Acrylates/adverse effects , Dermatitis, Allergic Contact/etiology , Gels/adverse effects , Ultrasonography , Urea/analogs & derivatives , Acrylates/analysis , Adult , Dermatitis, Allergic Contact/diagnosis , Emulsifying Agents/adverse effects , Emulsifying Agents/analysis , Female , Gels/chemistry , Humans , Male , Middle Aged , Patch Tests , Preservatives, Pharmaceutical/adverse effects , Preservatives, Pharmaceutical/analysis , Urea/adverse effects , Urea/analysis
BACKGROUND: Fixed drug eruption (FDE) is a characteristic form of intraepidermal CD8+ T cell-mediated drug reaction, with repeated appearance of isolated or multiple skin lesions in the same location after receiving the offending drug. Non-steroidal anti-inflammatory drugs (NSAID) are the most common cause. Selective inhibitors of inducible cyclooxygenase 2 (COX-2) provoke a lesser degree of allergic or idiosyncratic adverse reactions than conventional NSAID, but they can cause skin reactions of variable severity. OBJECTIVE: Etoricoxib has been related to a variety of unusual skin reactions, including several reports of FDE. METHODS: We perfomed epicutaneous test to diagnose patients with suspected etoricoxib fixe drug rash due to clinical features and reproducibility on at least two occasions. RESULTS: We present seven new cases of etoricoxib-induced fixed drug eruption, with a diagnosis based on clinical presentation. This diagnosis was confirmed by an etoricoxib-positive lesional patch test in six cases and by a positive low-dose oral challenge in the other one. Two patients showed negative patch tests with celecoxib (10% in pet.) on the residual lesions, and oral tolerance was confirmed in one. CONCLUSION: To our knowledge, this is the largest series on FDE induced by etoricoxib reported to date.
Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Cyclooxygenase 2 Inhibitors/adverse effects , Dermatitis, Allergic Contact/etiology , Drug Eruptions/etiology , Etoricoxib/adverse effects , Adult , Aged , Dermatitis, Allergic Contact/diagnosis , Drug Eruptions/diagnosis , Female , Humans , Male , Middle Aged , Patch Tests