Bullous fixed-drug eruption with intraoral lesions due to mefenamic acid: A case report
Abstract
Introduction: Bullous Fixed drug eruption (BFDE) is a form of skin and mucocutaneous allergic reaction formed as purplish plaque or bullae with purple base in the same previous place due to certain medication. One of the drug is known to trigger FDE is non-steroidal antiinflammation drugs (NSAIDs) including mefenamic acid. Clinically, FDE is often mimic Steven-Johnson syndrome with milder clinical symptoms. Case Illustration: A 24-year-old male came with complaint of multiple red spots with blisters and itch on his trunk, back, and leg. He also complained about his white painful scaled lip and lesion in his mouth since 1 day ago after he took mefenamic acid. The patient had the same complaint 1 year ago. Dermatological status showed multiple purpuric annular and oval well-demarcated lesions and tension bullae on his back and right leg. Less-demarcated erythema lesion were seen on his trunk. On his lips there were oedema with white desquamation and white lesions on his tongue along with multiple intraoral erosion. Blood examination showed good results. The patient was diagnosed with bullous fixed drug eruption and was treated with methylprednisolone injection 2x62,5mg with gradual tapering-off, ranitidine injection 2x50mg, and ringer lactate fluid 500cc per 12 hour. In 3 days the patient showed clinical improvement. Conclusion: Clinical manifestations of bullous fixed drug eruption are often mimic other dermatosis and can be differentiate with history of taking triggering medication and the place of the lesions. Education according drug-induced allergy is essential to prevent lesions recurrency.References
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