Reação de hipersensibilidade rara caracterizada pelo aparecimento de placas eritematosas ou violáceas, redondas, às vezes dolorosas, que podem ou não resultar em pigmentação duradoura e que são recorrentes (geralmente no mesmo local) após reexposição ao medicamento causador. A forma grave da doença, erupção bolhosa generalizada fixa por medicamento, ocorre tipicamente em idosos e pode ser fatal. O início geralmente ocorre 30 minutos a várias horas após a administração do medicamento causal. Muitos medicamentos, incluindo o paracetamol, foram implicados. A doença raramente pode ser induzida por alimentos. A histologia é caracterizada por dermatite de interface ou necrólise epidérmica nas formas bolhosas.
Introdução
O que você precisa saber de cara
Reação de hipersensibilidade rara observada pelo aparecimento de placas eritematosas ou violáceas, redondas, às vezes dolorosas, que podem ou não resultar em pigmentação rigorosa e que são recorrentes (geralmente no mesmo local) após reexposição ao medicamento causador. A forma grave da doença, herança bolhosa generalizada fixada por medicamento, ocorre tipicamente em idosos e pode ser fatal. O início geralmente ocorre 30 minutos a várias horas após a administração do medicamento causal. Muitos medicamentos, incluindo o paracetamol, foram implicados. Uma doença recentemente pode ser causada por alimentos. A histologia é caracterizada por dermatite de interface ou necrólise epidérmica nas formas bolhosas.
Escala de raridade
<1/50kMuito rara
1/20kRara
1/10kPouco freq.
1/5kIncomum
1/2k
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Publicações mais relevantes
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Generalized Bullous Fixed Drug Eruption (GBFDE) is a severe variant of Fixed Drug Eruption (FDE) characterized by widespread dusky erythematous plaques and blistering, often mimicking Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis (SJS/TEN). Early distinction is critical, as misdiagnosis can lead to delayed or inappropriate management. We report a case of nimesulide-induced GBFDE in a 32-year-old male who developed rapidly progressing dusky plaques and flaccid bullae within 24 hours of self-medicating with an over-the-counter Nimesulide formulation. A prior similar episode following exposure to the same drug strongly supported the diagnosis. Prompt withdrawal of the drug, systemic corticosteroids, and supportive care led to rapid clinical improvement. This case highlights the diagnostic challenges, the dangers of over-the-counter NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) use, and the importance of pharmacovigilance reporting, given that only three cases of nimesulide-associated GBFDE have been documented to date. Increased awareness among clinicians is essential to prevent morbidity and recognize this rare but potentially life-threatening adverse reaction.
Fixed Drug Eruptions in Malagasy Children: Clinical Observations and Characteristics.
Fixed drug eruption is a drug-induced hypersensitivity reaction characterized by recurrent erythematous-pigmented lesions at the same site after each exposure to the causative drug. The molecules most frequently implicated are sulfonamides, nonsteroidal anti-inflammatory drugs, anticonvulsants, and paracetamol. The first case involved a four-year-old boy with sickle cell disease who had presented with a recurrent hyperpigmented macule on the lip for 1 year. The second case involved a three-year-old girl with multiple pigmented, pruritic macules. The third case involved a ten-year-old boy presenting with pigmented plaques and flaccid bullae on his arm and left thigh. In all three cases, fixed drug eruption (including one bullous form) was diagnosed based on the patient history and recurrence. Management consisted of permanent withdrawing of the offending drug and providing symptomatic treatment with antihistamines and topical corticosteroids. There were favorable outcomes, but persistent residual pigmentation remained. These three cases illustrate the typical clinical presentation of fixed drug eruption in children in Madagascar. Recurrence of the same lesion at the same site is pathognomonic and requires discontinuation of the offending drug and reporting to pharmacovigilance.
Fluconazole-Induced Fixed Drug Eruption With Cross-Reactivity to Clotrimazole-Confirmation With Patch Testing.
First described in 1994, fixed drug eruption (FDE) to fluconazole is uncommon but possibly underdiagnosed. Of these, women with vaginal candidiasis remain the most affected, with on average more than four occurrences prior to diagnosis. We present a case of a 29-year-old female who presented after her third episode of an itchy, oedematous, blistering rash on her right hand that developed 2 h following ingestion of 150 mg of fluconazole. She reported two similar episodes in the 2 years prior, all following administration of fluconazole for vaginal candidiasis. Each episode resulted in a rash localized to her right hand, with each subsequent exposure resulting in faster onset of symptoms and signs. A FDE to fluconazole was suspected clinically, and lesional skin biopsies were consistent with this. The diagnosis was confirmed with a positive patch test to 5% fluconazole applied to the affected skin on the right hand. Cross-reactivity with clotrimazole was confirmed with a positive patch test to clotrimazole 5%. She was subsequently advised to avoid both fluconazole and clotrimazole. Although cross-reactivity between different azole antifungal agents has been described, cross-reactivity between fluconazole and clotrimazole is a novel finding. This case raises awareness of FDE to fluconazole, in particular for women being treated for vaginal candidiasis, and highlights the importance of patch testing to other antifungal agents to assess for cross-reactivity.
