Ibuprofen
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Generalised bullous fixed drug eruption: case report A 20-year-old man developed generalised bullous fixed drug eruption (GBFDE) following treatment with ibuprofen for severe toothache. The man presented with multiple painful bullous eruptions all over his body that he had been experiencing since last 5 days. Anamnesis revealed that a day prior to the appearance of skin lesions, he had received oral ibuprofen tablet for severe toothache [dosage not stated]. His medical history was significant for development of few similar bullous lesions over the trunk a year ago following ibuprofen intake, which had resolved spontaneously with hyperpigmentation. Upon current presentation, examination showed multiple discrete and coalescing bulla over his face, trunk and extremities. Erosion with crusting over his glans penis and lips was evident. Nikolsky’s sign was negative. Laboratory investigations revealed leucocytosis. Histopathological examination demonstrated necrosis of epidermal keratinocytes and perivascular mixed inflammatory infiltrates along with melanin incontinence in the upper dermis. These findings were consistent with fixed drug eruption. The man was treated with prednisolone and unspecified antihistamine. Within two weeks, all cutaneous lesions resolved with postinflammatory hyperpigmentation. According to objective causality assessment by the Naranjo probability scale, the causal relationship between ibuprofen and skin eruption was found to be "probable" (Naranjo score=7). As per the WHO-Uppsala Monitoring Centre criteria, the causal relationship between ibuprofen and skin eruption was evaluated as "probable/likely". Based on the clinical features, histopathology and temporal association with the drug, he was diagnosed with GBFDE secondary to ibuprofen. Bhanja DB, et al. Ibuprofen-induced generalised bullous fixed drug eruption. Postgraduate Medical Journal 96: 706-707, No. 1141, Nov 2020. Available from: URL: http:// doi.org/10.1136/postgradmedj-2020-137486 803519033
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Reactions 5 Dec 2020 No. 1833
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