Fixed drug eruption and intradermal provocation tests. 2008

Atiya Mahboob, and Tahir Saeed Haroon, and Zafar Iqbal, and Munir Akhtar Saleemi, and Asma Munir
Department of Dermatoloyg, Shaikh Zayed FPGMI, Lahore.

OBJECTIVE To determine the role of Intradermal Provocation (IDP) tests in Fixed Drug Eruption (FDE). METHODS Quasi-experimental study. METHODS Dermatology Unit, Shaikh Zayed Hospital, Lahore, from August 2004 to July 2006. METHODS The tests were performed in 96 patients in two stages. At stage I, suspected drugs were given intradermally. Changes at injection site in FDE lesions or any systemic effects were observed. In patients showing no response to IDP, Oral Provocation (OP) was performed (stage II) and its effects in FDE lesions or any systemic effect were observed. The positive response of FDE lesions after IDP and OP were compared with local changes at injection site. Control intradermal tests were repeated in normal persons with drugs and in FDE patients with distilled water on normal skin. RESULTS At stage I, 46 positive cases had local signs of erythematous indurated nodule with or without hemorrhagic centre, urticarial weal with hemorrhagic centre and erythematous indurated nodule with central vesicle. At stage II, 41 patients had similar local signs. The changes at injection site to those of FDE lesions were compared. Z-test for proportions showed no significant difference between groups (p-value > 0.05). Control tests were negative. CONCLUSIONS The drug producing erythematous indurated nodule with or without hemorrhagic centre, vesicle or urticarial weal with hemorrhagic centre at injection site was the most likely drug causing fixed eruption.

UI MeSH Term Description Entries
D007428 Intradermal Tests Skin tests in which the sensitizer is injected. Passive Transfer Test,Prausnitz-Kustner Test,Intradermal Test,Passive Transfer Tests,Prausnitz Kustner Test,Test, Intradermal,Test, Passive Transfer,Test, Prausnitz-Kustner,Tests, Intradermal,Tests, Passive Transfer
D008297 Male Males
D003875 Drug Eruptions Adverse cutaneous reactions caused by ingestion, parenteral use, or local application of a drug. These may assume various morphologic patterns and produce various types of lesions. Dermatitis Medicamentosa,Dermatitis, Adverse Drug Reaction,Maculopapular Drug Eruption,Maculopapular Exanthem,Morbilliform Drug Reaction,Morbilliform Exanthem,Drug Eruption,Drug Eruption, Maculopapular,Drug Eruptions, Maculopapular,Drug Reaction, Morbilliform,Drug Reactions, Morbilliform,Eruption, Drug,Eruption, Maculopapular Drug,Eruptions, Drug,Eruptions, Maculopapular Drug,Exanthem, Maculopapular,Exanthem, Morbilliform,Exanthems, Maculopapular,Exanthems, Morbilliform,Maculopapular Drug Eruptions,Maculopapular Exanthems,Morbilliform Drug Reactions,Morbilliform Exanthems,Reaction, Morbilliform Drug,Reactions, Morbilliform Drug
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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