Vikramjeet Singh, Angelika Batta, Nishtha Malik
Department of Pharmacology, Maulana Azad Medical College, New Delhi 110002, India.
Department of Microbiology, Government Medical College, Amritsar 110002, India.
Curr Drug Saf. 2019;14(1):72-76. doi: 10.2174/1574886313666180807095559.
Fixed drug eruption is a clinical entity occurring at the same site each time the drug is administered. They are usually found on lips, genitalia, abdomen, and legs but can occur at any location. The eruptions usually occur within hours of administration of the drug and resolves spontaneously. Most common drugs causing them include antimicrobials. Fluroquinolones especially norfloxacin is commonly used in the treatment of gastrointestinal infections. Cutaneous adverse drug reactions are very rare with norfloxacin.
In this case report, a young female, soon after taking Nofloxacin tablet, developed a blister with erythema and itching after self treatment for urinary tract infection. It got cured after stopping the drug and taking treatment from a dermatologist. It resolved as a hyper-pigmented scar. She experienced a similar episode of drug eruption on the same site when she again self medicated herself with Norfloxacin for diarrhoea. This time the reaction occurred within few hours and resolved with hyperpigmentation after medication. She was advised not to indulge in self-treatment in future. Suspecting association between the drug and the rash was confirmed and a diagnosis of Norfloxacin induced fixed drug eruption was made.
Causality assessment by Naranjo's algorithm revealed a definite relationship between the cutaneous adverse drug reaction and the offending drug.
固定性药疹是一种临床病症，每次用药时均在同一部位出现。通常见于唇部、生殖器、腹部和腿部，但也可能发生在任何部位。皮疹通常在用药数小时内出现，并可自行消退。引起固定性药疹的最常见药物包括抗菌药物。氟喹诺酮类药物尤其是诺氟沙星常用于治疗胃肠道感染。诺氟沙星引起的皮肤不良反应非常罕见。
在本病例报告中，一名年轻女性在自行治疗尿路感染后服用诺氟沙星片后，很快出现了一个伴有红斑和瘙痒的水疱。停药并接受皮肤科医生治疗后痊愈，留下了色素沉着过度的疤痕。当她再次自行服用诺氟沙星治疗腹泻时，在同一部位再次出现了类似的药疹发作。这次反应在数小时内发生，用药后色素沉着消退。建议她今后不要再自行治疗。怀疑药物与皮疹之间的关联得到证实，诊断为诺氟沙星引起的固定性药疹。
通过Naranjo算法进行的因果关系评估显示，皮肤不良反应与致病药物之间存在明确关系。
