Fixed Drug Eruption and Intradermal Provocation Tests

Atiya Mahboob; Tahir Saeed Haroon; Zafar Iqbal; Munir Akhtar Saleemi; Asma Munir

Author(s)

Atiya Mahboob Department of Dermatoloyg, Shaikh Zayed FPGMI, Lahore, Pakistan

Tahir Saeed Haroon Department of Dermatology, King Edward Medical University/Mayo Hospital, Lahore, Pakistan

Zafar Iqbal Department of Medicine, Shaikh Zayed FPGMI, Lahore, Pakistan

Munir Akhtar Saleemi Department of Social & Preventive Paediatric, King Edward Medical University/Mayo Hospital, Lahore, Pakistan

Asma Munir King Edward Medical University, Lahore, Pakistan

Abstract

Objective: To determine the role of Intradermal Provocation (IDP) tests in Fixed Drug Eruption (FDE). Study Design: Quasi-experimental study. Place and Duration of Study: Dermatology Unit, Shaikh Zayed Hospital, Lahore, from August 2004 to July 2006. Methodology: The tests were performed in 96 patients in two stages. At stage I, suspected drugs were given intradermally. Changes at injection site in FDE lesions or any systemic effects were observed. In patients showing no response to IDP, Oral Provocation (OP) was performed (stage II) and its effects in FDE lesions or any systemic effect were observed. The positive response of FDE lesions after IDP and OP were compared with local changes at injection site. Control intradermal tests were repeated in normal persons with drugs and in FDE patients with distilled water on normal skin. Results: At stage I, 46 positive cases had local signs of erythematous indurated nodule with or without hemorrhagic centre, urticarial weal with hemorrhagic centre and erythematous indurated nodule with central vesicle. At stage II, 41 patients had similar local signs. The changes at injection site to those of FDE lesions were compared. Z-test for proportions showed no significant difference between groups (p-value > 0.05). Control tests were negative. Conclusion: The drug producing erythematous indurated nodule with or without hemorrhagic centre, vesicle or urticarial weal with hemorrhagic centre at injection site was the most likely drug causing fixed eruption.

Publication Details

Page(s) 736-739

DOI DOI not available

Published Journal: Journal of College of Physicians and Surgeons--Pakistan : JCPSP, Volume: 18, Issue: 12, Year: 2008

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Keywords

erythema, Fixed drug eruption, Intradermal provocation test, Nodule