[Secondary dermatologic effects of serotonin reuptake inhibitor antidepressants: hypothesis of cross-reacting allergy. Apropos of 2 cases].

Toxidermia is a well-known complication of antidepressant therapy. The authors report two cases of adverse cutaneous reactions after treatment by several serotonin uptake blockers. The first case concerns a 38-year-old woman, who suffered from depressive disorder. She has been treated with fluoxetine. After eight days, a cutaneous reaction appeared. This reaction subsided when fluoxetine was stopped. Two months later, she had a prescription of paroxetine, and the same skin adverse effect appeared. The cutaneous lesion decreased with the suppression of paroxetine. The chronology of the eruption suggests that it was caused by an adverse reaction to the both serotonin uptake blockers. The second case concerns a 40-year-old man who had several prescriptions of antidepressant treatment in a period of one year: fluoxetine, fluvoxamine, paroxetine and sertraline. Each time a cutaneous reaction appeared. It is advisable to substitute after an adverse effect a medication from one of the other classes of antidepressants. But what we saw in these cases is that the serotonin uptake blockers could be involved in the same allergic reaction while these drugs have different chemistry structures. Only three of them have the same excipient. These cases ask the question of cross-reactivity between the serotonin uptake blockers.