Fixed drug eruption in Nigeria

Abstract

Fixed drug eruption (FDE) causes cosmetic embarrassment in Nigerian patients, particularly when the characteristic hyperpigmented patches affect the face and lips. Drugs that have been implicated in the etiology of FDE, and the sites of lesions, may vary from country to country. Antimalarials, such as Fansidar, Fancimef, Maloxine, Amalar, and Metakelfin, were the most common offending agents, accounting for 38% of FDEs, followed by trimethoprim + sulfamethoxazole (co-trimoxazole) (28%), dipyrones (10%), Butazolidin (6%), thiacetazone (6%), metronidazole (4%), paracetamol (3%), and naproxen (3%). Lesions induced by the combination of sulfadoxine and pyrimethamine (in antimalarials) mainly involved the face and lips. In most cases, patients took these sulfa-containing antimalarials in combination with numerous other drugs, particularly analgesics. Unlike chloroquine-induced pruritus, which affects most Africans, the association between antimalarials and FDE has not been well documented in our region. Co-trimoxazole was associated more often than antimalarials with FDEs involving the mucocutaneous junctions of the genitalia and lips. Males with genital lesions on the glans penis represented 11 (48%) of those with co-trimoxazole hypersensitivity. The trunk and limbs were affected mainly by pyrazoles and Butazolidin, respectively; however, solitary lesions on the trunk were usually due to co-trimoxazole, whereas solitary lesions on the limbs were associated with Butazolidin.

An update of fixed drug eruptions in Singapore

“…This finding may be related to genital lesions being less apparent in female patients or under‐reporting due to embarrassment. Etoricoxib was the most frequent cause of genital FDE in our study (five patients), a finding which differs from previous reports in which co‐trimoxazole was most often implicated …”

“…The clinical findings of FDE in our study were consistent with the findings of other authors in terms of gender distribution and age of presentation . Our patients presented more frequently with multiple (79.0%) than single (21.0%) lesions, a finding which is similar to previous reports .…”

Clinical Features of Fixed Drug Eruption at a Tertiary Hospital in Korea

“…As well as the distribution of lesions, some studies reported an association between multiplicity and specific drugs. Tetracycline, trimethoprim-sulfamethoxazole, and butazolidine were reported to be linked with single solitary lesions,11,12 and ibuprofen, trimethoprim-sulfamethoxazole, theophylline, and atenolol, were reported to be linked to multiple lesions 7. These correlations were not observed in this study.…”

Hyperpigmented mycosis fungoides: An unusual variant of cutaneous T-cell lymphoma with a frequent CD8+ phenotype

“…22 Moreover, several common dermatoses, such as drug eruption and contact dermatitis, may hyperpigmented lesions. [23][24][25][26] Hyperpigmented skin lesions, especially PIH, are very common in individuals with dark skin, 27 and the diagnosis is usually made on the basis of history and physical examination. Three of our patients were initially diagnosed with PIH by the clinical and histopathological findings, and only later in the course of the disease were biopsies performed which confirmed MF.…”