Dermatitis medicamentosa apparently due to tetracycline

Abstract

A 35-year-old nonatopic woman was treated with penicillin, streptomycin, and Achromycin for otitis media. One year later she was given two capsules of Achromycin, 250 mg. each, for a short febrile illness. On the same day the patient developed an intense itching, an extensive rash, and fever. These progressed in spite of antihistaminies and within one week formed maculopapular single and confluent lesions covering the entire skin, involving the mucous membrane of the mouth and tongue, and associated with marked pain in the large joints. She responded well to intravenous ACTH. An allergy work-up performed one year later revealed a negative collateral and direct passive transfer to Achromycin. Because of the risks involved, no testing with Achromycin was done on the patient directly. Nevertheless, on the basis of the history and the course of the disease, it is considered likely that the patient's dermatitis was an allergic reaction to tetracycline.