[
    {
        "id": "osp-2541",
        "type": "article-journal",
        "title": "Recurrent Solitary Skin Lesion on the Same Site",
        "author": [
            {
                "family": "Al Qassabi",
                "given": "Al Mutasim Hamood"
            },
            {
                "family": "Al Amri",
                "given": "Hajer"
            },
            {
                "family": "Al Hinai",
                "given": "Reham"
            }
        ],
        "URL": "https://omanscience.com/en/articles/recurrent-solitary-skin-lesion-on-the-same-site",
        "language": "en",
        "issued": {
            "date-parts": [
                [
                    2022
                ]
            ]
        },
        "container-title": "Oman Medical Journal",
        "DOI": "10.5001/omj.2022.12",
        "publisher": "Oman Medical Specialty Board",
        "ISSN": "1999-768X",
        "abstract": "A healthy 35-year-old male presented to the dermatology clinic with a skin lesion on the chest of two days duration. He reported an associated history of itching and mild pain. There was no history of fever or other constitutional symptoms. One day before the presentation, he took Panadol Cold-Flu tablet (each tablet contains paracetamol 500 mg, chlorpheniramine 2 mg, and pseudoephedrine hydrochloride 30 mg) for flu symptoms. No other medication was taken. There was no travel history. He denied history of mosquito or insect bites. Thorough history-taking revealed a similar episode on the same site two years previously, preceded by flu symptoms for which he had taken the same medication. Local skin examination showed a solitary, edematous, oval erythematous plaque over the left posterior chest with a central dusky color. There were no other skin lesions and the rest of the physical examination was unremarkable. Mucous membranes were not affected. The diagnosis is fixed drug eruption (FDE) based on the history and typical skin lesion. Pseudoephedrine was suspected to be the culprit drug as previously when the patient took paracetamol alone no such skin lesions had occurred, while a rechallenge with pseudoephedrine hydrochloride alone resulted in a similar lesion on the same site. Naranjo adverse drug reaction probability scale was > 9; therefore, histopathology examination was not done. The patient was treated with topical steroids which resulted in clearance of the lesion leaving post-inflammatory pigmentation. FDE is an immunological cutaneous adverse drug reaction characterized by skin lesions that occur at the same location every time there is exposure to the causative substance. Avoidance of the offending drug is the most important step in the management of FDE. Topical steroids with or without oral antihistamines may be used to alleviate associated pruritus and erythema."
    }
]