Fixed drug eruption induced by trimethoprim-sulfamethoxazole: Evidence for a link to HLA-A30 B13 Cw6 haplotype

• Published in: Journal of the American Academy of Dermatology Vol. 45; no. 5; pp. 712 - 717
• Main Authors: Özkaya-Bayazit, Esen, Akar, Uğur
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Elsevier Inc 01-11-2001; Elsevier
• Subjects: Adolescent; Adult; Aged; Anti-Infective Agents - adverse effects; Anti-Infective Agents - immunology; Biological and medical sciences; Child; Child, Preschool; Drug Eruptions - immunology; Drug toxicity and drugs side effects treatment; Female; Haplotypes; Histocompatibility Testing; HLA-A Antigens - analysis; HLA-A Antigens - biosynthesis; Humans; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Toxicity: skin, dermoskeleton; Trimethoprim, Sulfamethoxazole Drug Combination - adverse effects; Trimethoprim, Sulfamethoxazole Drug Combination - immunology; Human; Sulfanilamide derivatives; HLA-System; Skin disease; Drug combination; Sulfonamide; Toxicity; Fixed drug eruption; Trimethoprim; Sulfamethoxazole; Antiinfectious; Skin; Haplotype
• ISSN: 0190-9622; 1097-6787
• DOI: 10.1067/mjd.2001.117854

Background: Recent reports indicated a significant association between fixed drug eruption (FDE) and HLA class I antigens. A strong correlation was found between B22 antigen and feprazone-induced FDE. Objective: Our aim was to investigate the association between HLA class I antigens and FDE in Turkey, a country where feprazone is not on the market and trimethoprim-sulfamethoxazole is most often the offending drug. Methods: HLA class I typing was performed by lymphocytotoxicity assay in 67 unrelated patients with FDE, all established by oral provocation. The frequencies are compared with those of 2378 control subjects. Results: Significantly higher (P < .001) frequencies of the A30 antigen and A30 B13 Cw6 haplotype were found in 42 patients with FDE induced by trimethoprim-sulfamethoxazole. HLA-B55 (split of B22) was present exclusively in trimethoprim-sulfamethoxazole-induced FDE, and in higher frequency than in control subjects. Conclusion: To our knowledge, ours is the first report indicating a link between A30 B13 Cw6 haplotype and trimethoprim-sulfamethoxazole-induced FDE. In addition, HLA-B22 was increased in patients with FDE caused by a drug other than feprazone. (J Am Acad Dermatol 2001;45:712-7.)