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Fixed Drug Eruption Caused by Sildenafil Citrate

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Dear Editor: Fixed drug eruption (FDE) is a distinctive variant of drug-induced cutaneous reactions... Based on the patient's history, clinical findings and histological findings, we diagnosed FDE caused by sildenafil citrate... The patient was advised to avoid sildenafil citrate and successfully relieved of skin lesions through systemic and topical corticosteroids... The common adverse events of sildenafil are headache, vasodilation, rhinitis, flushing, and dizziness... Dermatitis are uncommon adverse events of sildenafil... Skin tests including prick and intradermal tests, patch test, and oral challenge test with suspected drugs may be useful in confirming the diagnosis of FDE... In the present case, there was obvious clinical correlation between sildenafil intake and typical recurrent cutaneous lesions, and the intradermal test with sildenafil produced positive results... And lesional patch test results confirmed the clinical suspicion of culprit drug, but the lack of sensitivity is a major limitation... Therefore, we did not perform a patch test and oral challenge or provocation test with sildenafil citrate... We recommend that physicians assessing a patient presenting with drug eruptions, especially healthy men, should consider a thorough personal history of lifestyle drugs including PDE5 inhibitors.

No MeSH data available.


Positive intradermal test with sildenafil at a concentration of 25 mg/ml (shown as 1:1), 2.5 mg/ml (shown as 1:10) and 1.25 mg/ml (shown as 1:20) (A) at 10 minutes and (B) 1 hour.
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Figure 2: Positive intradermal test with sildenafil at a concentration of 25 mg/ml (shown as 1:1), 2.5 mg/ml (shown as 1:10) and 1.25 mg/ml (shown as 1:20) (A) at 10 minutes and (B) 1 hour.

Mentions: An intradermal test with sildenafil citrate at concentrations of 25 mg/ml, 2.5 mg/ml and 1.25 mg/ml showed positive results at 10 minutes and 1 hour (Fig. 2). We did biopsy the lesion site on the back (Fig. 1B). The histopathological findings showed superficial perivascular lymphohistiocytic infiltrations and melanin deposits in the upper dermis, consistent with FDE (Supplementary Fig. 1). Based on the patient's history, clinical findings and histological findings, we diagnosed FDE caused by sildenafil citrate. The patient was advised to avoid sildenafil citrate and successfully relieved of skin lesions through systemic and topical corticosteroids.


Fixed Drug Eruption Caused by Sildenafil Citrate
Positive intradermal test with sildenafil at a concentration of 25 mg/ml (shown as 1:1), 2.5 mg/ml (shown as 1:10) and 1.25 mg/ml (shown as 1:20) (A) at 10 minutes and (B) 1 hour.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5383760&req=5

Figure 2: Positive intradermal test with sildenafil at a concentration of 25 mg/ml (shown as 1:1), 2.5 mg/ml (shown as 1:10) and 1.25 mg/ml (shown as 1:20) (A) at 10 minutes and (B) 1 hour.
Mentions: An intradermal test with sildenafil citrate at concentrations of 25 mg/ml, 2.5 mg/ml and 1.25 mg/ml showed positive results at 10 minutes and 1 hour (Fig. 2). We did biopsy the lesion site on the back (Fig. 1B). The histopathological findings showed superficial perivascular lymphohistiocytic infiltrations and melanin deposits in the upper dermis, consistent with FDE (Supplementary Fig. 1). Based on the patient's history, clinical findings and histological findings, we diagnosed FDE caused by sildenafil citrate. The patient was advised to avoid sildenafil citrate and successfully relieved of skin lesions through systemic and topical corticosteroids.

View Article: PubMed Central - PubMed

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Dear Editor: Fixed drug eruption (FDE) is a distinctive variant of drug-induced cutaneous reactions... Based on the patient's history, clinical findings and histological findings, we diagnosed FDE caused by sildenafil citrate... The patient was advised to avoid sildenafil citrate and successfully relieved of skin lesions through systemic and topical corticosteroids... The common adverse events of sildenafil are headache, vasodilation, rhinitis, flushing, and dizziness... Dermatitis are uncommon adverse events of sildenafil... Skin tests including prick and intradermal tests, patch test, and oral challenge test with suspected drugs may be useful in confirming the diagnosis of FDE... In the present case, there was obvious clinical correlation between sildenafil intake and typical recurrent cutaneous lesions, and the intradermal test with sildenafil produced positive results... And lesional patch test results confirmed the clinical suspicion of culprit drug, but the lack of sensitivity is a major limitation... Therefore, we did not perform a patch test and oral challenge or provocation test with sildenafil citrate... We recommend that physicians assessing a patient presenting with drug eruptions, especially healthy men, should consider a thorough personal history of lifestyle drugs including PDE5 inhibitors.

No MeSH data available.