A study of fixed-drug reactions at a rural-based tertiary care center, Gujarat

Introduction: Nowadays, due to the widespread availability of various drugs, adverse cutaneous drug reactions (ACDRs) have become very common. One type of ACDR that dermatologists encounter frequently these days is Fixed-drug reaction (FDR). FDR is a characteristic type of adverse cutaneous reaction, which occurs at the same site whenever a particular drug is taken. That is why there is a need to identify the drugs causing FDR and to counsel the patients properly to avoid recurrence. Aim and Objective: The aim and objective was to study the demographic details, clinical patterns, and the culprit drugs causing FDR. Setting and Design: We have conducted a cross-sectional, observational study. Materials and Methods: We have conducted an observational cross-sectional study from April 2010 to March 2018 at the Department of Dermatology, Venereology and Leprology at Shree Krishna Hospital, Pramukhswami Medical College, Karamsad, Gujarat, after taking approval from the research ethical committee of our hospital. All patients coming to the skin out patient department who were diagnosed clinically as FDRs were included in the study, irrespective of age and sex. In every case, a detailed history was elicited and proper clinical examination was carried out and it was recorded in a proforma. The data collected was analyzed using proportions, frequencies and chi-square test. All the patients were counseled and given a list of drugs causing FDR to avoid recurrence. Results: In our study, we enrolled 78 patients of FDR in which there were 43 (55.12%) males and 35 (44.88%) females. In these patients, the most frequent condition for which the offending drug was taken was fever (in 18 [23.08%] patients), while the most common complaint after intake of offending drug was pigmented patch (in 32 [41.03%] patients) followed by mucosal lesions (in 20 [25.64%] patients). Overall, antimicrobials (31 [39.74%]) were the most common group of drugs which caused FDR followed by nonsteroidal anti-inflammatory drugs (28 [35.90%]). Considering a single molecule, diclofenac (16 [20.51%]) was the most common drug causing FDR followed by metronidazole (6 [7.69%]) and then cotrimoxazole, fluconazole and ciprofloxacin (5 [6.41%]) each. Conclusion: Among ACDRs encountered in dermatology patients, FDRs form an important part. Antimicrobials are the most common group while diclofenac is the most common drug causing FDR.