Gonzalo Garijo M A, Bobadilla González P
Allergology Department, Infanta Cristina University Hospital, Badajoz, Spain.
Allergol Immunopathol (Madr). 1996 Mar-Apr;24(2):89-92.
A 28-year-old woman with a previous atopic history had been complaining of itching and burning erythematous plaques or blister eruptions on her face and neck for the last 2 years. These lesions became red-brown and then disappeared in 1-2 weeks. However, the site of two of them had remained heavily pigmented after resolution. Sometimes, vesicular lesions affected the oral mucosa causing a burning sensation. She had noticed that these eruptions reappeared in the same location and related to menstruation (when she used to take naproxen sodium because of dysmenorrhea). Furthermore, pigmented sites became red-brown, elevated and itchy. These findings suggested a fixed drug eruption (FDE) due to naproxen, a sporadic clinical event previously reported only once. Patch tests were performed on the back (normal skin) with a series of NSAIDs, and with naproxen both on the back and on previous FDE sites. The test were negative on the back, and on previous FDE sites the skin got dark. The value of this result as a diagnostic tool was unclear so we performed an oral challenge test with naproxen which proved the diagnosis definitely.
一名有特应性病史的28岁女性，在过去2年中一直抱怨其面部和颈部出现瘙痒、灼痛的红斑或水疱性皮疹。这些皮损变为红棕色，然后在1 - 2周内消失。然而，其中两处皮损消退后仍留有明显色素沉着。有时，水疱性皮损会累及口腔黏膜，引起烧灼感。她注意到这些皮疹会在同一部位复发，且与月经有关（她因痛经服用萘普生钠时）。此外，色素沉着部位会变为红棕色，隆起且瘙痒。这些发现提示为萘普生所致的固定性药疹（FDE），这是一种此前仅报道过一次的散发性临床事件。在背部（正常皮肤）用一系列非甾体抗炎药进行斑贴试验，同时在背部和先前的FDE部位用萘普生进行斑贴试验。背部试验结果为阴性，而在先前的FDE部位皮肤变黑。该结果作为诊断工具的价值尚不清楚，因此我们用萘普生进行了口服激发试验，最终明确了诊断。
