Metformin-Induced Generalized Fixed Drug Eruption With Cutaneous Hemophagocytosis

SummaryA fixed drug eruption (FDE) is a common cutaneous adverse drug reaction which occurs following administration of an offending drug. The aim of this review is to provide an update on the list of drugs causing FDE, with a focus on emerging drug culprits reported since the start of the century. Across published literature, triggers for FDE are widely varied. The most frequently implicated drugs include analgesics (nonsteroidal anti‐inflammatory drugs [NSAIDs] and paracetamol) and antibiotics. Co‐trimoxazole is perhaps the most well described single agent. Since the start of the century there have been over 200 drugs named in case reports on FDE. Newer, novel agents of note include cyclooxygenase‐2 specific inhibitors, fluconazole, and phosphodiesterase 5 inhibitors. Other implicated drugs include vaccines, such as various SARS‐CoV‐2 vaccines.Drugs incriminated in FDE vary based on the geographical region studied and prescribing patterns at a given time. Newer drugs continue to enter the market and are playing an increasing role in the field of FDE. Awareness of rarer culprits and emerging novel agents can help identify a trigger, allowing for prompt withdrawal of the causative agent, preventing recurrence.

show abstract

“…Endocrinology agents  Oral hypoglycemics drugs: dapagliflozin [43,44], metformin [115,116], sitagliptin [45] 2015 India [45] OT 3 Other 1 Hx 1…”

Section: Emerging Drugs Of Interestmentioning

confidence: 99%

Fixed drug eruptions – the common and novel culprits since 2000

McClatchy

Yap

Nirenberg

et al. 2022

J Deutsche Derma Gesell

View full text Add to dashboard Cite

show abstract

“…Erythroderma secondary to metformin is described as a very rare side effect (1 in 10,000 treated patients); the condition is more common with penicillins, sulfonamides or allopurinol [4, 5] . Treatment should include withdrawal of the precipitating drug, and administration of high-dose corticoids and PUVA.…”

Section: Discussionmentioning

confidence: 99%

Erythroderma and Chronic Lichenification Due to Metformin

Díaz

Bruñén

Cameo

et al. 2019

European Journal of Case Reports in Internal Medicine

View full text Add to dashboard Cite

We present the case of a 62-year-old man with a 4-year history of pruritus and erythroderma. The patient had been taking metformin for 5 years, so after contact allergies, contact with toxic products, and autoimmune diseases were ruled out, the condition was treated as erythroderma secondary to metformin. A skin biopsy subsequently confirmed the diagnosis and lichenification of some areas of the patient’s skin. LEARNING POINTS Erythroderma induced by drugs, even very common drugs, should be ruled out in all cases. Other causes of erythroderma should be investigated with exhaustive clinical history taking, specific tests and skin biopsy. Erythroderma should be treated as soon as possible once the cause is known.

show abstract

“…The cases of FDEs resulting from metformin varied from a generalized macular eruption with cutaneous hemophagocytosis to discrete erythematous lesions on the palms and soles of the patient [21,22]. Each resolved with metformin discontinuation, and like others in this family of drug reactions, recurred in the same location when exposed to the same medication.…”

Section: Metforminmentioning

confidence: 99%

Cutaneous Reactions to Antidiabetic Agents: A Narrative Review

Boccardi

Shubrook

2022

Diabetology

View full text Add to dashboard Cite

Diabetes is a common and complex disease affecting multiple organ systems throughout the body. With a consensus in care guidelines emphasizing the importance of glycemic control in determining the disease progression, people with diabetes worldwide have been placed on medication regimens targeting glucose stability from a variety of pathophysiologic pathways. Each of these medications also possesses its own potential for adverse events. In recent years, there has been increased reports of skin reactions to diabetes medications, adding to the more widely known eruptions such as insulin-induced lipohypertrophy and contact dermatitis of subcutaneous injections. The authors searched PubMed, Google, and Embase for articles including adverse reactions to anti-hyperglycemic medications. Key words and titles searched included, “antidiabetic drugs”, “skin reactions”, “adverse drug reactions”, “allergic reactions”, “diabetes”, “metformin”, “insulin”, “DPP4 inhibitors”, “thiazolindineones”, “sulfonylureas”, “SGLT2 inhibitors”, “GLP-1 agonists”, “diabetic medication”, “injection site reactions”. As a result, a total of 59 papers are included in this review. The great majority were case reports ranging from benign fixed drug eruptions to severe cutaneous reactions that threaten patients’ lives. Increasing physician awareness of both the potential for, and presentation of, such reactions to diabetes medications can reduce hospitalizations and optimize care in an already vulnerable patient population.

show abstract

Metformin-Induced Generalized Fixed Drug Eruption With Cutaneous Hemophagocytosis

Cited by 11 publications

References 11 publications

Fixed drug eruptions – the common and novel culprits since 2000

Fixed drug eruptions – the common and novel culprits since 2000

Erythroderma and Chronic Lichenification Due to Metformin

Cutaneous Reactions to Antidiabetic Agents: A Narrative Review

Contact Info

Product

Resources

About