Fixed drug eruption normally presents as single or multiple sharply demarcated erythematous lesions that recur at the same location upon re-exposure to the offending agent. When the acute inflammation subsides, it often leaves residual hyperpigmentation. Commonly implicated substances are phenolphthalein, barbiturates, sulfonamides, tetracyclines, salicylates, gold and pyrazolone derivatives. Despite frequent use of acetaminophen, drug eruptions, especially fixed drug eruptions, due to acetaminophen are extrernely rare. We report here a childhood case of fixed drug eruption caused by acetaminophen, which is extensively used as an over-the-counter drug, as well as in medical therapy.
Acetaminophen* ; Barbiturates ; Drug Eruptions* ; Hyperpigmentation ; Inflammation ; Phenolphthalein ; Salicylates ; Sulfonamides ; Tetracyclines

The term "fixed drug eruption" was coined by Louis Brocq in 1894 to describe a special type of reaction to antipyrine. It is now known that many drugs can cause a fixed drug eruption. Notorious offenders have included phenolphthalein, quinine and barbiturates. We present a case of multiple fixed drug eruption appearing in a 20 year-old male patient who has generalized slate-blue colored pigmentation on neck, trunk and extremities. The area of total pigmented skin lesions are over 50% of body surface. We could confirm the fixed drug eruption by positive phenobarbital provocation test.
Antipyrine ; Barbiturates ; Criminals ; Drug Eruptions* ; Extremities ; Humans ; Male ; Neck ; Numismatics ; Phenobarbital ; Phenolphthalein ; Pigmentation ; Quinine ; Skin ; Young Adult

A fixed drug eruption is a cutaneous reaction caused by various drugs, which include phenazone derivatives, barbiturates, sulfonamides, tetracyclines and phenolphthaleins. An eruption caused by piroxicam is very rare and there have been no previous reports in Korea. A 49-year-old woman was seen with mutiple erythematous patches and some bullae that appeared after oral administration of piroxicam. The patient had had two similar episodes after oral administration of piroxicam. We performed patch test with piroxicam and could confirm a fixed drug eruption caused by this durg.
Administration, Oral ; Antipyrine ; Barbiturates ; Drug Eruptions* ; Female ; Humans ; Korea ; Middle Aged ; Patch Tests ; Phenolphthalein ; Phenolphthaleins ; Piroxicam* ; Sulfonamides ; Tetracyclines

Fixed drug eruption (FDE) is an eruption, which recurs at the same site or sites on each administration of the causative drug, and heals with residual hyperpigmentation. FDE is caused by many drugs, barbiturates, tetracyclines, sulfonamide, and phenolphthalein. Salicylate and nonsteroidal anti-inflammatory drugs (NSAIDs) also cause FDE, but acetaminophen does so only rarely. A 9-year-old girl presented with a 3-year-history of symptomatic pigmented macules on her face, abdomen, and extremities. The eruption was first appeared three years ago, which was when she took medicine after she was discharged following suspicions of Kawasaki disease. Thereafter, she had the same eruption on the same sites when she took medicine for common colds including acetaminophen and ibuprofen. The oral challenge provocation test for ibuprofen was negative, whereas for acetaminophen it was positive. We report a rare case of FDE due to acetaminophen with clinical findings and results of oral challenge test.
Abdomen ; Acetaminophen* ; Barbiturates ; Child* ; Common Cold ; Drug Eruptions* ; Extremities ; Female ; Humans ; Hyperpigmentation ; Ibuprofen ; Mucocutaneous Lymph Node Syndrome ; Phenolphthalein ; Tetracyclines

OBJECTIVETo observe the efficacy and the influence on quality of life (QOL) of syndrome differentiation treatment with Chinese medicine (CM) for opioid-induced constipation as well as the safety and influence on analgesic effect of opioids.

METHODSTotally 406 cases enrolled from 53 collaborating medical centers were randomly assigned to a CM group and a control group. The CM group were treated with CM decoction based on syndrome differentiation, and the control group were treated with Phenolphthalein Tablet. Both groups were treated for 14 days. Cleveland constipation score (CCS), numerical rating scale (NRS) of pain and Chinese version of European Organisation for Research and Treatment of Cancer, Quality of Life Questionnaire-C30 V3.0 (EORTC QLQ-C30 V3.0) were used to evaluate the efficacy, pain controlled and QOL status.

RESULTSThe comparisons of CCS score reduction and QOL between the two groups after treatment suggested that the improvements of constipation and QOL in the CM group were better than that in the control group (P<0.05). The total efficiency of the CM group was better than the control group (93.5% vs. 86.4%, P<0.05). There was no significant difference in NRS scores between before and after treatment in both groups. There was no serious drug-related adverse event during the course of study.

CONCLUSIONCM decoction could effectively treat opioid-induced constipation and improve patients' QOL at the same time. It is safe and doesn't affect the analgesic effect of opioids when treating constipation.

Aged ; Analgesics, Opioid ; administration & dosage ; adverse effects ; Constipation ; chemically induced ; drug therapy ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoplasms ; complications ; Pain, Intractable ; drug therapy ; Phenolphthalein ; administration & dosage ; Quality of Life ; Treatment Outcome