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Agarwal A, Das A, Panda M, Kumar P. Uncommon variants of fixed drug eruption. Indian J Dermatol Venereol Leprol 2022; 89:475-481. [DOI: 10.25259/ijdvl_502_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 11/01/2021] [Indexed: 11/04/2022]
Affiliation(s)
| | - Anupam Das
- Department of Dermatology, KPC Medical College and Hospital, Kolkata, West Bengal, India
| | | | - Piyush Kumar
- Department of Dermatology, Katihar Medical College, Katihar, Bihar, India
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Razmi TM, Thakur V, Vinay K, Aggarwal D, Radotra BD, Kumaran MS, Parsad D. Periorbital Acquired Dermal Macular Hyperpigmentation: A Distinctive Clinical Entity in Young Adults-Observational Case-Control Study. Indian Dermatol Online J 2020; 11:590-593. [PMID: 32832448 PMCID: PMC7413451 DOI: 10.4103/idoj.idoj_415_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 10/10/2019] [Accepted: 12/15/2019] [Indexed: 11/22/2022] Open
Abstract
Introduction: Acquired dermal hyperpigmentation (ADMH) presenting on periorbital region has been described as individual case reports. We tried to characterize the features of periorbital ADMH. Materials and Methods: This was a retrospective case-control study among our patients who attended the pigmentary clinic during January 2016–December 2017. Clinical, dermoscopic, and histopathological features of subjects who were recruited during the study period were prospectively evaluated. Results: Total 19 subjects (11%) were identified among 177 ADMH patients. Periorbital ADMH patients had a relatively younger age of onset (23.26 ± 11.06 vs. 36.16 ± 13.41, P < 0.001). Dermoscopy of early periorbital ADMH showed only imperceptible speckled blue-gray dots that accentuated at outer-corner creases of eyes (the “outer-corner crease sign”). Clinicopathological features and prognosis of periorbital ADMH were similar to that of ADMH per se. Conclusion: Periorbital ADMH should be considered as a differential diagnosis of periorbital hyperpigmentation in children and young adults. Outer-corner crease sign on dermoscopy may help to rule out other differentials in its early presentation.
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Affiliation(s)
- T Muhammed Razmi
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Vishal Thakur
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Keshavamurthy Vinay
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Divya Aggarwal
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Bishan D Radotra
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Muthu Sendhil Kumaran
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Davinder Parsad
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Abstract
Drug eruptions in children are common but in general less studied than their adult counterparts. Aside from having significant impact on the child's health and quality of life, these reactions can limit what medications the patient can receive in the future. Familiarity with pediatric drug eruptions is important for accurate diagnosis and to prevent future recurrence or ineffective therapy. Our current understanding of how drug reactions differ mechanistically between children and adults is poor. There are multiple factors that could be contributing to the differing incidence, presentation, and treatment modalities offered to pediatric versus adult patients. For many of these cutaneous drug reactions, the treatment regime is not standardized, being based primarily on case reports. Although not comprehensive, this review highlights common pediatric drug eruption patterns and discuss diagnostic mimickers. Five cutaneous adverse drug reactions in the pediatric population are presented: morbilliform (exanthematous) eruptions, urticarial eruptions, serum sickness-like reactions, fixed drug eruptions, and DRESS syndrome. Clinical features, diagnostic workup, and management are discussed with an emphasis on the pediatric population.
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Affiliation(s)
- EmilyD Nguyen
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA; Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, USA
| | - Colleen K Gabel
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA; University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - JiaDe Yu
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA.
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Honma M, Takahashi C, Minami-Hori M, Ishida-Yamamoto A. Fixed exanthema emerged following narrowband ultraviolet B irradiation. J Dermatol 2017; 44:e40-e41. [DOI: 10.1111/1346-8138.13554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Masaru Honma
- Department of Dermatology; Asahikawa Medical University; Asahikawa Japan
| | - Chiaki Takahashi
- Department of Dermatology; Asahikawa Medical University; Asahikawa Japan
| | - Masako Minami-Hori
- Department of Dermatology; Asahikawa Medical University; Asahikawa Japan
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Agarwala MK, Mukhopadhyay S, Sekhar MR, Peter CD. Bullous Fixed Drug Eruption Probably Induced by Paracetamol. Indian J Dermatol 2016; 61:121. [PMID: 26951737 PMCID: PMC4763646 DOI: 10.4103/0019-5154.174098] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We report a case of a 42-year-old male who presented with second episode of bullous eruptions after ingestion of paracetamol. There were no systemic complaints. The temporal correlation with the drug, history of a similar episode and the quick improvement led us to a diagnosis of bullous fixed drug due to paracetamol. Applying Naranjo's algorithm, a causality score of 8 was obtained and was categorized as probable reaction to paracetamol. Clinicians should be vigilant of the possible adverse reactions to drugs with robust safety profiles. Drug alert cards could play an important role in preventing recurrences.