Generalized Bullous Fixed Drug Eruption: A Systematic Review.
Generalized bullous fixed drug eruption (GBFDE) is a severe cutaneous adverse reaction characterized by widespread plaques with bullae. Although regarded as less severe than Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN), emerging reports suggest GBFDE may be similarly life-threatening. Comprehensive characterization of GBFDE remains lacking. To review the epidemiology, causative agents, clinical features, histology, outcomes, and management of GBFDE. We conducted a systematic review according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched PubMed and Embase databases for studies from 1985 to October 27, 2024. Original observational cases of GBFDE were included. Studies without quantitative patient data were excluded. We assessed study quality using the Newcastle-Ottawa scale, analyzed data descriptively, and performed comparative analyses. Of 347 publications reviewed, 83 studies composed of 430 cases were included, median age 56 years (interquartile range [IQR], 41-75 years). Common causative agents include nonsteroidal anti-inflammatory drugs (48.7%) available over the counter in many countries without prescription and antibiotics (30.9%). Median latency was 24 hours (IQR, 12-72 hours). Mucosal involvement occurred, but no cases involved ocular mucosa. Internal organ involvement was uncommon. Intensive care unit stay was required in 19.9%. Mortality was 15.2% and was significantly associated with age (P = .01). Median time to resolution was 11 days (IQR, 8-17 days). Post-inflammatory hyperpigmentation occurred in 54.3%. Corticosteroids were the most commonly used treatment (22.4% topical and 50.6% systemic). Data were heterogeneous, and the retrospective nature of reporting limited long-term outcome assessment. Generalized bullous fixed drug eruption has a short latency. Nonsteroidal anti-inflammatory drugs and antibiotics are the commonest triggers. Systemic dysfunction is less common than in Stevens-Johnson syndrome/toxic epidermal necrolysis, but morbidity and mortality is significant, particularly in elderly people. The widespread availability of over-the-counter NSAIDs may pose a risk for GBFDE.
Doxycycline-induced fixed drug eruption: A case series highlighting a dermatological concern in antimicrobial stewardship.
To describe a series of doxycycline-induced fixed drug eruptions (FDE) observed in sexual health clinics, in a context of increasing doxycycline use for sexually transmitted infection (STI) management and prophylaxis in France. We conducted a retrospective case series, combined with a doxycycline prescription audit and a sexual health clinician survey. Thirteen male patients (mean age: 32.5 years) were diagnosed with doxycycline-induced FDE. Most were MSM (men who have sex with men, 84.6%) and received doxycycline for STI treatment (92.3%). Lesions were mainly genital (85%) and often misdiagnosed as ulcerative STIs. Doxycycline prescriptions increased by 345% between 2018 and 2024. When performed, allergy workups confirmed the diagnosis in 60% of cases. The sharp rise in doxycycline use for STI prophylaxis coincides with the identification of multiple FDE cases. Enhanced dermatological awareness is needed within antimicrobial stewardship programs to ensure safer implementation of doxycycline-based prevention strategies.
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📚 EuropePMC920 artigos no totalmostrando 197
Minocycline-Induced Fixed Drug Eruption of the Lips.
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Georgian medical newsMetformin-Induced Generalized Bullous Fixed-Drug Eruption with a Positive Dechallenge-Rechallenge Test: A Case Report and Literature Review.
Case reports in dermatological medicineA Fixed-Dose Combination of Ofloxacin-Ornidazole Induced Fixed Drug Eruption: A Case Report.
CureusNicorandil-Induced Bullous Fixed Drug Eruption on the Glans Penis.
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Journal of cosmetic dermatologyFixed drug eruption: the often forgotten cutaneous adverse drug reaction.
The Medical journal of AustraliaDelayed Drug Hypersensitivity Reactions: Molecular Recognition, Genetic Susceptibility, and Immune Mediators.
BiomedicinesAn Observational Study of Fixed Drug Eruption in A Tertiary Care Hospital in Bangladesh.
