, tobramycin, and clindamycin. Published desensitization protocols for intravenous and inhaled tobramycin, oral clindamycin, intravenous linezolid, and oral and intravenous metronidazole have also been reported and are reviewed.

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Bullous Fixed Drug Eruption Induced by Intravaginal Metronidazole Ovules, With Positive Topical Provocation Test Findings

Cited by 12 publications

References 5 publications

Fixed drug eruption induced by topical olopatadine ophthalmic solution

Fixed drug eruption induced by topical olopatadine ophthalmic solution

Contact allergies to topical antibiotic applications

Immediate and Delayed Hypersensitivity Reactions to Antibiotics: Aminoglycosides, Clindamycin, Linezolid, and Metronidazole

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