Two cases of multiple fixed drug eruption due to commercial analgesics

Abstract

We reported two cases of fixed drug eruption due to commercial analgesics. Case 1: A 31-year-old female had been taking commercial analgesics once a month for menorrhalgia since she was 12 years old. Itchy erythema and postinflammatory pigmentation had relapsed on the same lesions on the extremities and perianal area every time she took the analgesics. The results of closed patch test (PT) by Eve® A, New Kaiteki® Z, and their component, allylisopropylacetylurea (AIAU), on the lesional area were positive. We diagnosed case 1 as fixed drug eruption by AIAU. Case 2: A 33-year-old man had been taking Bufferin® once a month for migraine since he was 23 years old and New Sedes® for the past three years. Half a year ago, itchy, painful erythema developed on the hands and in the oral cavity and then improved, leaving pigmentation. The same symptoms relapsed and became more severe after every dosage of the medicine. Oral steroid was needed for severe mucosal erosions. The results of PT by New Sedes®, Sederin®, and their component, ethenzamide, on the lesional area were positive. The lymphocyte stimulation test by New Sedes® was positive. We diagnosed case 2 as fixed drug eruption by ethenzamide. The diagnosis of both cases was made easy by their clinical histories and the PT on the lesional area, which was useful in identifying the causative agents.