Fixed drug eruption due to fluoroquinolone group of drug ciprofloxacin – A case scenario and review of literature
Ciprofloxacin is a broad spectrum quinolone antibiotic which is used for treating a wide variety of infections. It inhibits cell division by inhibiting DNA gyrase and topoisomerase IV enzymes. The most common adverse reactions are mild nausea, vomiting and/or abdominal discomfort in 3% to 17% of patients, mild headache and dizziness in 0.9% to 11% of patients. Rashes including photosensitivity can also occur. We report a case of 62 years old male, admitted in the hospital with the history of itching, redness and raised multiple dark skin lesion over the chest, back and oral cavity, bilateral palms and upper limbs since 2 days. On examination, multiple well- defined hyperpigmented patches with peripheral erythema seen over chest, abdomen, and back. Hyperpigmentation of lips along with the erosion of buccal mucosa and angle of mouth; erythematous plaque and exfoliation were seen in the scrotal region. Palms and scalp were spared. The patient was then treated successfully with antihistamines and steroids. The Naranjo and WHO-Uppsala monitoring center scale showed as a “probable” adverse drug reaction. “Level 4b” severity was assessed using Modified Hartwig and Seigel severity assessment scale. The steroid was tapered and the patient was discharged with advice to avoid using ciprofloxacin (fluoroquinolones) group of drugs in future.
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