Fixed Drug Eruption Following Concurrent Ciprofloxacin and Metronidazole Therapy: A Dermoscopy-Assisted Diagnosis - PubMed
7 hours ago
- #Dermoscopy diagnosis
- #Antibiotic adverse reaction
- #Fixed drug eruption
- A 39-year-old male developed symmetric erythematous-violaceous macules in bilateral axillary, inguinal, and popliteal regions within 48 hours of starting concurrent ciprofloxacin and metronidazole for acute infectious diarrhea.
- Physical examination showed six well-demarcated, tender, pruritic macules without mucosal or systemic involvement. Dermoscopy revealed a homogeneous violaceous background with fine pigment granularity.
- Skin biopsy and definitive drug causality testing were not performed due to resource limitations. Both antibiotics were discontinued, and treatment included systemic corticosteroids, oral antihistamines, and topical therapy.
- Symptomatic improvement was achieved with emergency treatment, with near-complete resolution of erythema by day nine and residual post-inflammatory hyperpigmentation.
- The case highlights diagnostic challenges when multiple potential culprits are given simultaneously and confirmatory testing is unavailable, emphasizing the value of dermoscopy as a non-invasive tool in resource-limited settings.