A case of fixed drug eruption related to cefixime
Fixed drug eruption (FDE) is a distinctive type of drug reaction seen on skin or mucous membrane at the same location after administration of the causative drug. FDE is well recognized with many drugs, including sulfonamides, tetracyclines, dapsone, ampicillin, acetaminophen, aspirin, other nonsteroidal anti-inflammatory drugs, pseudoephedrine, anticonvulsants, and oral contraceptives; however, cefixime-related FDE is reported only a few in the literature.

The present case has been reported in The Journal of Allergy and Clinical Immunology.

A 16-year-old male patient followed by nephrology department with a diagnosis of chronic kidney failure, vesicoureteral reflux, and neurogenic bladder referred to pediatric allergy department with a complaint of patches on his skin.

He was under treatment with cefixime for urinary tract infection for 4 days. There was no history of any other drug intake before the patches. In the patient’s physical examination, an itchy, irregular-bordered, violet-colored 5 × 8 cm patch under the umbilicus, a red-colored 2 × 2 cm patch on the lateral side of the left popliteal fossa, and a 12 × 8 cm patch on the medial area of the right thigh were observed.

Blood tests were normal, but urine tests revealed 7 leukocytes per high power field. The patient stated that he also used cefixime 3 months ago, which caused similar patches in the same area, and those lesions regressed in 2 to 3 weeks when he discontinued the drug.

Keeping in view the nature of lesions and recurrence of reactions after the use of the same drug, a diagnosis of FDE was made and the patient advised to avoid the use of cefixime.

Patch tests were applied to the lesional skin and upper back with cefixime (10% in petrolatum) 6 weeks later; however, the results were negative even though the reaction reactivated after the reuse of the same drug. Patches in the thigh area did not regress completely after drug cessation and subsided with residual hyperpigmentation.

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