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Aktuelle Dermatologie 2023; 49(01/02): 41-46
DOI: 10.1055/a-1553-7278
Fehler und Irrtümer in der Dermatologie

Aus den Augen, aus dem Sinn – Knacknuss-Anamnese bei disseminierten Arzneimittelexanthemen auf „vergessene“ Selbstmedikation

Out of Sight, Out of Mind – Patient History in Disseminated Drug Exanthems from “Forgotten” over the Counter Medication, a Tough Nut to Crack
Andreas J. Bircher
1   Allergologie, Universitätsspital Basel, Schweiz
2   Facoltà di scienze biomediche, Università della Svizzera italiana, Lugano, Schweiz
,
Caroline Imhof-Gex-Collet
1   Allergologie, Universitätsspital Basel, Schweiz
,
Kathrin Scherer Hofmeier
3   Allergologie, Dermatologie, Kantonsspital Aarau, Schweiz
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Zusammenfassung

Es werden zwei Patienten vorgestellt, die zur Abklärung unklarer Exantheme zugewiesen wurden, bei beiden wurde die Diagnose initial nicht gestellt. Der erste Patient hatte ein ausgeprägtes Arzneimittelexanthem, die Patientin ein generalisiertes fixes Arzneimittelexanthem. Die wegen Verdacht auf Arzneimittelallergie durchgeführte aufwändige allergologische Diagnostik fiel zunächst unergiebig aus. Bei beiden wurde initial der Auslöser anamnestisch nicht erfasst, da die Patienten die Selbsttherapie mit frei verkäuflichen Medikamenten vergessen hatten oder als nicht relevant betrachteten. Erst auf intensive Befragung konnten die Auslöser Pseudoephedrin bzw. Paracetamol eruiert und bestätigt werden. Die zentrale Rolle einer umfassenden Anamneseerhebung und Dokumentation aller eingenommenen Therapeutika wird dargestellt.

Abstract

Two patients are presented who were referred for evaluation of unclear exanthema, in both of whom the diagnosis was not initially made. The first patient had a disseminated drug exanthema, the female patient a generalized fixed drug exanthema. The extensive allergological diagnostic work-up performed because of a suspected drug allergy was first negative. In both cases, the trigger was initially not obtained in the patient’s history, because both patients had forgotten the self-therapy with over-the-counter medications or considered it irrelevant. Only after intensive questioning could the triggers pseudoephedrine and paracetamol, respectively, be identified and confirmed. The central role of a comprehensive history collection and documentation of all therapeutic agents taken is discussed.



Publication History

Article published online:
14 January 2022

© 2022. Thieme. All rights reserved.

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