Abstract
We report a case of a woman which had in 6-months three episodes of a recurrent postcoital skin eruption, each lasting for a few weeks. It seemed like a sexually induced eruption. She admitted to take only her permanent therapy that could not be connected to her skin signs. Thanks to her Health Insurance Card with the digital record of all the drugs she had received in the last two years it was possible to find out that she was intermittently taking co-trimoxazole in order to prevent an after intercourse urinary bladder infection. A good evidence of the patient’s medication has a key role in the diagnosis of skin adverse drug reactions. Fixed drug eruption is a common adverse drug reaction and everyone prescribing a long term antibiotic prophylaxis should be aware of it.
Highlights
Fixed drug eruption (FDE) is a common adverse drug reaction
We report a case of a recurrent FDE appearing after the intercourse, not induced by it
Case Report A 41-year-old woman reported three episodes of skin and oral mucous eruption from October 2011 till March 2012 each time following a sexual intercourse with her husband
Summary
Fixed drug eruption (FDE) is a common adverse drug reaction. Co-trimoxazole, a combination of sulphamethoxazole and trimethoprim, is one of the most frequent causative agents. Co-trimoxazole induced FDE is often located on the male genital [1,2] It can be caused during the sexual intercourse by genital fluids of the partner taking the drug systemically or locally [3,4]. Multiple lesions were on the trunks, limbs and sometimes on the oral mucous (Fig. 1-4) She regularly takes levothyroxin and a combination of drospirenon and ethynilestradiol tablets. After we had warned her, she remembered that she used to take a half or whole tablet of co-trimoxazole after the intercourse in order to prevent a urinary bladder infection to which she was prone She attributed it to her husband insulin dependent diabetes mellitus. In the ten months period after she had stopped taking co-trimoxazole the FDE did not recur
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