Fixed Drug Eruptions Secondary to Fixed Drug Combination (ofloxacin/ornidazole): A Cross Sensitivity Case Report

2021 ◽  
Vol 16 ◽  
Author(s):  
Raushan Kumar Chaudhary ◽  
Anjali R Metgudmath ◽  
Ramesh Bhandari ◽  
Satish S Karoli ◽  
Uday Kumar R

Background: Fixed drug eruption (FDE) is an erythematous cutaneous patch caused by certain drugs through activation of immunologic reaction in the body. The onset of FDE is 30 minutes to 8 hours and is estimated to occur upto 16-21% of all cutaneous reactions. The irrational combination of fluoroquinolones and nitroimidazole is the most prescribed drug for diarrhea in India, and the drug is found to cause FDE either individually or in combination. Cross sensitivity is the major issue associated with Fluoroquinolones and nitroimidazole. Case repor: Our case is of a 45-year-old male who developed FDE due to a combination product of ofloxacin and ornidazole with past FDE history due to a combination product of norfloxacin and tinidazole. The patient presented with erythematous patches all over the body, swollen lips, mucosal erosion over the buccal cavity, and glans penis. Discussion: The patient was successively treated after the withdrawal of the culprit drug with oral Antihistamines, corticosteroids, and other topical creams and gels, which correlates with the standard management of FDE. Conclusion: Proper prescribing knowledge, documentation of drug allergies, and educating patient about allergic reaction play vital role to prevent future drug related problems.

Author(s):  
Rohini Sharma ◽  
Sameer Abrol

Background: Various studies have found the overall incidence of cutaneous adverse drug reactions (CADR’s) in developed countries as 1-3%, while the incidence in developing countries is thought to be higher between 2 and 5%. FDEs’ share is seen to be about 15 -30% of all CADR’s as reported in various studies. Aim of the research work was to study the clinical and epidemiological features of fixed drug eruptions and to identify probable culprit drug or drugs using Naranjo ADR probability scale and to provide information to the patient regarding the drug responsible for his/her drug rash.Methods: A total of 180 patients of fixed drug eruptions were taken up for study who presented to skin OPD at a tertiary centre of North India. Diagnosis was made on the basis of history of drug intake prior to drug eruption, repetition of similar lesions on same as well as new sites on intake of same drug with improvement of skin lesions on discontinuation of the causative drug. Further on examination, skin lesions with typical morphology compatible with FDE were seen. Causality of the FDE was assessed according to the NARANJO ADR probability scale.Results: A total of 180 patients of FDE were studied. Males outnumbered the females. The most common class of drug implicated was antimicrobials seen in 115 patients followed by NSAIDS 65 patients. Regarding the clinical presentation both skin and mucosal involvement was seen. The most common skin lesions were erythematous to hyperpigmented and violaceous macules followed by bullous FDE.Conclusions: In summary, early recognition of FDE is important not only for the dermatologists but also for the clinicians of other specialties, so that the culprit drug is recognized and stopped immediately. Drug reactions are a common reason for litigation and has medicolegal pitfalls.


2012 ◽  
Vol 52 (5) ◽  
pp. 775-777 ◽  
Author(s):  
Nadia Ben Fredj ◽  
Karim Aouam ◽  
Amel Chaabane ◽  
Dorra Braham ◽  
Naceur Abderrazek Boughattas

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Hossein Kavoussi ◽  
Mansour Rezaei ◽  
Katayoun Derakhshandeh ◽  
Alireza Moradi ◽  
Ali Ebrahimi ◽  
...  

Background.Generalized fixed drug eruption is a specific variant of fixed drug eruption with multifocal lesions. Diagnosis of this drug reaction is straightforward, but occasionally recognition of the causative drug is not possible. This study was aimed at evaluating the clinical features and culprit drugs in generalized fixed drug eruptions in the west of Iran.Method.This cross-sectional study was carried out on 30 patients with criteria of generalized fixed drug eruption over 9 years. Demographic, clinical, and drug intake information were collected.Results.Out of 30 patients (17 females and 13 males) with the mean age of26.67±10.21years, 28 (93.3%) and 2 (6.7%) cases had plaque and bullous clinical presentation, respectively. Upper limbs were the most common (90%) site of involvement. The antibiotic group, especially cotrimoxazole (26.1%), was reported to be the most common offending drug, but the causative drug was not determined in 7 (23.3%) patients.Conclusion.Many cases of generalized fixed drug eruption firstly presented as limited lesions and led to generalized lesion due to repeated intake of the causative drug. No causative drug was found in some patients, which might be associated with concurrent intake of several drugs, multiple FDE, and peculiarity of the patch test.


