Etoricoxib-Induced Fixed Drug Eruption with Cutaneous and Mucosal Involvement: A Case Report
Eritema pigmentado fijo en brazos y mucosa oral posterior a la ingesta de etoricoxib: reporte de caso.
DOI:
https://doi.org/10.57188/ricsa.2026.010Keywords:
Fixed drug eruption; Etoricoxib; Cyclooxygenase-2 Inhibitors; Drug Hypersensitivity; Pharmacovigilance. (Source: MeSH-NLMAbstract
Introduction: Fixed drug eruption (FDE) is a delayed hypersensitivity reaction characterized by erythematous- violaceous plaques recurring at identical anatomical sites upon re-exposure to the causative drug, with persistent residual hyperpigmentation. Etoricoxib, a widely used COX-2 inhibitor, is an increasingly recognized trigger. Case Report: A 49-year-old woman developed hyperpigmented plaques on the arms and oral mucosa eight hours after a single dose of etoricoxib 120 mg for acute low back pain. A clinically identical episode had occurred two years earlier at the same sites, initially misdiagnosed as herpetic infection. Diagnosis was established by temporal chronology, exact anatomical recurrence, and a Naranjo score of 10 (definite causal relationship). Management comprised drug discontinuation, oral antihistamine, and topical corticosteroid, with favorable outpatient evolution. Conclusion: This case illustrates etoricoxib-induced FDE with cutaneous and mucosal involvement and exact site recurrence. Early recognition, definitive discontinuation, and pharmacovigilance reporting are clinical imperatives to prevent recurrence and ensure safe alternatives.
Downloads
References
1. Porr C, Harris DM, Vidrighin A, et al. Etoricoxib- induced fixed erythema. J Clin Med. 2025;14(23):8504. doi:10.3390/jcm14238504
2. Makris M, Papapostolou N, Koumprentziotis IA, Pappa G, Katoulis AC. Nimesulide-induced fixed drug eruption followed by etoricoxib-induced fixed drug eruption: an unusual case report and review of the literature. J Clin Med. 2024;13(6):1583. doi:10.3390/jcm13061583
3. Rawlings N, Joshi S, Sandison A, Carey B. Fixed drug eruption secondary to etoricoxib. Br J Oral Maxillofac Surg. 2024;62(6):571-574. doi:10.1016/j.bjoms.2024.05.001
4. Perks A, Bates TJ, Velangi S, Brown RM, Poveda- Gallego A. Probable etoricoxib-induced fixed drug eruption involving the oral mucosa: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol. 2021;131(4):e100-e107. doi:10.1016/j.oooo.2020.12.019
5. Roy SS, Mukherjee S, Era N, Mukherjee M. Etoricoxib-induced toxic epidermal necrolysis: a fatal case report. Indian J Pharmacol. 2018;50(3):139-142. doi:10.4103/ijp.IJP_39_17
6. Khan DA, Banerji A, Blumenthal KG, et al. Drug allergy: a 2022 practice parameter update. J Allergy Clin Immunol. 2022;150(6):1333-1393. doi:10.1016/j.jaci.2022.08.028
7. Dextre-Vilchez, Rí´os-Lozano. Eritema medicamentoso pigmentado fijo por etoricoxib. Iatreia. 2025. doi:10.17533/udea.iatreia.280
8. Siriwattanasatorn M, Kamudhamas A, Sivapornpan N, Noonpugdee M, Kamalashiran C, Phetkate P. Fixed drug eruption induced by etoricoxib in Thailand: a case report. Toxicol Rep. 2025;14:102010. doi:10.1016/j.toxrep.2025.102010
9. Mota D, Coutinho RM, Mesquita M, Cernadas J, Carneiro-Lea˜o L. Generalized fixed drug eruption secondary to etoricoxib. Dermatitis. 2025;36(4):e405-e406. doi:10.1089/derm.2024.0324.
10. Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. Adverse Drug Reaction Probability Scale (Naranjo) in Drug Induced Liver Injury. [Updated 2019 May 4]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK548069.
11. Naranjo CA, Busto U, Sellers EM, et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther. 1981;30(2):239-245. doi:10.1038/clpt.1981.154.
12. Sousa AS, Gonçalo M. Fixed drug eruption by etoricoxib confirmed by patch test. An Bras Dermatol. 2016;91(6):777-779. doi:10.1590/abd1806 4841.20164777
13. Martí´nez Anto´n MD, Gala´n Gimeno C, Sa´nchez de Vicente J, Ja´uregui Presa I, Gamboa Setie´n PM. Etoricoxib-induced fixed drug eruption: Report of seven cases. Contact Dermatitis. 2020 Aug 18; doi: 10.1111/cod.13659
Downloads
Published
Issue
Section
License
Copyright (c) 2026 LUZ MARIA Moyano Vidal, Lucia Margarita Bolivar Herrada, Martha Patricia Diaz Guevara
This work is licensed under a Creative Commons Attribution 4.0 International License.
RICSA is an open access journal distributed under the terms and conditions of Creative Commons Attribution 4.0 International license