Mymensingh medical journal : MMJNovel cutaneous eruptions in the setting of programmed cell death protein 1 inhibitor therapy.
JAAD case reportsPossible Plasticity of Cytotoxic Resident Memory T Cells in Fixed Drug Eruption.
The Journal of investigative dermatologyA case of fixed drug eruption from cetirizine with cross-reaction to levocetirizine and hydroxyzine.
Contact dermatitisFixed drug eruption to aripiprazole, cetirizine, and hydroxyzine hydrochloride.
Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & ImmunologyGeneralized fixed drug eruption following Pfizer-BioNtech COVID-19 vaccination.
Clinical case reportsCase report: Severe non-pigmenting fixed drug eruption showing general symptoms caused by chondroitin sulfate sodium.
Frontiers in medicineUncommon variants of fixed drug eruption.
Indian journal of dermatology, venereology and leprologyCutaneous adverse drug eruption: the role of drug patch testing.
International journal of dermatologyCross-reactivity between nonsteroidal anti-inflammatory drugs in fixed drug eruption: Two unusual cases and a literature review.
British journal of clinical pharmacologyFixed drug eruptions - the common and novel culprits since 2000.
Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDGHypopigmented penile fixed drug eruption.
Clinical case reportsNicotine-induced bullous fixed drug eruption.
JAAD case reportsA case of recurrent fixed drug eruption following the administration of 2 different coronavirus disease 2019 vaccines verified using intradermal and patch tests.
JAAD case reportsFixed Drug Eruption: An Underrecognized Cutaneous Manifestation of a Drug Reaction in the Primary Care Setting.
CureusStudy protocol: Australasian Registry of Severe Cutaneous Adverse Reactions (AUS-SCAR).
BMJ openDrugs and the skin: A concise review of cutaneous adverse drug reactions.
British journal of clinical pharmacologySulphamethoxazole-trimethoprim induced fixed drug eruption in a patient with Chronic Granulomatous Disease.
Qatar medical journalSevere cutaneous adverse reactions: A 5-year retrospective study at Hospital Melaka, Malaysia, from December 2014 to February 2020.
The Medical journal of MalaysiaGeneralized Bullous Fixed Drug Eruption to Iodinated Contrast Media in Skin of Color.
The American journal of medicineAnnular lichenoid eruption following treatment with casirivimab/imdevimab for COVID-19.
JAAD case reportsCommon pitfalls and bias learned from the COVID-19 pandemic: Keeping a clear mind of judgment.
JAAD case reportsFixed drug eruption after the Sinopharm COVID-19 vaccine.
JEADV clinical practiceA Fixed Drug Eruption to Medroxyprogesterone Acetate Injectable Suspension.
CutisA case of paracetamol-induced nonpigmented fixed drug eruption confirmed by a lymphocyte transformation test.
European journal of dermatology : EJDReprint of: Fixed-Drug-Eruption associated with NSAID exposure.
Disease-a-month : DMSevere Cutaneous Adverse Drug Reactions in Children: Epidemiological, Clinical and Etiological Aspects in Dermatology-Venereology Unit at National and Teaching Hospital of Cotonou.
West African journal of medicineFixed drug eruption due to clindamycin with tolerance to lincomycin.
Contact dermatitisFixed drug eruption from atezolizumab.
Dermatology online journalFixed drug eruption after Pfizer-BioNTech COVID-19 vaccine: A case report.
The journal of allergy and clinical immunology. In practiceEcstasy-induced fixed drug eruption.
Contact dermatitisOral fixed drug eruption: Analyses of reported cases in the literature.
Journal of stomatology, oral and maxillofacial surgeryAngioedema and fixed drug eruption simultaneously induced by naproxen sodium: A rare clinical entity.
Journal of cosmetic dermatologyAnother case of generalized bullous fixed drug eruption following an adenoviral vector-based COVID-19 vaccine (ChAdOx1 nCov-19).
Journal of the European Academy of Dermatology and Venereology : JEADVMultifocal Bullous Fixed Drug Eruption.
Acta medica portuguesaFixed Drug Eruption Associated with Nonsteroidal Anti-Inflammatory Drugs for Menstrual Pain: A Case Report.
Case reports in dermatologyA Case of Mucosal Fixed Drug Eruption Caused by Tamsulosin Administration.
Annals of dermatologyMucosal fixed drug eruption to levetiracetam with early positive patch test on non-lesional skin.
Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and ImmunologyFixed drug eruption in a patient of HLA-B*58:01 negative after allopurinol administration: A case report.
