Mahsa Rekabi, Jamal Mirzaei, Vahab Rekabi and Sepideh Darougar
Background: More than 30 different cutaneous drug reaction patterns, ranging from mild dermatitis to extensively affected skin, are reported, among which fixed drug eruption is the third most common involvement pattern. Fixed drug eruption is an immunological reaction characterized by lesions recurring at the same location every single time after exposure to a causative substance.
Case Report: A healthy 26-year-old male patient developed red erythematous itching macules on his lips, hands and genitalia 15 days following COVID-19 infection in May 2022. With the passage of time, they turned to bullous lesions, which were then ulcerated. He did not have any history of previous allergic disorders. The only medication used by the patient during the course of the disease was acetaminophen, which he was used to consuming regularly at the times of pain and
fever without the appearance of any signs, symptoms or skin lesions. Two months later, the eruption recurred on exactly the same sites after taking a 500mg naproxen tablet. Laboratory tests were all within normal limits. A diagnosis of fixed drug eruption was suspected and a skin biopsy specimen from the involved area was indicative of the aforementioned diagnosis.
Conclusion: Considering the widespread use of acetaminophen and NSAIDs, it seems important to be aware of the adverse reactions of drugs. Actually, in a case such as our patient, who had already tolerated acetaminophen safely prior to COVID-19 infection, the triggering effect of viral infection in inducing skin lesions may become more prominent