Piroxicam‐induced fixed drug eruption: cross‐reactivity to meloxicam

Background

Non‐steroidal anti‐inflammatory drugs are a main cause of fixed drug eruption (FDE). A few cases of piroxicam‐induced FDE have been reported, however, the cross‐reactivity among oxicams has been rarely evaluated.

Objectives

To describe a series of patients with piroxicam‐induced FDE mostly confirmed by a positive patch test in whom cross‐reactivity to meloxicam has been assessed.

Methods

We included all cases of piroxicam‐induced FDE, diagnosed in the department of pharmacovigilance of Monastir. Patch tests for piroxicam and meloxicam were performed in the involved skin according to the ENDA recommendations. Oral provocation test (OPT) was performed for patients with negative skin tests.

Results

Seven patients were included in this study. FDE was multiple for five patients and solitary for two. Bullous eruption was noticed in two cases. Lesional patch tests for piroxicam were positive in six patients. To assess cross‐reactivity to meloxicam, this was patch tested. The test was positive in only one patient. An OPT with meloxicam was positive in two patients with negative patch test.

Conclusion

Meloxicam is not a safe alternative in piroxicam‐induced FDE, and OPT can confirm tolerance before prescribing this drug as a safer alternative.

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