Abstract
BackgroundCutaneous adverse reactions to medications are extremely common and display characteristic clinical morphology. A fixed drug eruption is a cutaneous adverse drug reaction due to type IV or delayed cell-mediated hypersensitivity. Ivermectin, a broad-spectrum anti-parasitic compound, has been an essential component of public health campaigns targeting the control of two devastating neglected tropical diseases: onchocerciasis (river blindness) and lymphatic filariasis.Case presentationWe report the case of a 75-year-old Cameroonian man of the Bamileke ancestry who developed multiple fixed drug eruptions a few hours following ivermectin intake that worsened with repeated drug consumption. Discontinuation of the drug, counselling, systemic steroids, and orally administered antihistamines were the treatment modalities employed. Marked regression of the lesions ensued with residual hyperpigmentation and dyschromia.ConclusionKeen observation on the part of physicians is mandatory during the administration of ivermectin for quick recognition and prevention of this adverse drug reaction.
Highlights
Cutaneous adverse reactions to medications are extremely common and display characteristic clinical morphology
Keen observation on the part of physicians is mandatory during the administration of ivermectin for quick recognition and prevention of this adverse drug reaction
Further consumption of ivermectin (2 months prior to consultation) during the ensuing campaign resulted in worsening of the old lesions with development of multiple new lesions over his face, back, and extremities
Summary
A fixed drug eruption (FDE) is a cutaneous adverse drug reaction (CADR) due to type IV or delayed cellmediated hypersensitivity [1] It can occur even when some drugs are used within normal doses and describes the development of one or more annular or oval erythematous patches as a result of systemic exposure to that drug [2]. Further consumption of ivermectin (2 months prior to consultation) during the ensuing campaign resulted in worsening of the old lesions with development of multiple new lesions over his face, back, and extremities. His family and medical history were not remarkable for any previous drug or cross-reactivity reactions. Close patient follow-up revealed marked regression of lesions within a fortnight with residual hyperpigmentation (Figs. 2 and 3)
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