Abstract

Introduction:

Itraconazole is a usually well tolerated drug with a good safety profile. Adverse cutaneous reactions to Itraconazole are uncommon. Only a few cases of Itraconazole induced maculopapular rash, purpuric drug reaction, acute generalized exanthematous pustulosis, urticaria, angioedema, and symmetrical drug related intertriginuous and flexural exantham have been reported in the literature. There are only three case reports of FDE induced by Itraconazole and no cases of pityriasis rosea like eruptions secondary to Itraconazole use to the best of the author’s knowledge.

Case 1: A 21-year-old male presented with erosions and erythema over genitals and lips one day following intake of C.Itraconazole which he had taken for the treatment of tinea cruris. Past h/o of similar episodes was present following Itraconazole use. Naranjo adverse drug reaction probability scale score was 5 – Probable and on WHO-UMC casuality assessment scale, the reaction has been graded as “Probable/likely”.

Case 2: A 30 year old female diagnosed with Tinea corporis was advised C.Itraconazole 100mg BD. One week following the intake of the drug patient presented to us with Pityriasis Rosea-like eruptions over thighs. No herald patch was seen and lesions were extremely itchy. Naranjo adverse drug reaction probability scale score was 5 – Probable and on WHO-UMC casuality assessment scale – Probable. Diagnosis of drug induced Pityriasis Rosea secondary to itraconazole was made. Itraconazole was stopped and the patient was started on topical sertaconazole and oral Terbinafine. Lesions resolved on the stoppage of the drug.

Conclusion:

In conclusion, we here present an uncommon adverse cutaneous reactions to a common drug – Itraconazole. Awareness regarding these conditions will increase the likelihood of early diagnosis and resolution of the lesions following the withdrawal of the offending drug.