Abstract

CUNHA, Inês Machado; MARQUES, Maria Luís  and  GOMES, Eva. Fixed drug eruption due to non steroidal anti-inflammatory drugs: From pathophysiology to diagnostic workup. Rev Port Imunoalergologia [online]. 2023, vol.31, n.3, pp.193-203.  Epub Sep 30, 2023. ISSN 0871-9721.  https://doi.org/10.32932/rpia.2023.04.108.

Fixed Drug Eruption (FDE) is a drug hypersensitivity reaction representing about 22% of all drug skin reactions. It is often associated with drugs, in particular Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). It is characterized by violet macular lesions or bullous lesions, which appear between 2 days to 1 week after initial exposure to the drug, resolve with residual hyperpigmentation and reappear in case of re-exposure. The skin lesions are a manifestation of a type IV hypersensitivity reaction, characterized by CD8+ T cells activation, that play a major role on acute lesions development and its recurrence. The diagnosis and identification of the involved drug can be carried out using in vivo or in vitro tests, in particular epicutaneous tests. Drug discontinuation is recommended and treatment should be adjusted to the clinical presentation. In the case of NSAIDs, the identification of a safe therapeutic alternative must be carried out. This review aims to update knowledge on the epidemiology, pathophysiology, diagnosis and therapeutic approach of FDE caused by NSAIDs.

Keywords : Cross-reactivity; diagnosis; fixed drug eruption; NDAIDs hypersensitivity.

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