RECURRENT FIXED DRUG ERUPTION INDUCED BY OFLOXACIN?ORNIDAZOLE COMBINATION: A CASE REPORT AND LITERATURE REVIEW

Dr. Syed Bilal Yahya, Dr. Saba Afreen and Dr. Azher Sharif

ABSTRACT

Fixed drug eruption (FDE) is a distinctive variant of cutaneous adverse drug reaction marked by the dramatic re-appearance of well-demarcated erythematous or violaceous plaques in precisely the same location whenever the patient is re-exposed to the culprit drug. Although classic triggers include sulfonamides, tetracyclines and non-steroidal anti-inflammatory drugs, recent pharmacovigilance data highlight an increasing contribution from broad-spectrum antimicrobial fixed-dose combinations (FDCs). Here we describe a 36-year-old man who, within 24 hours of ingesting this FDC, developed multiple sharply circumscribed hyper pigmented macules in his penile region, the identical sites affected during an episode one year earlier after taking the same tablet. No systemic involvement or mucosal lesions were noted. Withholding the drug led to gradual resolution, leaving residual slate-grey pigmentation characteristic of FDE. This case reinforces the importance of meticulous drug histories, rational prescribing and patient education. Recognizing FDE early not only prevents needless investigations but also averts potentially more extensive reactions on future exposure particularly relevant given the widespread, often unsupervised use of antimicrobial FDCs.

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