Dolutegravir-induced hand-foot skin reaction in a seropositive male: A rare presentation.

Hand-foot skin reaction (HFSR) is a specific but uncommon cutaneous side effect mainly following chemotherapeutic drugs such as multitargeted kinase inhibitors. HFSR is reversible and non-life-threatening. HFSR, also known as palmoplantar erythrodysesthesia, presents with various degrees of erythema, edema, hyperkeratosis, blister, and sometimes with a fine white scale. Dolutegravir, a first next-generation integrase inhibitor, is used with other antiretroviral therapy (ART) to treat mainly HIV infections. HFSR is diagnosed depending on the suggestive association of drug intake and characteristic palmoplantar eruption. ART can cause several cutaneous adverse drug reactions though no case report of dolutegravir-induced HFSR has been reported till date in literature. Here, we present a case of HFSR in a seropositive male on ART.

Tadalafil-Induced Generalized Bullous Fixed Drug Eruption: A Rare Side Effect of a Common Drug.

Tadalafil is a phosphodiesterase-5 (PDE-5) inhibitor, an FDA-approved treatment for erectile dysfunction (ED), pulmonary arterial hypertension (PAH), benign prostate hyperplasia, etc. It is also widely used by otherwise healthy individuals for recreational purposes. Fixed drug eruption (FDE) is a distinctive type of adverse drug reaction in which every exposure to the offending medication leads to the appearance of lesions at the same 'fixed' sites. A sharply defined erythematous patch or plaque with a violaceous hue is typically seen. A clinical variant featuring classic FDE lesions along with blistering in at least three out of six anatomical sites or involving at least 10% of body surface area is known as generalized bullous fixed drug eruption (GBFDE). Tadalafil-induced FDE is in itself an uncommon phenomenon, with only a handful of documented cases, none of which seem to have reported GBFDE-type presentation post-tadalafil intake. Here, we present a case of GBFDE following tadalafil administration.