A Study on Genital Fixed Drug Eruption
in a Tertiary Care Hospital
700-702
Correspondence
Dr. Sanjay Kumar Kanodia
C-90, Sethi Colony, Jaipur-302004
Phone numbers-09928977411
Facsimile numbers 01412607053
E-mail: drskin2@gmail.com
Background: Genital fixed drug eruption (FDE) present as single oval lesion, most commonly over glans penis and are many times wrongly diagnosed and treated as sexually transmitted diseases.
Objectives: The aim of this study was to present a series of cases of genital lesions with fixed drug eruptions, diagnose the suspected drug and identify the change in pattern of drugs causing them.
Methods and Material: Patients with the genital FDE were interviewed for onset and duration the disease with history of all drugs taken and a list of suspected drugs was made for each patient. Rechallenge test (oral provocation test) was done for the suspected drug with a quarter of a single therapeutic dose, followed if necessary, by a step-wise increase to one half, one full and double of a dose for subsequent days. A definiteerythema at or around the existing lesion was considered as positive provocation test.
Results: Thirty eight cases (35 males and 3 females) were enrolled in the study with clinical diagnosis of FDE. The lesions were most commonly present on the glans penis (68.42%) as hyperpigmented macule (47.36%) accompanied with pruritus (71.05%), burning (55.26%) and pain sensation (28.94%). Oral rechallenge test showed positive result in 29 cases with nimesulide (35.29%) as the most common offending drug followed by fluconazole (25.52%) and tetracycline (14.70%).
Conclusion: The study emphasizes the changing trend of genital FDE and the importance of oral provocation test for diagnosing genital fixed drug eruptions. The findings in this study is in contrast to the previous studies which showed antimicrobials (tetracyclines) as the commonest cause of genital FDE’s.