Journal of clinical pharmacy and therapeuticsThe Role of Patch Testing in Evaluating Delayed Hypersensitivity Reactions to Medications.
Clinical reviews in allergy & immunologyNeutrophils in Fixed Drug Eruptions: Correction of a Mistaken Hypothesis.
The American Journal of dermatopathologyCutaneous Adverse Drug Reactions in a Tertiary Teaching Hospital: A Prospective, Observational Study.
Indian journal of dermatologyBizarre Cutaneous Ulcers due to Self-Administered Intravenous Dexketoprofen Trometamol.
The international journal of lower extremity woundsAnnular lichenoid diseases.
Clinics in dermatologyImmediate and Delayed Hypersensitivity Reactions to Antibiotics: Aminoglycosides, Clindamycin, Linezolid, and Metronidazole.
Clinical reviews in allergy & immunologyThe Initial Stage of Neutrophilic Dermatosis of the Dorsal Hands: A Case Report and Discussion of Differential Diagnoses.
The Journal of clinical and aesthetic dermatologyFixed Drug Eruption Secondary to Four Anti-diabetic Medications: An Unusual Case of Polysensitivity.
CureusA Study of Cutaneous Adverse Drug Reactions and their Association with Autoimmune Diseases at a Tertiary Centre in South-West Rajasthan, India.
Indian journal of dermatologyBullous Erythema Multiforme Secondary to Trimethoprim-Sulfamethoxazole Use, Treated With Cyclosporine in a 91-Year-Old Male.
CureusHyperpigmentation From Fixed Drug Eruption Successfully Treated With a Low-Fluence 1064 nm Nd:YAG Picosecond Laser.
Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]Analysis of severe cutaneous adverse reactions (SCARs) in Taiwan drug-injury relief system: 18-year results.
Journal of the Formosan Medical Association = Taiwan yi zhiPatch testing versus interferon-gamma release assay in evaluation of drug eruptions.
Fundamental & clinical pharmacologyMultiple fixed drug eruption due to carbocysteine: Presence of circulating interferon-γ-producing CD8+ T cells reactive with its night metabolite thiodiglycolic acid.
Allergology international : official journal of the Japanese Society of AllergologyVulvar and areolar fixed drug eruption.
American journal of obstetrics and gynecologyA Review of Fixed Drug Eruption with a Special Focus on Generalized Bullous Fixed Drug Eruption.
Medicina (Kaunas, Lithuania)Skin Resident Memory T Cells May Play Critical Role in Delayed-Type Drug Hypersensitivity Reactions.
Frontiers in immunologyAssociações
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Referências e fontes
Bases de dados externas citadas neste artigo
Publicações científicas
Artigos indexados no PubMed ligados a esta doença no grafo RarasNet — título, periódico e PMID direto da fonte, sem intermediação de IA.
- Nimesulide-Associated Generalized Bullous Fixed Drug Eruption: A Rare Pharmacovigilance Case Report.
- Fixed Drug Eruptions in Malagasy Children: Clinical Observations and Characteristics.
- Fluconazole-Induced Fixed Drug Eruption With Cross-Reactivity to Clotrimazole-Confirmation With Patch Testing.
- Generalized Bullous Fixed Drug Eruption: A Systematic Review.
- Doxycycline-induced fixed drug eruption: A case series highlighting a dermatological concern in antimicrobial stewardship.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases· 2026· PMID 41429253mais citado
- Fixed drug eruption induced by mycophenolate mofetil, a rare entity with significant consequences.
- Cutaneous adverse drug reactions: A prospective observational study at a tertiary care hospital in Central India.
- Fixed Drug Eruption Following Concurrent Ciprofloxacin and Metronidazole Therapy: A Dermoscopy-Assisted Diagnosis.
- Minocycline-Induced Fixed Drug Eruption of the Lips.
- First Reported Case of Treosulfan-Induced Fixed Drug Eruption.
Bases de dados e fontes oficiais
Identificadores e referências canônicas usadas para montar este verbete.
- ORPHA:293812(Orphanet)
- MONDO:0017395(MONDO)
- GARD:21170(GARD (NIH))
- Busca completa no PubMed(PubMed)
- Q719727(Wikidata)
Dados compilados pelo RarasNet a partir de fontes abertas (Orphanet, OMIM, MONDO, PubMed/EuropePMC, ClinicalTrials.gov, DATASUS, PCDT/MS). Este conteúdo é informativo e não substitui avaliação médica.
Conteúdo mantido por Agente Raras · Médicos e pesquisadores podem colaborar
