Case Report: Fixed Drug Eruption Caused by Dapagliflozin

ABSTRACT

Type 2 diabetes mellitus (T2DM) is a global health concern. It has multifactorial pathophysiology and its incidence is increasing day by day. The treatment is mainly targeted at maintaining cardiovascular and renal functions. Administration of sodium-glucose co-transporter-2 (SGLT2) inhibitors is one of the emerging medications for T2DM. It improves glycemia by employing insulin-independent mechanisms that increase urinary glucose excretion. The authors hereby report a case of a 62-year-old male with T2DM, who was referred to our outpatient clinic for glycemic control. The patient was taking metformin and gliclazide for five years in addition to dapagliflozin, an SGLT-2 inhibitor, for one year. Physical examination revealed a few, sharply-demarcated erythematous plaques on the patient’s forearm for fifteen days. The patient previously had psoriasis, and to rule out this diagnosis a skin punch biopsy was taken from one of the lesions. The histopathological evaluation was found to be compatible with drug eruption; however, skin patch test performed with dapagliflozin was non-reactive. After performing oral provocation test with dapagliflozin, new erythematous plaques appeared around the same sites on the forearm. On withdrawing dapagliflozin, the lesions resolved completely. This case gives an insight that dapagliflozin may also cause drug eruptions, which should be kept in mind, especially in a patient with psoriasis.