Amoxicillin
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Amoxicillin Symmetrical drug-related intertriginous and flexural exanthema and fixed drug eruption in a child: case report A 12-year-old boy developed symmetrical drug-related intertriginous and flexural exanthema, and a fixed drug eruption, during treatment with amoxicillin. The boy presented with symmetrical, well-defined, sharply demarcated, round to oval, slightly elevated, reddish plaques within 12 hours of oral treatment with amoxicillin tablet 500mg [Amoksina; indication not stated]. The plaques were located on the buttocks, the antecubital, popliteal and axillary fossae, the flexural aspect of the femoral areas, the elbows and knees, and the intergluteal region. Amoksina was withdrawn and topical corticosteroids were initiated. The lesions resolved, leaving slight postlesional hyperpigmentation. Investigation into the boy’s medical history revealed the appearance of similar lesions in the same areas 2 months earlier following ingestion of amoxicillin. Histopathological analysis of an axillary lesion in the subacute phase demonstrated focal parakeratosis, melanophages in the papillary dermis, mild acanthosis, and mild mononuclear perivascular inflammatory infiltration. A rechallenge with oral Amoksina tablets was performed, starting with one-eighth of a single dose (500mg). The boy’s dose was increased at 12-hour intervals to onequarter and one-half of a tablet, with the latter resulting in site-specific recurrence of the lesions with pruritus and erythema within 8 hours. In addition, new-onset, sharply demarcated, round plaques appeared on the flexural aspect of his right upper arm and neck. The lesions had healed within 1 week of topical corticosteroid therapy, leaving residual hyperpigmentation. No recurrence was noted during 1 year of follow-up. Author comment: "The Naranjo probability score was eight, suggesting a probable causal relationship between amoxicillin and the eruption." Ozkaya E, et al. A challenging case: Symmetrical drug related intertriginous and flexural exanthem, fixed drug eruption, or both? Pediatric Dermatology 28: 711-714, No. 6, Nov-Dec 2011. Available from: URL: http://dx.doi.org/10.1111/ 803066554 j.1525-1470.2011.01656.x - Turkey
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Reactions 4 Feb 2012 No. 1387
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