Fixed drug eruption by fluconazole: A case report

Abstract

A common kind of cutaneous adverse medication reaction is fixed drug eruption (FDE). There are many groups of drugs that are notorious culprits. Fluconazole is a very commonly prescribed anti-fungal agent in dermatology outpatient departments, and up till now, less than 30 cases have been reported where Fluconazole was an established causative agent of the FDE. We report a case of FDE caused by Fluconazole which had not ever been established in our dermatology outpatient department prior to this, with an influx of about 1000 patients every day. The lack of clinical suspicion of the association of FDE with fluconazole might be the reason for under diagnosis. A follow-up patient of SLE presented to us with oral candidiasis for which she was prescribed oral fluconazole. A week later, she came back to the OPD with complaints of FDE-like lesions involving her truck and proximal extremities associated with burning pain. She admitted to having experienced such episodes twice before this time, but they were of much less severity and subsided on their own within a few days. The intermitted nature of the flares upon drug intake and the morphology of her skin lesions rose our clinical suspicion of FDE. While dealing with cases of FDE, dermatologists should keep in their mind to identify causes other than the well-established and notorious culprits. This will help in making the correct association and diagnosis and will be beneficial to avoid more severe flares subsequently.