Fixed Drug Eruptions (FDE) in an Urban Centre in South-South Nigeria

Abstract

Background Fixed drug eruptions are adverse cutaneous reactions to ingested drugs, characterized by  the formation of solitary or multiple erythematous patches, plaques, bullae or erosions that reoccur at an identical skin site within hours of re ingestion of the offending drug. The objective of this study was to describe the epidemiology of Fixed drug eruptions with the identification of common causative drugs among patients at the dermatology clinic of an urban tertiary hospital in the South-south region ofNigeria.
Methods All consecutive patients with a diagnosis of fixed drug eruptions seen at the dermatology clinic  between January 2005 to January 2013 were included in the study. The diagnosis of fixed drug eruptions was made based on clinical findings of lesion (s) of the same form occurring twice or more at the same  sites as a result of a readministration of a causative drug, and confirmation by a challenge test.
Results The diagnosis of fixed drug eruption was made in 99 out of5106 (1.93%) patients, with a slight female dominance. FDE affected all age groups, the youngest presented at 9months of age and the oldest at 86years. Majority of patients (66. 7%) did not know the offending drug. The most implicated drugs  were the sulphonamides (21.2%), followed by antibiotics made up of ampiclox, tetracycline and penicillin ( 4.04%) and Non steroidal anti inflammatory drugs (3.03%). The commonest site of presentation was the face (32%), especially the mucosa of the mouth, followed by generalized presentation (28%).The frequency of Lower limb presentation was (13%),followed by the upper limb (11%) and the trunk(7.1%). Conclusion Fixed drug eruptions are a cause for great concern to the patient. Consistent with some other studies sulphonamides, clotrimoxazole and fansidar were the most implicated drugs.

Keywords Fixed drug eruptions; Epidemiology: Out Patient clinic; Nigeria.