2018 ◽  
Vol 27 (1) ◽  
pp. 29-33
Author(s):  
Md Moksedur Rahman ◽  
Md Abdullah ◽  
Moriom Nessa ◽  
Muhammad Afsar Siddique ◽  
Md Moazzem Hossain ◽  
...  

Fixed drug eruption (FDE) is a distinctive type of cutaneous drug reaction that characteristically recurs in the same site or sites each time a particular drug is taken. FDEs are among the most frequent problems encountered by the dermatologists. The present study was carried out to recognize offending drugs, to educate the patients and to avoid self-administration of drugs and re-administration of the offending drugs. The study was conducted in Skin & VD outpatient department of Rajshahi Medical College Hospital, Rajshahi over a period of one year. One hundred ten cases with established FDE were evaluated clinically. The causative drugs were identified and confirmed by provocation tests. Cotrimoxazole (25%) was the most common cause of FDE. Other drugs incriminated were NSAID (21.8%), Tetracycline (15.4%), Ciprofloxacin (10%), Amoxicillin (7.2%), Metronidazole (5.4%), Griseofulvin (2.7%) and Fluconazole (1.8%). The lesions were found to be distributed on the oro-genital mucosa, trunk and the acral regions.The main presentation of FDE was circularhyperpigmented lesion.TAJ 2014; 27(1): 29-33


2021 ◽  
Vol 2 (1) ◽  
pp. 36-38
Author(s):  
Monika Kapoor

Introduction: An immunological cutaneous adverse drug reaction is distinguished as sharply defined lesions with red rashes and sharp borders, erythematous lesions with or without blisters developing within an hour or in a few cases within a week after drug administration is termed as fixed drug eruptions (FDE). FDE is one of the major forms of drug-induced dermatosis. Various class of drugs that are causative agents for FDE includes antibiotics, anticonvulsants, antivirals, and Non-steroidal anti-inflammatory drugs (NSAID). FDE is easily recognized and differentiated from other drug eruptions since it does not occur voluntarily or during infection. Case report: This case report is to spotlight the case of a 52-year-old male patient who was undergoing treatment for acute gastroenteritis and suffered from FDE due to administration of IV Ofloxacin.


Drug Safety ◽  
2006 ◽  
Vol 29 (10) ◽  
pp. 911-1010
Author(s):  
G. Lakhoua ◽  
S. Kastalli ◽  
S. El Aidli ◽  
R. Daghfous ◽  
M. Lakhal ◽  
...  

2021 ◽  
pp. 24-26
Author(s):  
Jaydip Tank ◽  
Radha Dhudshia ◽  
Mitesh Thakkar ◽  
Bela Shah

The patterns of cutaneous eruption and the offending agent vary amongst the different population previously studied. This study aims to determine the different clinical patterns of cutaneous adverse drug reactions (CADRs) in our population and recognize the common drug implicated. A prospective observational study was conducted over a period of two years recording various CADRs. Out of the 630 patients, common reactions observed were Fixed drug eruption (25.71%), Urticaria / Angioedema (21.27%), Exanthematous rash(15.87%), Erythema multiforme(3.81%), Steven-Johnson Syndrome (4.13%) and Toxic epidermal necrolysis (2.07 %). The most common pharmacological group was Antimicrobials (37.01%), NSAIDS (16.64%), Anticonvulsants (7.61%) and Antiretroviral therapy (12.52%). Cotrimoxazole was the culprit in 11.11%, Nevirapine in 9.36%, Amoxycillin in 7.61% and Phenytoin in 5.23% of patients. 10 patients of TEN proved to be fatal. Among 15.56% HIV reactive patients, the most common pattern was exanthematous rash (45.91%) with Nevirapine(59.20%) as the most common culprit drug.


2013 ◽  
Vol 88 (4) ◽  
pp. 617-619 ◽  
Author(s):  
Milan Bjekic ◽  
Milica Markovic ◽  
Sandra Sipetic

Fixed drug eruptions (FDE) are commonly reported type of mucocutaneous drug eruption. The aim of this paper is to present a patient with multiple mucocutaneous erythema fixum type lesions caused by oral tadalafil use. A short course of topical corticosteroid therapy resulted in complete resolution of all lesions leaving residual hyperpigmentation of the involved skin sites. Mucosal oral lesions were effectively treated with gingival hyaluronic acid 0.2% gel. Conclusion: when assessing a patient of any age with drug eruptions, a thorough personal history should be obtained, in particular data on regular or recreational use of phospodiesterase type 5 inhibitors.


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