Ann Dermatol.  2011 Dec;23(Suppl 3):S329-S332. 10.5021/ad.2011.23.S3.S329.

Fexofenadine-Induced Urticaria

• Lee SW
• Byun JY
• Choi YW
• Myung KB
• Choi HY

• KMID: 2171864
• DOI: http://doi.org/10.5021/ad.2011.23.S3.S329

Abstract

Fexofenadine (Allegra(R) 180) is a second-generation antihistamine. It is widely used as anti-allergic drug, which suppresses various allergic reactions mediated by histamines. A few cases of H1-antihistamine-induced urticaria have been reported. Herein, we report a rare case of fexofenadine-induced urticaria which was confirmed by a prick test, oral provocation test, and flow cytometry assisted-basophil activation test.

Keyword

Basophil degranulation test; Drug eruotion/etiology; Fexofenadine; Histamine H1 antagonist/adverse effects

MeSH Terms

Basophil Degranulation Test
Flow Cytometry
Hypersensitivity
Terfenadine
Urticaria
Terfenadine

Figure

• 

  Fig. 1 (A) A prick test was done on the forearm with saline as a negative control, and 0.01%, 0.05%, 0.1% fexofenadine. (B) Fifteen minutes later, a wheal developed at the 0.1% fexofenadine-provoked area.

• 

  Fig. 2 (A) Urticarial eruptions with itching sensation developed about 1 hour after provocation with a 180 mg dose of fexofenadine. (B) Close-up view.

• 

  Fig. 3 In the flow cytometry-assisted basophil activation test, 4.57% and 22.77% of basophils were activated in negative and positive controls, respectively (A, B). When a challenge with fexofenadine at 2.5 mg and 1.25 mg was done, 44.73% and 10.58% of basophils were activated, respectively (C, D). UL: upper left, UR: upper right, LL: lower left, LR: lower right.

Reference

1. Lew BL, Haw CR, Lee MH. Cutaneous drug eruption from cetirizine and hydroxyzine. J Am Acad Dermatol. 2004. 50:953–956.

2. Stingeni L, Caraffini S, Agostinelli D, Ricci F, Lisi P. Maculopapular and urticarial eruption from cetirizine. Contact Dermatitis. 1997. 37:249–250.

3. Epstein E. Dermatitis due to antihistaminic agents. J Invest Dermatol. 1949. 12:151.

4. Barranco P, López-Serrano MC, Moreno-Ancillo A. Anaphylactic reaction due to diphenhydramine. Allergy. 1998. 53:814.

5. Karamfilov T, Wilmer A, Hipler UC, Wollina U. Cetirizine-induced urticarial reaction. Br J Dermatol. 1999. 140:979–980.

6. Demoly P, Messaad D, Benahmed S, Sahla H, Bousquet J. Hypersensitivity to H1-antihistamines. Allergy. 2000. 55:679–680.

7. Calista D, Schianchi S, Morri M. Urticaria induced by cetirizine. Br J Dermatol. 2001. 144:196.

8. Tella R, Gaig P, Bartra J, Garcia-Ortega P. Urticaria to cetirizine. J Investig Allergol Clin Immunol. 2002. 12:136–137.

9. Schröter S, Damveld B, Marsch WC. Urticarial intolerance reaction to cetirizine. Clin Exp Dermatol. 2002. 27:185–187.

10. Kränke B, Mayr-Kanhäuser S. Urticarial reaction to the antihistamine levocetirizine dihydrochloride. Dermatology. 2005. 210:246–247.

11. González de Olano D, Roán Roán J, de la Hoz Caballer B, Cuevas Agustín M, Hinojosa Macías M. Urticaria induced by antihistamines. J Investig Allergol Clin Immunol. 2006. 16:144–146.

12. Inomata N, Tatewaki S, Ikezawa Z. Multiple H1-antihistamine-induced urticaria. J Dermatol. 2009. 36:224–227.

13. Rodríguez del Río P, González-Gutiérrez ML, Sánchez-López J, Nuñez-Acevedo B, Bartolomé Alvarez JM, Martínez-Cócera C. Urticaria caused by antihistamines: report of 5 cases. J Investig Allergol Clin Immunol. 2009. 19:317–320.

14. Markham A, Wagstaff AJ. Fexofenadine. Drugs. 1998. 55:269–274.

15. Boumiza R, Debard AL, Monneret G. The basophil activation test by flow cytometry: recent developments in clinical studies, standardization and emerging perspectives. Clin Mol Allergy. 2005. 3:9.