Oral Fixed Drug Eruption Induced by Ofloxacin: A Case Report

Abstract

Fixed drug eruption (FDE) is a distinct cutaneous and mucosal adverse drug reaction that characteristically recurs at the same anatomical site on re-exposure to the causative agent. Isolated mucosal involvement without any skin lesions is uncommon, and often being misdiagnosed as herpetic stomatitis, aphthous ulceration, erythema multiforme or an autoimmune vesiculobullous disorder. We report a case of a 50-year-old woman who developed a solitary, well-demarcated erosive plaque of the oral mucosa, with a central white slough and surrounding erythema, following intake of oral ofloxacin. The lesion was confined entirely to the oral cavity with no cutaneous, ocular, genital or other mucosal involvement. A temporal association between drug intake and lesion onset, together with the characteristic clinical morphology, supported a diagnosis of ofloxacin-induced oral FDE. The offending drug was withdrawn, and the patient was managed conservatively/with topical–systemic corticosteroids, with satisfactory resolution. This report highlights the need for a high index of suspicion for FDE when evaluating  oral ulcerative lesions, particularly in patients with a recent history of fluoroquinolone use, and underscores the importance of a detailed drug history in the diagnostic workup of oral mucosal ulceration.