Servicio de Alergia, Hospital Universitario Cruces, Barakaldo, Bizkaia, Spain.
Contact Dermatitis. 2021 Mar;84(3):192-195. doi: 10.1111/cod.13659. Epub 2020 Aug 18.
Fixed drug eruption (FDE) is a characteristic form of intraepidermal CD8 T cell-mediated drug reaction, with repeated appearance of isolated or multiple skin lesions in the same location after receiving the offending drug. Non-steroidal anti-inflammatory drugs (NSAID) are the most common cause. Selective inhibitors of inducible cyclooxygenase 2 (COX-2) provoke a lesser degree of allergic or idiosyncratic adverse reactions than conventional NSAID, but they can cause skin reactions of variable severity.
Etoricoxib has been related to a variety of unusual skin reactions, including several reports of FDE.
We perfomed epicutaneous test to diagnose patients with suspected etoricoxib fixe drug rash due to clinical features and reproducibility on at least two occasions.
We present seven new cases of etoricoxib-induced fixed drug eruption, with a diagnosis based on clinical presentation. This diagnosis was confirmed by an etoricoxib-positive lesional patch test in six cases and by a positive low-dose oral challenge in the other one. Two patients showed negative patch tests with celecoxib (10% in pet.) on the residual lesions, and oral tolerance was confirmed in one.
To our knowledge, this is the largest series on FDE induced by etoricoxib reported to date.
固定型药物疹（FDE）是一种表皮内 CD8 T 细胞介导的药物反应的特征形式，在接受致病药物后，同一部位会反复出现孤立或多个皮肤损伤。非甾体抗炎药（NSAID）是最常见的原因。与传统 NSAID 相比，选择性诱导型环氧化酶 2（COX-2）抑制剂引起过敏或特发性不良反应的程度较小，但它们可能引起不同严重程度的皮肤反应。
依替膦酸已与多种不寻常的皮肤反应有关，包括几例 FDE 的报告。
我们对疑似依替膦酸固定性药疹的患者进行了斑贴试验，以基于临床特征和至少两次的可重复性来诊断。
我们报告了 7 例新的依替膦酸诱导的固定型药物疹病例，基于临床表现做出了诊断。在 6 例中，依替膦酸阳性的皮损斑贴试验证实了这一诊断，而在另 1 例中，低剂量口服挑战阳性。2 例患者在残留皮损上用塞来昔布（10%在 pet.）进行斑贴试验呈阴性，1 例患者口服耐受。
据我们所知，这是迄今为止报告的依替膦酸引起的 FDE 最大系列。
