期刊
ANNALES DE DERMATOLOGIE ET DE VENEREOLOGIE
卷 137, 期 1, 页码 40-43出版社
MASSON EDITEUR
DOI: 10.1016/j.annder.2009.10.180
关键词
DRESS; Doxycycline; Drug eruption; Black; HLA; Patch-tests
类别
Background. - While many cases of DRESS reaction to minocycline have been described, few of these involve doxycycline. Case study. - A 59-year-old woman of African origin was repatriated after a journey to Ghana for hyperthermia with infiltrated maculopapular exanthema, facial oedema (no mucosal involvement) and polyadenopathy. Laboratory tests revealed hypereosinophilia, hepatic cytolysis and mononucleosis syndrome. Cutaneous histology was non-specific. The patient had been taking doxycycline as antimalarial prophylaxis for three weeks before the onset of symptoms. DRESS to doxycycline was diagnosed. Patch-tests with doxycycline three months later proved negative. The patient's HLA phenotype was A3/A30 and B39/B42. Discussion. - An intrinsic causal relationship with doxycycline was likely in this case (13). Although patch-test sensitivity and specificity with doxycycline remains unknown in DRESS exploration, a negative result does not necessarily rule out the diagnosis. A number of cases of DRESS to doxycycline have been described recently, possibly as a result of more frequent prescription (malarial prophylaxis, acne). Subjects of African ethnicity or having specific HLA phenotypes are at higher risk of developing drug hypersensitivity. Conclusion. - This patient is the third case of DRESS to doxycycline described in the literature. The originality of this case ties in the allergological investigation using patch-tests and HLA determination. (C) 2009 Elsevier Masson SAS. All rights reserved.
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