Furosemide
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Fixed drug eruption: case report A 40-year-old man developed fixed drug eruption (FDE) during treatment with furosemide for pedal oedema. The man, who had three days history of breathlessness and swelling of lower limbs, and a two days history of decrease urine output and facial puffiness, was admitted to a hospital. His social history was significant for alcohol use, but it was discontinued three months prior. At current hospitalisation, his investigations were significant for acute renal failure and acute liver disease. Treatment with IV furosemide 40mg injection twice a day was initiated for pedal oedema. He also received concurrent treatment with dexamethasone, ursodeoxycholic acid, spironolactone, pantoprazole, lactulose, ondansetron, norepinephrine in sodiumchloride. On day 2 of hospitalisation, his examination revealed hyperpigmentation on his trunks, over the upper and lower lips with an angled mouth and buccal mucosa erosion. Additionally, hyperpigmentation was also observed over the right hand, umbilical region and right foot. Initially, an fixed drug eruption secondary to furosemide was suspected. The causality assessment scale including Naranjo’s Scale, WHO-UMC Scale and Karsch and Lasagna Scale for adverse reaction was probable and modified Hardwig and Seigel Scale showed Moderate severity with Level 4a. He was diagnosed with extensive fixed drug eruption secondary to furosemide. Hence, the man’s treatment with furosemide was switched to spironolactone and the frequency of dexamethasone was increased. Thereafter, his symptoms improved gradually and within seven days it resolved. He was discharged with the following medications: esomeprazole, ursodeoxycholic acid, lactulose, cetirizine, mupirocin and steroid with tapered dose. He was also advised to avoid furosemide in the future. Luhar MB, et al. Extensive fixed drug eruption due to furosemide: A case report. International Journal of Pharmaceutical Research 12 (Suppl.): 460-463, Jul 2020. Available 803500272 from: URL: http://doi.org/10.31838/ijpr/2020.SP1.062
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Reactions 12 Sep 2020 No. 1821
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