Systemic provocation in doxycycline induced fixed drug eruption: a case report

https://doi.org/10.19106/JMedScie004502201306

Anik Murwaningsih(1*), Rosmarini Estri Sih Hananti(2), Niken Indrastuti(3)

(1) Sentra Medika Hospital, Bogor, West Java,
(2) Department of Dermato-Venereology, Faculty of Medicine, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
(3) Department of Dermato-Venereology, Faculty of Medicine, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
(*) Corresponding Author

Abstract


Fixed drug eruption (FDE) is recurrent lesions that upon repeated uptake of causative drug, always appears at the same skin and mucosal site. Determination of causal relationship in drug allergy is very important. In this case report, cases of doxycycline-induced FDE was reported. The subject of the research was a 29-year-old male, referred by dermatologist, with history of reccurent FDE. Physical examination revealed an oval well demarcated patch hyperpigmentation. Patch test was perfomed on previous involved and uninvolved site. The result of the patch test was irrelevant. Retesting patch test gave similar result. Systemic provocation test or drug provocation test (DPT)  with doxcycline were done with suspected drug under ambulatory survelance and gave positive result. In this case, the DPT succeeded to identify doxycycline as the causal agent of FDE. The work-up of a suspected drug hypersensitivity includes a detailed clinical history, physical examination, skin tests, and provocation tests. The DPT is recommended to confirm drug’s hypersensitivity reactions. Systemic provocation test is considered as the gold standard for diagnosing FDE.

Keywords


fixed drug eruption - doxycycline - causal relationship - patch test - systemic provocation test




DOI: https://doi.org/10.19106/JMedScie004502201306

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Journal of the Medical Sciences (Berkala Ilmu Kedokteran) by  Universitas Gadjah Mada is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Based on a work at http://jurnal.ugm.ac.id/bik/.