Bucillamine-induced toxic epidermal necrolysis and fixed drug eruption

J Dermatol. 2005 May;32(5):397-401. doi: 10.1111/j.1346-8138.2005.tb00914.x.

Abstract

We report two cases of bucillamine-induced bullous reactions with keratinocyte necrosis. The first patient, a 27-year-old woman, developed toxic epidermal necrolysis (TEN) over her whole body after taking bucillamine 300 mg/day for seven days. The second patient, a 63-year-old woman, developed several bullous erythemas on the mucous membranes and legs after taking bucillamine for more than two years. The fixed drug eruptions were diagnosed based on a provocation test in addition to clinical and histopathologic findings. These cases highlight the importance of considering fixed drug eruption as well as TEN in the differential diagnosis of bucillamine-induced bullous drug eruption.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Arthritis, Rheumatoid / diagnosis
  • Arthritis, Rheumatoid / drug therapy
  • Biopsy, Needle
  • Cysteine / adverse effects
  • Cysteine / analogs & derivatives*
  • Cysteine / therapeutic use
  • Drug Eruptions / etiology*
  • Drug Eruptions / pathology
  • Female
  • Follow-Up Studies
  • Humans
  • Immunohistochemistry
  • Long-Term Care
  • Middle Aged
  • Risk Assessment
  • Severity of Illness Index
  • Stevens-Johnson Syndrome / etiology*
  • Stevens-Johnson Syndrome / pathology*

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Cysteine
  • bucillamine