A case of fixed drug eruption due to doxycycline and erythromycin present in food.

Case Report  Open Access

Allergy Asthma Immunol Res. 2013 Sep;5(5):337-339. English. Published online 2013 May 07.  http://dx.doi.org/10.4168/aair.2013.5.5.337  Copyright © 2013 The Korean Academy of Asthma, Allergy and Clinical Immunology • The Korean Academy of Pediatric Allergy and Respiratory Disease Won-Suk Lim,1 Do-Hun Kim,1 Sang-Yun Jin,1 Yun-Seok Choi,1 Seung-Ho Lee,1 Hee-Jin Huh,2 Seok-Lae Chae,2 and Ai-Young Lee1 1Department of Dermatology, Dongguk University Ilsan Hospital, College of Medicine, Dongguk University, Goyang, Korea. 2Department of Laboratory Medicine, Dongguk University Ilsan Hospital, College of Medicine, Dongguk University, Goyang, Korea.  Correspondence to: Ai-Young Lee, MD, PhD, Department of Dermatology, Dongguk University Ilsan Hospital, 27 Dongkuk-ro, Ilsandong-gu, Goyang 410-773, Korea. Tel: +82-31-961-7240; Fax: +82-31-961-7258; Email: lay5604@naver.com  Received August 21, 2012; Revised December 21, 2012; Accepted December 26, 2012. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract A fixed drug eruption (FDE) is not difficult to diagnose, given its clinical characteristics. However, the causative agent can be difficult to identify, particularly when the patient denies ingestion of any drugs. To the best of our knowledge, we present herein the first reported case of an FDE caused by antibiotics taken in food; doxycycline and erythromycin contained in pork and fish. A 57-year-old female experienced repeated episodes of well-demarcated erythematous patches covering her entire body. She denied taking any medications, but she thought that the lesions appeared after consuming pork and/or fish. An oral provocation test showed positive results for doxycycline and erythromycin, commonly used antibiotics in live-stock farming and in the fishing industry. Because of the antibiotics' thermostability, cooking does not guarantee the elimination of residual drugs. From the patient's history, we concluded that doxycycline and erythromycin contained in the pork and fish that she ate were the cause of the FDE. Keywords: Fixed drug eruption, doxycycline, erythromycin, residual antibiotics, food. Formats: Abstract Article PubReader PDF Figures + Tables References