Independent lesions of fixed eruption due to two unrelated drugs in the same patient

Cross‐reactivity between nonsteroidal anti‐inflammatory drugs in fixed drug eruption: Two unusual cases and a literature review

“…Cross‐reactivity in the case of FDE has been largely described among various drugs sharing the same chemical structure, such as tetracycline derivatives, 12 antifungal azoles, 13 quinolones, 14 antihistamines, 15 nitroimidazole derivatives 16 and cyclines 17 . In addition, cross‐reactivity in cases of FDE has been described between two distinct drug families, 18 between NSAIDs and antibiotics such as between coxibs and sulfonamides, 19 metamizole and tetracycline, 20,21 trimethoprim‐sulfamethoxazole and tenoxicam 22 …”

“…3,4,6 Cross-reactivity in the case of FDE has been largely described among various drugs sharing the same chemical structure, such as tetracycline derivatives, 12 antifungal azoles, 13 quinolones, 14 antihistamines, 15 nitroimidazole derivatives 16 and cyclines. 17 In addition, cross-reactivity in cases of FDE has been described between two distinct drug families, 18 between NSAIDs and antibiotics such as between coxibs and sulfonamides, 19 metamizole and tetracycline, 20,21 trimethoprim-sulfamethoxazole and tenoxicam. 22 Among NSAIDs, cross-reactivity in cases of FDE has been described between those sharing the same chemical structure, that is, among the oxicam group [23][24][25][26][27] (piroxicam, tenoxicam and meloxicam) and between oxyphenbutazone and phenylbutazone.…”

Clinical implications of in vitro drug-induced interferon gamma release from peripheral blood lymphocytes in cutaneous adverse drug reactions

“…[11][12][13][15][16][17][18]41,42 It has been suggested that drugs can be immunogenic by pharmacologic interactions with receptors (labile noncovalent binding to MHCpeptide molecules) and by their metabolic transformation to reactive compounds. 3,43,44 On the other hand, positive interferon gamma responses to more than one drug may imply the occurrence of cross-reactivity, eg, between anticonvulsants in DRESS 36 or multiple drug allergy syndrome, [45][46][47][48] although false-positive in vitro tests cannot be excluded.…”

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

“…[7][8][9]13 A unique case reported by Kanwar et al 11 had two groups of FDE lesions, one group reacting to two unrelated drugs in identical sites, and the other group to a third, also unrelated drug in a separate site. Polysensitivity with identical site involvement by different drugs may indicate the role of nonspecific stimuli in the activation of epidermal T cells residing in the lesional skin.…”