Rahman Muhammad Hasibur
Department of Dermatology & VD, Community Based Medical College, Mymensingh, Bangladesh.
Int J Dermatol. 2014 Feb;53(2):255-8. doi: 10.1111/ijd.12197. Epub 2013 Aug 22.
Fixed drug eruption is designated as a typical allergic reaction occurring due to exposure to a medicine. This common dermatological condition is often being ignored for its causative agent as well as the patient's sufferings sometimes become unpredictable.
The objective of this large population study is to identify the causative agents responsible for fixed drug eruption.
MATERIALS & METHODS: The study is comprised of 120 suspected patients of fixed drug eruption. History, classic clinical features of well circumscribed erythema, edema, and violaceous pigmentation, and the recurrence of the eruptions on the same sites upon re-administering drug were used as diagnostic criteria. The drug(s) causing allergic reactions were confirmed by provocation tests.
The incidence of drug eruption was found distributed in 0.62% amongst all dermatology outpatient attendees. The male to female ratio recorded was 7:2. The highest number of cases was observed within in the age group of 21-35 years. The provocation tests were positive in 92 among 120. The genitalia and lips/face were the most commonly affected site for fixed drug eruption.
The drug sulphonamide (including co-trimoxazole) accounted for the highest number of cases of eruptions (28.33 %). The other drugs, in order of frequency, responsible for the cause of eruptions were identified as nonsteroidal anti-inflammatory drugs, tetracycline, metronidazole, herbal medicine, paracetamol, fluconazole, penicillin, Griseofulvin, and homeopathic medicine, etc.
Drug reactions are very frequently experienced by dermatologists in their day-to-day practice. The patients are often ignorant of the drugs consumed and often do not accept them as an etiologic factor. A detailed drug history as well as the complaints will be helpful before undertaking the provocation test.
固定性药疹被认定为因接触药物而发生的一种典型过敏反应。这种常见的皮肤病状况因其致病因素常常被忽视，而且患者的痛苦有时变得难以预测。
这项大规模人群研究的目的是确定导致固定性药疹的致病因素。
该研究由120名疑似固定性药疹患者组成。病史、边界清晰的红斑、水肿和紫蓝色色素沉着等典型临床特征，以及再次用药时皮疹在相同部位复发的情况被用作诊断标准。通过激发试验确认引起过敏反应的药物。
在所有皮肤科门诊就诊者中，药疹的发生率为0.62%。记录的男女比例为7:2。在21 - 35岁年龄组中观察到的病例数最多。120例中有92例激发试验呈阳性。生殖器和嘴唇/面部是固定性药疹最常受累的部位。
磺胺类药物（包括复方新诺明）引发皮疹的病例数最多（28.33%）。按频率顺序，其他导致皮疹的药物被确定为非甾体抗炎药、四环素、甲硝唑、草药、对乙酰氨基酚、氟康唑、青霉素、灰黄霉素和顺势疗法药物等。
皮肤科医生在日常实践中经常遇到药物反应。患者往往对所服用的药物不知情，且常常不认为它们是病因。在进行激发试验之前，详细的用药史以及患者的主诉会有所帮助。
