Fixed drug eruption on the TONGUE associated with piroxicam: report of TWO caseS and literature review

Publication date: Available online 6 February 2019

Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

Author(s): Eleni-Marina Kalogirou, Konstantinos I. Tosios

Abstract

Objective

To describe two patients with piroxicam-associated fixed drug eruption on the tongue and review the literature.

Study Design

Two females presented with recurrent ulcers after piroxicam intake for dysmenorrhea and pelvic pain. The English literature was reviewed on cases of piroxicam-induced fixed drug eruptions with reported site.

Results

The ulcers reappeared in the identical lingual site after piroxicam intake; three times in patient-#1 and two times in patient-#2. Extraoral lesions were not observed. Following discontinuation of piroxicam, no relapse was reported. The literature review found 25 patients with piroxicam-associated fixed drug eruption. The oral mucosa/lips were affected in 8 patients who also had cutaneous/genital lesions. Solitary tongue involvement was not reported in any of them. Cross-sensitivity among different drugs of the same class is not unusual.

Conclusion

Fixed drug reactions to piroxicam are rare, although nonsteroidal, anti-inflammatory drugs are among the most common causes of fixed drug eruptions. Of these rare fixed drug reactions to piroxicam, cutaneous lesions are reported much more often compared to oral mucosal lesions. Discontinuation of the causative drug is essential to promote healing and to avoid recurrences. Patients with history of piroxicam-induced fixed drug eruption should also avoid other oxicams, due to potential cross-sensitivity.

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