Fixed Drug Eruption of the Penis Due to Hydroxyzine Hydrochloride

Abstract

Objective To report four cases of fixed drug eruption induced by hydroxyzine hydrochloride (Otarex, Teva, Israel). Case Summary Four children with restlessness who were treated with hydroxyzine hydrochloride developed fixed drug eruption of the penis. Drug discontinuation was followed by complete resolution of the skin eruption. Rechallenge resulted in the same drug rash. Macrophage migration inhibiting factor (MIF) assay with hydroxyzine hydrochloride was positive. Discussion The pathogenesis of fixed drug eruption and the role of macrophage MTF assay in diagnosis is discussed. Conclusions A fixed drug eruption induced by hydroxyzine hydrochloride is possible, but is a rare phenomenon.

Adverse drug reactions of systemic antihistamines in children in the Netherlands

“…Skin eruptions were reported many times—after cetirizine,15 hydroxyzine,16 17 loratadine18 and fexofenadine 19. Many drugs are associated with skin eruptions and therefore it is not surprising that antihistamines can also cause skin problems.…”

Baboon syndrome induced by hydroxyzine

“…A review of literature identify only 17 reported cases of hydroxyzine-induced drug eruptions. [6–16] They include mainly maculopapular eruption (eight cases)[781013–15] and fixed drug eruption (seven cases). [6912] Urticaria[11] and acute generalized exanthematous pustulosis[16] have been reported each in one case.…”

Cutaneous drug eruption from cetirizine and hydroxyzine

“…[8][9][10][11][12][13][14][15][16][17][18][19][20] According to the reports, drug eruption from cetirizine, unlike eruptions from hydroxyzine and other drugs, is usually in the form of urticaria. Because of that, it is sometimes misinterpreted as urticaria that fails to respond to antihistamines.…”