Multiple drug hypersensitivity associated with severe cutaneous adverse reaction
© Lin Choo et al; licensee BioMed Central Ltd. 2014
Published: 18 July 2014
Multiple Drug Hypersensitivity (MDH) was first described by Sullivan et al in 1989 as drug allergies to two or more chemically different drugs proven by in-vivo or in-vitro testing. Pichler et al added to this description by suggesting that there are two subtypes of MDH: one where sensitisation to different drug classes may occur simultaneously; the other, sequentially - sometimes even years apart.
We describe three patients matching the description of MDH.
We described three patients, aged 47, 68 and 75 with a history of severe cutaneous adverse reaction (SCAR) to non-antibiotic medication (two of the cases were to allopurinol and the other was to omeprazole). All three later developed an exanthem ( 4 to 37 months later) to penicillin-based antibiotics that they were exposed to during the period of 5 to 20 days of their initial SCAR. 1 patient had a positive patch test to the antibiotic.
Our findings support the hypothesis that concomitant sensitisation to medication(s) given at or around the time of a previous severe cutaneous drug reaction results in multiple drug hypersensitivity syndrome. New or unnecessary medication should be avoided in the initial period following SCAR.
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