Paracetamol interaction
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Paracetamol interaction Multilocular bullous fixed drug eruption in combination with severe migraine attacks: case report
A 30-year-old woman developed multilocular bullous fixed drug eruption (FDE) elicited by paracetamol in combination with severe migraine attacks. The woman presented with a history of three recurrent episodes of skin lesions that had always developed at the same site (right forearm). At the last episode of skin lesions, there was also a blister in the centre of one lesion. The lesions persisted for weeks. Subsequently, it was healing with hyperpigmentation. She was free from dyspnoea and gastrointestinal symptoms. Upon amnesias, she revealed that the skin lesions always occurred during severe migraine attacks with concurrent intake of 1g paracetamol, taken at time intervals of 6 hours (cumulative daily dose of 3g paracetamol) [route not stated]. Additionally, she took 600mg ibuprofen during the last episode of migraine. It was also noted that she was able to tolerate paracetamol at lower doses for other unspecified conditions, without any skin lesions. Based on her medical history and the typical skin lesions, she was diagnosed with multilocular bullous FDE. A patch test with paracetamol and ibuprofen were negative. An intracutaneous test with paracetamol and a scratch test with ibuprofen were both also negative. An oral provocation test with paracetamol 3g dose administered on a migraine-free day remained unremarkable without skin lesions. Thus, it was determined that the multilocular bullous FDE elicited by paracetamol in combination with severe migraine attacks (Drug-disease interaction), but not by paracetamol alone [time to reaction onset not stated]. Jamiolkowski D, et al. Multilocular bullous fixed drug eruption elicited by paracetamol and migraine attacks, but not by paracetamol alone. Contact Dermatitis 83: 233-234, 803501851 No. 3, Sep 2020. Available from: URL: http://doi.org/10.1111/cod.13567
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Reactions 19 Sep 2020 No. 1822
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