International Journal of Basic & Clinical Pharmacology | December 2020 | Vol 9 | Issue 12 Page 1903 International Journal of Basic & Clinical Pharmacology Malathi DC et al. Int J Basic Clin Pharmacol. 2020 Dec;9(12):1903-1905 http://www.ijbcp.com pISSN 2319-2003 | eISSN 2279-0780 Case Report Self-medicated, satranidazole induced fixed drug eruption: a case report Divyashanthi Chellathambi Malathi*, Anusha Bommasani, Raman Palanisami Priyadharsini INTRODUCTION Cutaneous drug reactions are the most frequently occurring adverse reactions to drugs. The frequency of cutaneous reactions to specific drugs may exceed 10%. There are four categories of cutaneous drug reactions: immediate-type immune-mediated reactions, delayed- type immune-mediated reactions, photosensitivity reactions, and autoimmune syndromes. 1 Drug induced cutaneous eruptions frequently display a characteristic clinical morphology such as morbilliform exanthem, urticaria, hypersensitivity syndrome pseudolymphoma, photosensitivity, pigmentary changes, acute generalized exanthematous pustulosis, lichenoid dermatitis, vasculitis, Steven-Johnson syndrome, or fixed drug eruption. 2 Fixed drug eruption (FDE) are distinct type of drug eruptions that appear as pruritic, well circumscribed, round or oval-shaped, erythematous macules or edematous plaques and characteristically recur at the same sites up on re exposure to the offending drug. They usually resolve spontaneously with hyperpigmentation. 3 After healing, lesions present on the skin and mucous membrane for prolonged periods as grey brown macules. On repeated exposure the number and severity of lesions may increase. Symptoms like swelling and redness of skin can be seen as early within 30 minutes of exposure to the drug. Extremities, genitals and perianal areas are the most common areas where the lesions can be seen but they may appear on any location. Nitroimidazoles are low molecular weight antimicrobial compounds with excellent activity against anaerobic micro-organisms and protozoa. They are the first line drugs for hepatic and intestinal amoebiasis. All the nitroimidazoles: metronidazole, tinidazole, ornidazole, secnidazole and satranidazole, have a similar nitroimidazole ring but different side chains. Although all these molecules have been used for a long time without many side-effects, only metronidazole and Department of Pharmacology, Jawaharlal Institute of Postgraduate Medical Education and Research, Karaikal, Puducherry, India Received: 23 September 2020 Accepted: 29 October 2020 *Correspondence: Dr. Divyashanthi Chellathambi Malathi, Email: dishanthii@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Fixed drug eruption (FDE) is described as the development of one or more annular or oval erythematous patches as a result of systemic exposure to a drug; these reactions normally resolve with hyperpigmentation and may recur at the same site with re-exposure to the drug. Repeated exposure to the offending drug may cause new lesions to develop in addition to lighting up the older hyperpigmented lesions. Here we present an interesting case of satranidazole induced FDE with a past history of FDE to the same drug 5 months back. Since the eruption occurred in the same site on re- exposure to the same drug, a diagnosis of FDE was made and causality assessment by Naranjo adverse drug reaction probability scale showed a certain relationship between the cutaneous adverse reaction and the offending drug Keywords: Fixed drug eruption, Satranidazole, Self-medication DOI: https://dx.doi.org/10.18203/2319-2003.ijbcp20205131