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Copyright of Revue Francaise d'Allergologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

L'érythème pigmenté fixe bulleux généralisé est une variante de l'érythème pigmenté fixe qui peut se manifester dans de rares cas. C'est une toxidermie sévère d'origine médicamenteuse nécessitant une prise en charge spécialisée. Peu de cas d'érythème pigmenté fixe bulleux généralisé imputables au vaccin grippal sont décrit dans la littérature, nous rapportons un nouveau cas d'érythème pigmenté fixe bulleux généralisé induit par le vaccin de la grippe. Il s'agit d'une patiente de 58 ans présentant un érythème pigmenté fixe bulleux survenant trois jours après la vaccination contre la grippe. La patiente ne recevait aucun traitement pouvant expliquer la symptomatologie clinique. La biopsie cutanée a montré des kératinocytes apoptotiques dans l'épiderme avec un début de clivage sous-épidermique. L'érythème pigmenté fixe est une toxidermie courante aux médicaments, caractérisée par des plaques érythémateuses arrondies, uniques ou multiples, cédant la place à des macules hyper-pigmentées cicatricielles. Elle réapparaît sur les mêmes sites cutanés ou muqueux, avec la possibilité d'apparition d'autres plaques, chaque fois que l'agent incriminé est réintroduit. Les médicaments les plus fréquemment incriminés sont les anti-inflammatoires non stéroïdiens, les antibiotiques et les antiépileptiques. L'érythème pigmenté fixe bulleux généralisé est une variante rare de l'érythème pigmenté fixe. Seuls quelques cas ont été rapportés suite à l'administration du vaccin annuel contre la grippe. Le diagnostic différentiel inclut le syndrome de Stevens-Johnson et la nécroépidermolyse toxique dans lesquels les lésions apparaissent au bout de 1 à 4 semaines après la prise du médicament et touchent presque toujours les muqueuses, avec une atteinte systémique marquée. Bien que l'érythème pigmenté fixe bulleux généralisé soit moins grave que ces syndromes, il peut s'avérer potentiellement mortel, surtout chez les sujets âgés. L'érythème pigmenté fixe bulleux généralisé est une entité rare de l'érythème pigmenté fixe, souvent confondu avec les dermatoses bulleuses et les toxidermies graves. Les médicaments incriminés sont nombreux, mais peu de cas d'érythème pigmenté fixe bulleux généralisé suivant une vaccination contre la grippe ont été rapportés. Generalized bullous fixed drug eruption is a variant of fixed drug eruption occurring in rare cases. It is a severe drug-induced eruption requiring special management. Few cases of generalized bullous fixed drug eruption occurring after the influenza vaccine have been described in the literature, we report a new case of generalized bullous fixed drug eruption occurring after the influenza vaccine. The patient is a 58-year-old female patient with generalized bullous fixed drug eruption occurring three days after the influenza shot. The patient did not receive any treatment that could potentially cause the clinical symptomatology. Skin biopsy showed apoptotic keratinocytes in the epidermis with the onset of subepidermal cleavage. Fixed drug eruption is a common drug eruption characterized by single or multiple rounded erythematous plaques giving way to scarring hyperpigmented macules. It recurs on the same cutaneous or mucosal sites, with the possibility of the appearance of other plaques, each time the incriminated agent is taken. The most commonly incriminated drugs are non-steroidal anti-inflammatory drugs, antibiotics and anti-epileptic drugs. Generalized bullous fixed drug eruption is a rare variant of fixed drug eruption, with only a few cases reported following the annual flu vaccine. The differential diagnosis includes Stevens-Johnson syndrome and toxic epidermal necrolysis in which lesions appear within 1 to 4 weeks of drug administration and almost always involve mucous membranes with marked systemic involvement. Although generalized bullous fixed drug eruption is less severe than these syndromes, it can be potentially fatal, especially in elderly subjects. Generalized bullous fixed drug eruption is a rare entity of fixed drug eruption, often confused with bullous dermatoses and severe drug eruptions such as Stevens-Johnson syndrome and toxic epidermal necrolysis. The drugs involved are numerous, but few cases of generalized bullous fixed drug eruption following the influenza vaccination have been reported. [ABSTRACT FROM AUTHOR]

