Cross‐sensitivity among oxicams in piroxicam‐caused fixed drug eruption: two case reports

Abstract

Fixed drug eruption (FDE) caused by oxicams is very rare. There are few reports of FDE induced by piroxicam, and this explains why cross-sensitivity among oxicams (piroxicam, tenoxicam, and droxicam) has been studied in only one patient. The patch test on residual lesions has lately been used by some authors in FDE diagnosis with variable results. We describe two cases of piroxicam-caused FDE and demonstrate cross-sensitivity among piroxicam, tenoxicam, and droxicam in both of them. One patient had residual lesions and the patch test was useful for diagnosis and cross-sensitization studies. The second patient had no residual lesions, and the patch test was negative on normal but previously affected skin; therefore, the study was performed by single-blind controlled oral challenge.

Fixed drug eruption from piroxicam

“…Photosensitivity is the most frequent reaction 4 . FDE caused by piroxicam is rare but a few cases have been reported 5–10 …”

Independent lesions of fixed drug eruption caused by trimethoprim-sulfamethoxazole and tenoxicam in the same patient: A rare case of polysensitivity

“…3 Although a single drug is usually responsible for FDE, it may also occur as a reaction to multiple drugs in the same individual. This is referred to as crosssensitivity when the causative drugs are chemically related such as the tetracyclines 4,5 or oxicams, 6 and polysensitivity when the drugs are chemically not related. 7 In comparison with cross-sensitivity, which is a well-known phenomenon, polysensitivity in FDE has only rarely been reported in the literature (Table I).…”

Deri Yama Testi ile Doğrulanan Tenoksikamın Neden Olduğu Fiks İlaç Erüpsiyonu

“…Bunlar arasında sıklıkla, asetilsalisilik asit, allopu- rinol, antibiyotikler, antikonvülzanlar, ko-trimaksazol, flukonazol, dipiron, parasetemol, non-steroidal antiinflamatuvar ilaçlar, oral kontraseptifler, kininler ve sedatifler yer almaktadır (1,2). Tenoksikam ile FİE ise oldukça nadir rapor edilmiştir (3)(4)(5). Bu tip geç hipersensitivite reaksiyonu gösteren ilaç allerjisi olgularında deri yama testleri tam anlamıyla standardize olmamakla birlikte FİE tanı-sının doğrulanmasında oldukça yaralıdır.…”