Acebrophylline-induced generalized fixed drug eruption confirmed by an oral provocation test

Su Jin Jeong; Heon Sa-Kong; Dong-Hee Park; Sung Geun Lee; So Young Jung; Chan Sun Park

doi:10.4168/aard.2017.5.5.298

Journal List > Allergy Asthma Respir Dis > v.5(5) > 1059277

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Jeong, Sa-Kong, Park, Lee, Jung, and Park: Acebrophylline-induced generalized fixed drug eruption confirmed by an oral provocation test

Case Report

Allergy Asthma Respir Dis 2017;5(5):298-301.

Published online: 5 September 2017

DOI: https://doi.org/10.4168/aard.2017.5.5.298

Acebrophylline-induced generalized fixed drug eruption confirmed by an oral provocation test

Su Jin Jeong¹, Heon Sa-Kong¹, Dong-Hee Park¹, Sung Geun Lee¹, So Young Jung², Chan Sun Park¹

¹Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea

²Department of Dermatology, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea

Correspondence to: Chan Sun Park https://orcid.org/0000-0003-0113-8354 Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, 875 Haeun-daero, Haeundae-gu, Busan 48108, Korea Tel: +82-51-797-2210, Fax: +82-51-797-0941, E-mail: chansun@paik.ac.kr

Received 23 February 20174 May 2017 Accepted 4 May 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The diagnosis of fixed drug eruption is straightforward because of characteristic findings, including recurrence of similar lesions at the same site and healing with residual hyperpigmentation. However, generalized or multiple fixed drug eruption, a rare variant form, can be a diagnostic challenge. Acebrophylline is a widely prescribed oral bronchodilator with mucosecretolyic and anti-inflammatory activity and is known to be relatively safe. A 34-year-old woman presented with recurrent numerous erythematous patches after ingestion of cold medications containing clarithromycin, loxoprofen, acebrophylline, and pseudoephedrine. Skin biopsy results showed vacuolar degeneration of the basal cell layer, scattered necrotic keratinocytes in the epidermis, and perivascular lymphohistiocytic infiltration in the upper dermis. A patch test showed negative results. However, in an oral challenge with acebrophylline 3 hours later, lesions reappeared at the same sites. To the best of our knowledge, this is the first case report of acebrophyl-line-induced generalized fixed drug eruption.

Keywords: Acebrophylline, Drug eruptions, Patch tests

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Fig. 1.

Multiple well-demarcated erythematous to hyperpigmented annular patches were showed on right shoulder (A, initial visit; B, 3 hours after oral provocation test).

Fig. 2.

Histopathologic findings showed vacuolar degeneration of basal cell lay-er, scattered necrotic keratinocytes in epidermis and perivascular lymphohistiocytic infiltration in upper dermis (H&E, ×200).

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