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皮肤溃疡作为一名老年患者短期使用非那吡啶的并发症:一例报告。

Skin ulcers as a complication of short-term use of phenazopyridine in an old man: A case report.

机构信息

Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.

Department of Infectious Disease, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

出版信息

J Infect Chemother. 2022 Dec;28(12):1654-1657. doi: 10.1016/j.jiac.2022.08.005. Epub 2022 Aug 10.

Abstract

INTRODUCTION

Phenazopyridine is an azo dye, which exerts local anesthetic or analgesic action on urinary tract mucosa through an unknown mechanism. Besides its common complications including orange discoloration of the urine and gastrointestinal problems, it may have rare side effects like hemolytic anaemia, methemoglobinemia, renal failure, and skin changes. We reported a paraplegic man with skin ulcers on scretom and right foot after about 3 days of phenazopyridine use CASE REPORT: A 62-year-old man presented with flesh shaped deep ulcers in lower parts of the body. He declared that at first a bluish discoloration was developed in the lower extremities and scrotum skin after use of eight phenazopyridine tablets (200 mg) and then these lesions turned to blisters and ulcers and they were prurient. The patient underwent sonography and CT-angiography; however, no pathologic findings were found. He just received losartan for many years as past drug history. According to the history, a delayed drug hypersensitivity reaction was suspected and the patient wounds healed after using special type of dressings and antibiotic therapy regarding positive wound cultures.

CONCLUSION

Phenazopyridine severe skin changes are hardly reported. We described a case who experienced severe skin reactions and ulcers following phenazopyridine use not related to other complications including renal dysfunction, methemoglobinemia, and hemolytic anemia.

摘要

简介

匹那吡啶是一种偶氮染料,通过未知机制对尿路黏膜发挥局部麻醉或镇痛作用。除了常见的并发症,如尿液呈橙色变色和胃肠道问题外,它还可能有罕见的副作用,如溶血性贫血、高铁血红蛋白血症、肾衰竭和皮肤改变。我们报告了一例使用匹那吡啶约 3 天后出现皮肤溃疡和右足瘫痪的患者。

病例报告

一名 62 岁男性因身体下部和阴囊皮肤出现肉状深溃疡就诊。他说,最初使用 8 片匹那吡啶(200mg)后,下肢和阴囊皮肤出现蓝色变色,然后这些病变变成水疱和溃疡,并有瘙痒。患者接受了超声和 CT 血管造影检查,但未发现病理发现。他多年来一直服用氯沙坦,作为过去的药物史。根据病史,怀疑发生了延迟药物过敏反应,并且在对阳性伤口培养物进行特殊类型的敷料和抗生素治疗后,患者的伤口愈合。

结论

匹那吡啶严重的皮肤改变很少见报道。我们描述了一例患者在使用匹那吡啶后出现严重皮肤反应和溃疡的病例,与肾功能障碍、高铁血红蛋白血症和溶血性贫血等其他并发症无关。

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