Fixed drug eruption at a dermatology clinic in Lagos, Nigeria

Abstract

Background: Fixed drug eruption (FDE) is common cutaneous drug eruption characterized by the development of one or more annular, oval, erythematous, and hyperpigmented patches as a result of systemic exposure to a drug. Drugs causing FDE vary with prevailing diseases and prescription pattern in different parts of the world. This study is aimed at reviewing cases of FDE seen at the dermatology outpatient clinic of Lagos University Teaching Hospital (LUTH) over a 9-year period, highlighting the spectrum of drugs implicated and the clinical characteristics. Materials and Methods: Data were obtained from the clinic records and patients' case notes. These included the demographic details, duration of presentation, drugs implicated, and clinical characteristics. Results: FDE was diagnosed in 1.8% (295/16,160) of patients seen. There was a slight female preponderance. Antimalarials were the commonest group of medications implicated (51.0%) followed by antibiotics (27.9%); analgesics (10.2%), herbal toothpaste (6.1%), and oral hypoglycemic agents (4.1%). Sulfonamides were the commonest group of drugs found in 78 patients (53.1%) predominantly as sulfadoxine/pyrimethamine antimalarials and trimethoprim/sulfamethoxazole antibiotics (co-trimoxazole). Conclusion: Concerted efforts are needed to discourage over-the-counter sales and purchase of nonprescription sulfonamide-based medications. A change in prescription pattern from sulfonamides to other classes of antimalarials and antibiotics is desirable and/or recommended. Patients should inform their caregivers at any point of care about their reaction to drugs. It is advised that they have a list of common implicating drugs and they wear a medic alert or carry an ID card bearing this information.

Keywords

• Adverse cutaneous eruptions
• antibiotics
• antimalarials
• sulfonamides