Case report: Severe non-pigmenting fixed drug eruption showing general symptoms caused by chondroitin sulfate sodium

Haruhiko Otsuka; Takeshi Fukumoto; Masahiro Oka; Chikako Nishigori

doi:10.3389/fmed.2022.1041492

Case report: Severe non-pigmenting fixed drug eruption showing general symptoms caused by chondroitin sulfate sodium

Front Med (Lausanne). 2022 Oct 28:9:1041492. doi: 10.3389/fmed.2022.1041492. eCollection 2022.

Authors

Haruhiko Otsuka¹, Takeshi Fukumoto¹, Masahiro Oka², Chikako Nishigori¹

Affiliations

¹ Division of Dermatology, Department of Internal Related, Kobe University Graduate School of Medicine, Kobe, Japan.
² Department of Dermatology, Kita-Harima Medical Center, Ono, Japan.

Abstract

Non-pigmenting fixed drug eruption (NPFDE) is a subtype of fixed drug eruption (FDE) in which repeated eruptions occur at the same site. Clinically, NPFDE disappears without pigmentation changes; however, it sometimes causes fever or arthralgia. Its histopathological characteristics reportedly include infiltrations of CD8-positive T cells with a paucity of melanocytes as compared to FDE. We present the first case of severe NPFDE exhibiting general symptoms caused by chondroitin sulfate sodium. The patient was a 44-year-old man. Intravenous injection of chondroitin sulfate sodium caused erythema in the affected area. A histopathological examination of the biopsy tissue revealed infiltration of CD3-positive lymphocytes (both CD4-positive and CD8-positive lymphocytes) into the epidermis, minimal liquefaction degeneration in the basal layer of the epidermis, and few dermal melanophages, which may be responsible for non-pigmentation.

Keywords: chondroitin sulfate sodium; general symptoms; histopathological examination; melanophages; non-pigmenting fixed drug eruption.

Publication types

Case Reports