FIXED DRUG ERUPTION. A STUDY OF 11 CASES AND A REVIEW OF THE LITERATURE ERITEMUL FIX MEDICAMENTOS. UN STUDIU DE 11 CAZURI ŞI UN REVIEW AL LITERATURII

Mihai-Alexandru Badea, Mihai Dorin Vartolomei, Mihaela Georgescu, Mihai Anton Tilea, Luminita Emilia Decean, Silviu-Horia Morariu

Abstract


Fixed drug eruption represents a drug-related cutaneous reaction which appears in the same place in case of repeated administration of a drug to which the patient shows intolerance. Skin lesions are characterized by erythematous patches or plaques that appear between 30 minutes and 8 hours after the therapy is introduced. The pathogenetic mechanism is represented by the awareness of CD 8 T lymphocytes from the skin, remaining in a sleeping state and reactivating in case of a new administration. This type of after-treatment reaction is most frequently cited in connection with cotrimoxazole, betalactamine and nonsteroidal antiinflamatory drugs (NSAIDs). We will present eleven clinical cases of fixed drug eruptions from the casuistry of the Dermatology Clinic fromTârgu Mureş. The knowledge of this dermatosis by clinicians and pharmacists leads to full remission and it also helps avoid recurrence of the lesion.

Eritemul fix medicamentos reprezintă o reacţie cutanată postmedicamentoasă ce apare în acelaşi loc în cazul administrării repetate a unui medicament faţă de care pacientul prezintă intoleranţă. Leziunile cutanate se caracterizează prin pete sau plăci eritematoase ce apar între 30 de minute şi 8 ore de la introducerea terapiei. Mecanismul patogenetic este reprezentat de sensibilizarea limfocitelor T CD8 de la nivel cutanat care rămân în stare dormandă şi se reactivează la o nouă administrare. Acest tip de reacţie postmedicamentoasă este citată cel mai frecvent la cotrimoxazol, betalactamine şi antiinflamatoare nesteroidiene. Vom prezenta unsprezece cazuri clinice de eritem fix postmedicamentos din cazuistica Clinicii de Dermatovenerologie din Târgu Mureş. Cunoaşterea acestei dermatoze de către clinicieni duce la o atitudine terapeutică corectă cu remisiunea completă, precum şi la prevenirea reapariţiei leziunii. 


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