Ibuprofen-induced intra-oral fixed drug eruption

Abstract

Background: Ibuprofen is commonly used in many countries to relieve pain from various conditions, such as headache, dental pain, menstrual cramps, muscle aches or arthritis. However, it has been reported that ibuprofen can have deleterious and unpredictable side effects at both therapeutic and toxic doses. Herein we report a case of an ibuprofen-induced fixed drug eruption (FDE). Clinical details: A 35-year-old female underwent surgery for anal fissures at a secondary care hospital in India. After surgery, the patient was prescribed ibuprofen 400 mg, t.i.d., for 7 days. On Day 3, the patient complained of a burning sensation, discoloration of the lips and ulcers in the oral cavity. Based on the presenting signs and symptoms, she was diagnosed as experiencing an ibuprofen-induced FDE. Outcome: Symptoms improved significantly after withdrawal of ibuprofen. The patient was treated with intravenous fluids, prednisolone 40 mg oral tablets and levocetirizine 20 mg. A causality assessment of the reaction was undertaken, indicating a probable relationship between the patient's symptoms and her use of ibuprofen. Conclusion: This report highlights the importance of regular monitoring for adverse drug reactions due to ibuprofen because it is likely to cause an FDE.