Prozac Induced Urticaria

[Zenman1]

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Saw a patient who was started on Prozac 20 mg 3 weeks prior to developing what he says was Like 3 mosquito bumps" on left upper arm when then progressed down his arm and in 12 hrs he was covered in hives. He could not remember doing anything differently that might cause the reaction. I thought drug induced reactions would just appear all over vs the progression he describes.

 

[DermViser]

Saw a patient who was started on Prozac 20 mg 3 weeks prior to developing what he says was Like 3 mosquito bumps" on left upper arm when then progressed down his arm and in 12 hrs he was covered in hives. He could not remember doing anything differently that might cause the reaction. I thought drug induced reactions would just appear all over vs the progression he describes.

In reading this thread title, I seriously thought it was going to be a patient asking for medical advice. 😆

 

[Zenman1]

In reading this thread title, I seriously thought it was going to be a patient asking for medical advice. 😆

Nope. I'm just disagreeing with the guy's primary care provider as I don't think it's due to the prozac.

 

[asmallchild]

Saw a patient who was started on Prozac 20 mg 3 weeks prior to developing what he says was Like 3 mosquito bumps" on left upper arm when then progressed down his arm and in 12 hrs he was covered in hives. He could not remember doing anything differently that might cause the reaction. I thought drug induced reactions would just appear all over vs the progression he describes.

Coming close to requesting medical advice so let's be careful

Drug reactions, in particular urticarial drug reactions, don't necessarily have to appear all over at first presentation. That being said, 3 weeks is a bit of an odd timeframe for an urticarial drug eruption

 

[Zenman1]

Coming close to requesting medical advice so let's be careful

Drug reactions, in particular urticarial drug reactions, don't necessarily have to appear all over at first presentation. That being said, 3 weeks is a bit of an odd timeframe for an urticarial drug eruption

Actually mod, I didn't ask a question at all but would appreciate an "educational moment." I didn't do anything for the guy except reassure him that I didn't think Prozac was the culprit. This was important as the Prozac was working well for him. Primary care already put him on prednisone and Benadryl. He's seeing his primary psychiatrist in 3-4 days so just told him to heal up in the meantime. Thanks.

 

[asmallchild]

Actually mod, I didn't ask a question at all but would appreciate an "educational moment." I didn't do anything for the guy except reassure him that I didn't think Prozac was the culprit. This was important as the Prozac was working well for him. Primary care already put him on prednisone and Benadryl. He's seeing his primary psychiatrist in 3-4 days so just told him to heal up in the meantime. Thanks.

No worries, I would look back 24-72 hours (and probably closer to the 24 hour range) for the trigger. I agree with you that Prozac would be unlikely to cause this kind of reaction 3 weeks later.