Cetirizine-induced fixed drug eruption

Abstract

Cetirizine, a piperazine-derivative second-generation antihistaminic, is used for a wide variety of disorders such as urticaria, eczema, and allergies. Adverse reactions due to this drug are usually rare, especially fixed drug eruption (FDE), a delayed cell-mediated hypersensitivity reaction, is scarce. Here, we report a case of cetirizine-induced FDE. A 34-year-old female developed hyperpigmented, itchy patches over both forearms, legs, feet, and right side of the chest after taking tablet cetirizine for dry cough with similar episode 2 years back on the same sites. The patient responded slowly with conservative treatment and the lesions disappeared after 10 days. She was advised to avoid the causative in near future. This case report highlighted FDE due to an antihistaminic which themselves will be prescribed to treat allergies.

A case of fixed drug eruption from cetirizine with cross‐reaction to levocetirizine and hydroxyzine

“…This is a typical case of FDE with positive patch tests exclusively on residual pigmented lesional skin, explained by the reactivation of drug specific epidermal skin‐resident memory CD8+ T lymphocytes 4 . Skin testing showed reactivity to cetirizine, which is seldom reported as a cause of FDE.…”

“…This is a typical case of FDE with positive patch tests exclusively on residual pigmented lesional skin, explained by the reactivation of drug specific epidermal skin-resident memory CD8+ T lymphocytes. 4 Skin testing showed reactivity to cetirizine, which is seldom reported as a cause of FDE. To the best of our knowledge, so far there are nine case reports of FDE to this anti-H1, 2,4,5 and only two of those with positive patch tests to the three piperazine derivatives (hydroxyzine, cetirizine, and levocetirizine).…”

“…4 Skin testing showed reactivity to cetirizine, which is seldom reported as a cause of FDE. To the best of our knowledge, so far there are nine case reports of FDE to this anti-H1, 2,4,5 and only two of those with positive patch tests to the three piperazine derivatives (hydroxyzine, cetirizine, and levocetirizine). 2,5 Despite the relative low sensitivity of lesional patch testing, which depends mostly on the culprit, 6,7 this is a safe procedure that allows simultaneous testing of many possible culprits and the study of cross-reactivity between drugs, 6 as in the present case.…”

“…Skin testing showed reactivity to cetirizine, which is seldom reported as a cause of FDE. To the best of our knowledge, so far there are nine case reports of FDE to this anti‐H1, 2,4,5 and only two of those with positive patch tests to the three piperazine derivatives (hydroxyzine, cetirizine, and levocetirizine) 2,5 …”

Fixed Drug Eruptions Due To/Caused by Levocetirizine and Cetirizine: An Uncommon Adverse Cutaneous Drug Reaction to Commonly Used Piperazine Derivatives

“…Twenty one cases of FDE to piperazines have been reported till date [ Table 1 ]. [ 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 ] Mean age of presentation was 37.5 years (4–73 years) with male preponderance (Male: Female - 2.4:1). Clinical presentation was macular or bullous, as in our cases.…”