Copyright of Revue Francaise d'Allergologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Stevens-Johnson syndrome and Lyell syndrome are severe bullous drug reactions that can be life-threatening. The aim of this study is to describe the epidemiological, etiological, clinical, therapeutic and evolutionary data of patients hospitalized in our Dermatology Department. This is a retrospective descriptive study over a period of 10 years. All records of patients admitted to the Dermatology Department for these cutaneous adverse drug reactions were included. A total of 30 patients were recorded, with a male predominance. There were 18 cases of Lyell syndrome, 8 cases of Stevens-Johnson syndrome and 4 cases of overlap syndrome. The mean time to onset after drug administration was 7.5 days. The average skin area detached was 48%. Visceral involvement was frequently observed: pulmonary involvement, renal involvement, hepatic cytolysis and hematological involvement. The notion of medication was found in all our patients, with self-medication in 23% of cases. The reason for prescription was dominated by post-surgical anticonvulsant prophylaxis. All our patients received symptomatic treatment, and corticosteroid therapy was administered in only one patient for macrophagic activation syndrome. The mortality rate was of 17%. Skin area involved, presence of renal failure or respiratory distress were the main prognostic factors. [ABSTRACT FROM AUTHOR]

Background: The increase in prescriptions of antiretrovirals (ARVs) implies the increasing occurrence of side effects, including skin manifestations. The objective of this work was to identify the epidemiological and therapeutic aspects of drug eruptions during ARV treatment in the support and counseling units (SCU) of commune IV of the district of Bamako. Material and methods: In a documentary study, the data of patients living with HIV (PLHIV) followed in the SCUs between January 2008 and December 2010, i.e. 3 years, in strict respect of their confidentiality were collected. Parameters of interest included epidemiological, clinical and therapeutic characteristics. Results: The frequency of drug eruptions was 2.85% of cases, ie 50 patients out of 1748 PLWHA. Women accounted for 76% of cases with a sex ratio of 0.32. The mean age was 30.8 ± 11.46 years with extremes ranging from 5 to 60 years. PLHIV were in WHO clinical stage III, or 48% of cases. The mean time to onset of drug eruption was 23.5 ± 17.7 days. Common clinical manifestations were pruritus (24%), rash (22%) and Lyell’s syndrome (12%). 96% of patients (48 cases) were on ARVs, of which 78% were on nevirapine and 14% on efavirenz. The treatment was symptomatic. Conclusion: Antiretrovirals are sources of drug eruption despite their benefits in the treatment of HIV/AIDS. Rigorous monitoring is essential to prevent these harmful effects. [ABSTRACT FROM AUTHOR]

La pustulose exanthématique aiguë généralisée (PEAG) est une toxidermie rare mais potentiellement grave. Elle est d'origine médicamenteuse dans la plupart des cas. La PEAG secondaire à l'hydroxychloroquine était rapporté dans une quarantaine de cas dans la littérature. Nous rapportons le cas d'une patiente ayant développé une PEAG suite à la prise d'hydroxychloroquine et ayant bien évolué après arrêt du traitement et mise sous corticoïdes. Acute generalized exanthematous pustulosis (PEAG) is a rare but potentially serious toxidermia. Most cases are drug-induced. PEAG secondary to hydroxychloroquine has been reported in around forty cases in the literature. We report the case of a patient who developed PEAG after taking hydroxychloroquine, which progressed well after discontinuation of treatment and initiation of corticosteroids. [ABSTRACT FROM AUTHOR]

Copyright of Revue Francaise d'Allergologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Le syndrome de Lyell est une toxidermie grave pouvant entraîner le décès. Les médicaments les plus souvent en cause, sont les antiépileptiques, les sulfamides, les anti-inflammatoires non stéroïdiens, et l'allopurinol. Les macrolides sont des antibiotiques largement utilisés mais rarement incriminés dans les toxidermies. Nous rapportons un 2e cas rare de toxidermie type syndrome de Lyell, suite à une prise d'azithromycine. L'évolution était favorable après 3 semaines, et sans séquelles après un recul de 6 mois. À travers notre observation, nous tenons à rappeler les effets secondaires potentiels de l'azithromycine, particulièrement avec son utilisation de plus en plus fréquente. Toxic epidermal necrolyis (TEN) is a severe drug reaction that can lead to death. The drugs most often involved are anti-epileptic drugs, sulfonamides, non-steroidal anti-inflammatory drugs, and allopurinol. Macrolides are widely used antibiotics but rarely implicated in skin drug reactions. We report a second rare case of TEN following azithromycin use. The evolution was favorable after 3 weeks, and without sequelae after a 6-month follow-up. Through our observation, we would like to recall the potential side effects of azithromycin, particularly with its increasingly frequent use. [ABSTRACT FROM AUTHOR]