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Affiliation(s)
- Manoj Kumar Agarwala
- Department of Dermatology, Christian Medical College, Vellore, Tamil Nadu, India
| | | | - M Raja Sekhar
- Department of Dermatology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Cv Dincy Peter
- Department of Dermatology, Christian Medical College, Vellore, Tamil Nadu, India
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Abstract
Fixed drug eruption (FDE) usually presents as a single oval to round violaceous patch after administration of the causative drug. We describe a case of FDE presenting with multiple annular erythematous lesions over dorsal aspects of both feet following the administration of phenobarbital. To the best of our knowledge, such an atypical demonstration had never been reported. Fixed drug eruption should be considered in the differential diagnosis of annular lesions.
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Affiliation(s)
- Cheng Tan
- Department of Dermatology, First Affiliated Hospital of Nan Jing University of Traditional Chinise Medicine, Jiang Su Province, China
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8
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Affiliation(s)
- Virendra N Sehgal
- Dermato-Venereology (Skin/VD) Centre, Sehgal Nursing Home, Panchwati, Azadpur, Delhi, and Skin Institute and School of Dermatology, Greater Kailash, New Delhi, India.
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Sardana K, Rajpal M, Garg V, Mishra D. Periorbital hyperpigmentation mimicking fixed drug eruption: a rare presentation of erythema dyschromicum perstans in a paediatric patient. J Eur Acad Dermatol Venereol 2006; 20:1381-3. [PMID: 17062091 DOI: 10.1111/j.1468-3083.2006.01735.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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10
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Sebbag N, Lacour JP. [Erythema dyschromicum perstans]. Ann Dermatol Venereol 2006; 133:79-82. [PMID: 16495863 DOI: 10.1016/s0151-9638(06)70853-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- N Sebbag
- Service de Dermatologie, Hôpital Archet-2, CHU de Nice
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Affiliation(s)
- Robert A Schwartz
- Dermatology, New Jersey Medical School, 185 South Orange Avenue, Newark, NJ 07103-2714, USA.
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12
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Abstract
The knowledge of many specific skin diseases that predominantly affect Latinos has been increasing; however, the understanding of common skin disease in Latinos is superficial. There are few prospective studies done in the Latino population and none that differentiate between diverse Latino backgrounds. In view of the expanding Latino population in this country, such research is timely.
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Affiliation(s)
- Miguel R Sanchez
- Department of Dermatology, New York University School of Medicine, 560 First Avenue, Office H-100, New York, NY 10016, USA.
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14
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Abstract
Drug eruptions often have nonspecific clinical findings, and the evaluation of the probability of an eruption being a drug-induced event is difficult. A few types of drug eruption do not present such problems, and the fixed drug eruption is one of those whose clinical findings are specific enough to allow a diagnosis. The fixed drug eruption is a commonly reported type of drug eruption. The incidence of fixed drug eruptions has tended to increase, although the overall number of drug eruption cases has decreased. This is one of the reasons why fixed drug eruptions are familiar to dermatologists. The most characteristic findings of a fixed drug eruption are recurrence of similar lesions at the same sites and healing with residual hyperpigmentation. The residual hyperpigmentation serves as an indicator of site recognition. Diagnosis is not always easy; for example, as is the case for nonpigmenting fixed drug eruptions, which do not have any residual hyperpigmentation. The development of molecular biology may help to clarify the pathogenesis of fixed drug eruptions, but the reason for their recurrence on the same sites is still unknown. Identification of the causative drug or drugs is essential for the management of fixed drug eruptions, as it is for other drug eruptions. The causative drug or drugs and cross-reactants should be avoided to prevent recurrence. To date, rechallenge is the most reliable method of identifying causative drugs, but increasingly the use of skin tests has gained the attention of investigators. The validity and the problems of skin tests are discussed, and an approach to the clinical management of fixed drug eruptions is presented.
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Affiliation(s)
- A Y Lee
- Department of Dermatology, Eulji Hospital College of Medicine, Seoul, South Korea.
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