Department of Geriatrics, Peking University First Hospital, Beijing, China.
J Clin Pharm Ther. 2022 Jun;47(6):841-843. doi: 10.1111/jcpt.13616. Epub 2022 Feb 3.
Allopurinol is widely used for hyperuricemia and gouty arthritis, but is associated with cutaneous adverse drug reactions (CADRs). HLA-B*58:01 is a highly specific and effective genetic marker for the detection of allopurinol-induced CADRs, especially for Asian descents.
A 60-year-old Chinese Han male patient took allopurinol for lowering uric acid after the negative result from HLA-B*58:01 testing. Then, he experienced episodes of well-demarcated pruritic erythematous patches on the whole body that developed into blisters and pustular eruption. Fixed drug eruption (FDE) was diagnosed by skin biopsy and improved with withdrawal and hormone treatments.
It should be kept in mind that cutaneous drug eruption might occur after allopurinol administration in Asians of HLA-B*58:01 negative. Awareness among medical practitioners about FDE can lead to correct diagnosis, treatment and decreased damage as well as lower therapeutic costs.
别嘌醇广泛用于高尿酸血症和痛风性关节炎，但与皮肤不良反应（CADR）有关。HLA-B*58:01 是一种高度特异性和有效的遗传标志物，可用于检测别嘌醇诱导的 CADR，特别是针对亚洲血统。
一名 60 岁的汉族男性患者在 HLA-B*58:01 检测结果为阴性后服用别嘌醇降低尿酸。随后，他全身出现界限清楚的瘙痒性红斑，发展为水疱和脓疱性皮疹。皮肤活检诊断为固定性药疹（FDE），经停药和激素治疗后病情改善。
对于 HLA-B*58:01 阴性的亚洲人，服用别嘌醇后可能会发生皮肤药物反应，这一点应该牢记在心。医疗从业者对 FDE 的认识可以导致正确的诊断、治疗和减少损害以及降低治疗成本。