Aim: Pfizer/BioNTech (BNT162b2) is a COVID-19 vaccine with a reassuring safety profile. The main adverse reactions are mild local reactions. Cutaneous reactions are generally minor. The most common cutaneous reaction reported was a local injection-site reaction., Case Study: Here we present 2 cases of erythema multiform (EM) following BNT162b2 vaccination with positive rechallenge. The 1 st case was about a 51-year-old woman who developed 5 days after the 1st dose of the mRNA Pfizer/BioNTech (BNT162b2) a macular, erythematous, roundshaped lesions on the hands, knees and soles. She experienced a positive rechallenge one month later. In the 2 nd case, a 55-year-old man presented 6 days following the 2 nd shot of the mRNA Pfizer/ BioNTech (BNT162b2), targetoid eruption on the upper and lower members. The patient reported that he had the same skin lesions in ankles and soles few days following the 1 st shot of the same vaccine., Conclusion: Few cases of EM following COVID-19 vaccination were reported in the literature and positive rechallenge in only one case. Rechallenge was not performed in most cases. Our two cases are particular because of the positive rechallenge in both patients. This is the gold standard to confirm that the vaccine was the culprit agent in inducing EM., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Copyright of Revue Francaise d'Allergologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

L'érythème pigmenté fixe est une toxidermie dont les causes sont médicamenteuses. L'éruption récidive sur les mêmes sites après réadministration du médicament. Nous avons observé un cas d'érythème pigmenté fixe après consommation de moringa oleifera. Dans la littérature, ce phytomédicament a été la cause d'autres types de toxidermie : un cas syndrome de Stevens Johnson et un cas d'anaphylaxie. Devant un cas d'EPF dont l'imputation a un médicament n'est pas évidente il faudrait rechercher une cause alimentaire. Pigmented fixed erythema is a toxidermia with drug-related causes. The rash recurs at the same sites after re-administration of the drug. We observed a case of pigmented fixed erythema after consumption of moringa oleifera. In the literature, this phytomedicine has been the cause of other types of toxidermia: one case of Stevens Johnson syndrome and one case of anaphylaxis. In a case of EPF whose attribution to a drug is not obvious a dietary cause should be sought. [ABSTRACT FROM AUTHOR]

Les toxidermies de l'enfant représentent 35 à 36 % des effets indésirables médicamenteux chez l'enfant [1]. Elles peuvent dans 2 % des cas, engager le pronostic vital et ou fonctionnel [2]. Le but de ce travail était de : déterminer les médicaments responsables de toxidermie chez l'enfant en milieu hospitalier à Dakar. Il s'agissait d'une étude transversale, observationnelle, descriptive, sur une période de 10 ans, portant sur les enfants ayant été vus dans les 3 centres hospitaliers universitaires dermatologiques de référence à Dakar. Nous avons colligé 116 cas, soit une fréquence hospitalière de 0,08 % sur une population de 146 000 patients. Le sex ratio était de 1,23. L'âge moyen des patients était de 7 ans. Les types de toxidermie étaient le syndrome de Stevens Johnson/Lyell dans 42,2 %, l'EPF dans 11,2 %, l'EMP dans 10,3 %, l'urticaire dans 8,6 %. Une atteinte muqueuse était retrouvée dans 50,9 %. Les complications étaient des troubles hydro-électrolytiques dans 22,4 %, une infection 7,7 % et une hypothermie dans 1,7 %. Les classes médicamenteuses incriminées étaient les antibiotiques dans 41,4 %, les antiépileptiques dans 17,2 %, les AINS et les antalgiques dans 15,5 % chacun, les antipaludéens dans 8,6 %. Les plantes traditionnelles ont été incriminées dans 7,7 % des cas. Les antibiotiques constituent les médicaments les plus incriminés dans les toxidermies en milieu hospitalier à Dakar, suivis des antiépileptiques. Le syndrome de Stevens Johnson/Lyell constitue la forme clinique la plus fréquente. Toxidermia in the paediatric population accounts for 35 to 36% of adverse drug reactions in children [1]. In 2% of cases, they can affect the vital and/or functional prognosis [2]. The aim of this work was to determine the drugs responsible of toxidermia in pediatric population in a hospital environment in Dakar. This was a cross-sectional, observational, descriptive study, over a period of 10 years, of children seen in the 3 dermatological university hospitals of reference in Dakar. We collected 116 cases, representing a hospital incidence of 0.08%. The sex ratio was 1.23. The mean age of the patients was 7 years. The types of toxidermia were Stevens Johnson/Lyell syndrome in 42.2%, EPF in 11.2%, EMP in 10.3%, urticaria in 8.6%. Mucosal involvement was found in 50.9%. Complications were hydro-electrolytic disorders in 22.4%, infection in 7.7% and hypothermia in 1.7%. The incriminated drug classes were antibiotics in 41.4%, antiepileptics in 17.2%, non steroidal anti-inflammatory drugs in 15.5%, analgesics in 15.5% and antimalarials in 8.6%. Traditional plants were incriminated in 7.7% of cases. Antibiotics and antiepileptics are the most common drugs involved in children toxidermia in Dakar. Stevens Johnson/Lyell syndrome is the most frequent clinical form. [ABSTRACT FROM AUTHOR]