Fixed drug eruption to fluconazole: a case report and review of literature

A Routine over the Counter Phenylephrine Causing Rarer Drug Eruption as Adverse Drug Reaction - A Case Report

BACKGROUND

Phenylephrine is a sympathomimetic, which means it acts analogous to adrenaline. Phenylephrine can be taken orally to treat nasal congestion symptoms. It is also frequently mixed with other medicines in products meant to relieve cough and cold symptoms. Given the widespread usage of phenylephrine, related drug eruptions appear to be uncommon.

CASE PRESENTATION

Here we discuss a case of a 19-year-old female patient who reported to our hospital with blebs on the skin throughout her legs and torso. The drug eruption or adverse drug response was linked with itching, had a slow beginning, and progressed. Her medical history indicated that she had been taking phenylephrine 10 mg orally twice a day. On the sixth day, she experienced an adverse medication response caused by the medicine phenylephrine. Phenylephrine was stopped immediately and the other medications, such as levocetirizine, montelukast, and nasal spray, were continued. The patient was told not to use phenylephrine, either alone or in combination with FDCs. There are no other complaints. As a result, the patient was diagnosed with phenylephrine- induced eruption.

CONCLUSION

We present this case to highlight the importance of inspiring a pharmacovigilance mindset among all clinicians providing care as a routine alert drug, phenylephrine-induced drug eruption.

Food Colour Additives: A Synoptical Overview on Their Chemical Properties, Applications in Food Products, and Health Side Effects

Colour is one of the most relevant organoleptic attributes that directly affects consumers' acceptance and food selection. However, as food colouring pigments are generally unstable and become modified during processing, in order to maintain or restore product colour uniformity, colourants are added to food products around the world. In this context, although they are still widely used, synthetic food colorants, due to their potential hazards, are being replaced by those obtained from natural origins. Indeed, numerous side effects and toxicities, at both the medium and long-terms-namely allergic reactions, and behavioral and neurocognitive effects-have been related to the use of synthetic colourants, whereas their naturally-derived counterparts seem to provide a somewhat high-quality and effective contribution as a health promoter. In order to further understand the implications of the use of synthetic and naturally derived food colourants, this review aims to provide a synoptical approach to the chemical characteristics, properties, uses and side effects on health of those which are currently allowed and applied during food processing.

A pediatric case report of fixed drug eruption related to carmoisine colorant present in paracetamol syrup

Various adverse drug reactions, including hypersensitivity skin reaction after the exposure to carmoisine colorant, have already been reported in the literature. This case report gives the details of a 5-year-old male child with a recurrent fixed drug eruption (FDE) over the neck and trunk after the use of paracetamol syrup containing carmoisine as a colorant. Patch test to the carmoisine colorant in the paracetamol syrup was positive. This case report adds an increased awareness of the probability of allergic skin reaction to carmoisine in a previously sensitized person. The report also emphasizes the necessity to consider artificial dyes in pharmaceutical products as a potential cause for FDE.

Cefotaxime induced generalized bullous fixed drug eruption - A case report

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Based on the characteristics of the antimicrobial spectrum of Cefotaxime, low incidence of allergy, and lack of adverse effects, Cefotaxime has been used successfully for prophylaxis of a number of infectious diseases.

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Drug reactions like FDE are very frequently seen by dermatologists in the day to day practice. FDE to Cefotaxime is not usual.

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Healthcare professionals should have a high index of suspicion should aware of the possibility of reactions to Cephalosporin.

Fixed drug eruption (FDE) is the most common cutaneous adverse drug reaction. Cefotaxime, a broad-spectrum third-generation cephalosporin, appeared to be a safe and effective therapy in greater than 90% of infections including cellulitis, abscesses and necrotizing ulcers of the skin and subcutaneous tissues but here we report a rare case of 36 years old female patient developed generalized bullous FDE after intravenous administration of Cefotaxime.

Cutaneous effects associated with fluconazole in patients treated for coccidioidomycosis

BACKGROUND

Fluconazole is the most commonly used antifungal treatment for various forms of coccidioidomycosis. Although we had anecdotally observed a high proportion of patients reporting cutaneous adverse effects associated with fluconazole treatment, this observation was not well described in the medical literature, and we were unsure of the additional effect of the arid desert environment of Arizona.

METHODS

We performed a one-time, voluntary survey of patients with coccidioidomycosis and compared the responses of patients treated with fluconazole with those of untreated patients.

RESULTS

From January 1, 2015, to August 22, 2017, 62 fluconazole-treated and 35 untreated patients with coccidioidomycosis provided consent and were enrolled in the study; demographics were similar between the two groups. Among the 62 fluconazole-treated patients, daily dosages ranged from 200 mg to 800 mg. However, most (44/62, 71%) took 400 mg daily, the typical dose for the treatment of coccidioidomycosis. The median fluconazole treatment duration at the time of study participation was 6 months. When compared with untreated patients, those taking fluconazole had more moderate to severe dry lips (74.2% [46/62] vs. 23.5% [8/34]; P < 0.001), dry skin (45.8% [27/59] vs. 22.9% [8/35]; P = 0.03), and alopecia (31.1% [19/61] vs. 11.4% [4/35]; P = 0.004).

CONCLUSIONS

For the treatment of coccidioidomycosis, patients receiving fluconazole reported significantly more severe cutaneous effects, including dry lips, dry skin, and alopecia, than untreated patients. Our findings identify an association but do not prove causality.

Cetirizine-Induced Fixed Drug Eruption

Cetirizine, a piperazine-derivative second-generation antihistaminic, is used for a wide variety of disorders such as urticaria, eczema, and allergies. Adverse reactions due to this drug are usually rare, especially fixed drug eruption (FDE), a delayed cell-mediated hypersensitivity reaction, is scarce. Here, we report a case of cetirizine-induced FDE. A 34-year-old female developed hyperpigmented, itchy patches over both forearms, legs, feet, and right side of the chest after taking tablet cetirizine for dry cough with similar episode 2 years back on the same sites. The patient responded slowly with conservative treatment and the lesions disappeared after 10 days. She was advised to avoid the causative in near future. This case report highlighted FDE due to an antihistaminic which themselves will be prescribed to treat allergies.

Doxycycline induced generalized bullous fixed drug eruption - A case report

Adverse drug reactions are a major hazard of modern medicine. Fixed drug eruption, which is a cutaneous adverse drug reaction, is commonly seen with antimicrobials and analgesics. Here we report 37-year-old female with bullous fixed drug eruptions due to doxycycline administration.