Paracetamol induced fi xed drug eruptions: A case report

Abstract

To report a case of fi xed drug eruption (FDE) due to paracetamol intake. FDE is cutaneous reactions in already sensitized individuals. The characteristic of FDE is recurrence at same site on repeated insults with the off ending drug. Paracetamol induced FDE is widely reported in children and adolescents but not among elderly individuals. A 62-year-old male patient had a chief complaint of burning sensation in lips and oral cavity since 3 days. History revealed intake of paracetamol. Encrusted lesions were present on the cutaneous surfaces of lips, and erythematous areas were present on the anterior third of the hard palate. Based on Naranjo's casualty assessment scale, provisional diagnosis of adverse drug reaction (ADR) was given. All drugs were stopped, but the patient had a similar episode of such lesions on the same site after 8 weeks. This establishes the diagnosis of FDE due to paracetamol ingestion. Though paracetamol is widely used and is considered a safe drug, ADR to it are possible and reported earlier. Clinical signifi cance: Reporting of FDE to dentist is uncommon. But on encountering such a situation, the dentist should be able to identify FDE and isolate the causative drug by means of history. A simple clinical assessment scale like Naranjo's casualty assessment scale can establish the presence of ADR.