ro13-9904 and Erythema-Multiforme

Topics: Adrenal Cortex Hormones; Aged; Anti-Bacterial Agents; Antiviral Agents; Azithromycin; C-Reactive Protein; Ceftriaxone; COVID-19; COVID-19 Drug Treatment; Drug Combinations; Erythema Multiforme; Female; Fibrin Fibrinogen Degradation Products; Hospitalization; Humans; Hydroxychloroquine; Lopinavir; Lymphocyte Count; Middle Aged; Ritonavir

Topics: Adolescent; Anti-Bacterial Agents; Azithromycin; Betacoronavirus; Ceftriaxone; Coronavirus Infections; COVID-19; Diagnosis, Differential; Erythema Multiforme; Humans; Inflammation; Male; Pandemics; Pneumonia, Viral; SARS-CoV-2; Tomography, X-Ray Computed; Treatment Outcome

Adverse skin reactions to drugs are frequent, with rates of reaction to many commonly used drugs exceeding 1%. We describe a 29-year-old woman admitted with a history of itching, rash, vesicles on her hands and soles, and edema on her tongue and oropharynx after trimethoprim-sulfamethoxazole, ciprofloxacin, methenamine anhydromethylene citrate, piroxicam, azithromycin, and ceftriaxone intake. Erythema multiforme (EM) was diagnosed by skin biopsy after oral challenge with piroxicam. EM lesions reappeared after oral challenge with levofloxacin. Although EM is quite common with trimethoprim-sulfamethoxazole and there are some reports of EM appearing after intake of ciprofloxacin, it has rarely been attributed to piroxicam and no reports have identified levofloxacin as a cause.

Topics: Adult; Anti-Infective Agents; Anti-Inflammatory Agents, Non-Steroidal; Azithromycin; Ceftriaxone; Ciprofloxacin; Drug Hypersensitivity; Erythema Multiforme; Female; Humans; Levofloxacin; Methenamine; Ofloxacin; Piroxicam; Skin Tests; Trimethoprim, Sulfamethoxazole Drug Combination; Urinary Tract Infections