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What Causes Red Patch On Toe While On Ciprofloxacin And Prilosec?
Question: I have had a UTI for four days . dr. Put me on Cipro. What I thought was a blister on the top of my big toe turned out to be ringworm, so that area as been infected for about 2 weeks. I also have very bad reflux staring about a week ago, I am taking Prilosec, ARE ANY OF THESE PROBLEMS RELATED?
Brief Answer:
A FDE to drug rather than a ringworm is the likely possibility
Detailed Answer:
Hello. Thank you for writing to us
I have gone through your query and I have also reviewed the Image. I can see a coin sized patch of red skin in this Image.
I would keep a likely possibility of a Fixed Drug Eruption (FDE) to either Ciprofloxacin Or Prilosec (Omeprazole) rather than a ringworm. A fixed drug eruption classically presents with a red patch of skin which may be either single or multiple, the area may blister; there is a temporal history of the eruption preceded by a drug intake. There might be either a burning sensation Or itching associated with the eruption. Which of these 2 drugs preceded the eruption? is the likely cause of FDE.
If I was the treating doctor I would suggest you to avoid taking the implicating drug in future Or this eruption may recur. For FDE I would suggest that you use a moderately potent topical steroid e.g traimcinolone acetonide 0.1% cream Or mometasone furoate 0.1% cream, twice daily for a few days.
Regards
A FDE to drug rather than a ringworm is the likely possibility
Detailed Answer:
Hello. Thank you for writing to us
I have gone through your query and I have also reviewed the Image. I can see a coin sized patch of red skin in this Image.
I would keep a likely possibility of a Fixed Drug Eruption (FDE) to either Ciprofloxacin Or Prilosec (Omeprazole) rather than a ringworm. A fixed drug eruption classically presents with a red patch of skin which may be either single or multiple, the area may blister; there is a temporal history of the eruption preceded by a drug intake. There might be either a burning sensation Or itching associated with the eruption. Which of these 2 drugs preceded the eruption? is the likely cause of FDE.
If I was the treating doctor I would suggest you to avoid taking the implicating drug in future Or this eruption may recur. For FDE I would suggest that you use a moderately potent topical steroid e.g traimcinolone acetonide 0.1% cream Or mometasone furoate 0.1% cream, twice daily for a few days.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your review and diagnosis. I had this before I started taking either of the two medications. I thought it was a blister. Not sure if you can tell from the pic, there is a definite, almost perfectly round raised circle around the perimeter of this paych . There are some very small "pustules " in this raised area, which seem to be breaking open occasionally, they contain a clear liquid. It really itches. Any further thoughts? I would really appreciate your opinion. Thank you so much. XXXXXXX XXXXXXX
Brief Answer:
A topical antifungal cream
Detailed Answer:
Hi.
Thank you for such a detailed description of the morphology of skin lesion. It is much better described than I can see from the Image and I would certainly manage it as a case of Tinea/ fungal infection. I would suggest you to apply an otc topical antifungal cream e.g either clotrimaziole 1% cream Or miconazole nitrate 2% cream, twice daily for 2 weeks. In addition I would like to add a tablet of cetrizine 10 mg once daily in evening for symptomatic relief from itching.
FDE is a possibility only if there was a preceding history of drug intake and since there is no temporal history of preceding drug intake in your case, therefore I rule it out.
Regards
A topical antifungal cream
Detailed Answer:
Hi.
Thank you for such a detailed description of the morphology of skin lesion. It is much better described than I can see from the Image and I would certainly manage it as a case of Tinea/ fungal infection. I would suggest you to apply an otc topical antifungal cream e.g either clotrimaziole 1% cream Or miconazole nitrate 2% cream, twice daily for 2 weeks. In addition I would like to add a tablet of cetrizine 10 mg once daily in evening for symptomatic relief from itching.
FDE is a possibility only if there was a preceding history of drug intake and since there is no temporal history of preceding drug intake in your case, therefore I rule it out.
Regards
Above answer was peer-reviewed by :
Dr. Yogesh D
Thank you, one last concern...with a fungal infection on my right foot, and a Urinary track infection ( which I think is a bacterial infection, should I be concerned about complications due to a metal toe implant ( in the unaffected foot?). I ask because I have to premedicTe before any dental procedure because of the danger of an infection ??? I think I scared myself by looking at the Internet too much and saw all the info about brain and heart infections. Please elaborate your thoughts as much as possible as this is the last question I am able to ask you. Thank you so much
Brief Answer:
just use topical antifungal cream for tinea
Detailed Answer:
Hi. I apologise for some delay in my reply.
As far as UTI is concerned the bacteria can disseminate through blood and localise at the site of metal implant- which can act as a nidus- thus causing orthopedic complications like osteomyelitis including others, therefore it should be treated promptly with oral antibiotics however systemic dissemination is not an expected complication of cutaneous fungal infection, in otherwise healthy individuals, primarily because the fungus feeds on keratin which is present in skin or nail and would not disseminate unless the patient is severely immunocompromised e.g a organ transplant recipient. Therefore you need not take oral antifungals or worry about this superficial fungal infection on your toe regardless of metal implant.
Regards
just use topical antifungal cream for tinea
Detailed Answer:
Hi. I apologise for some delay in my reply.
As far as UTI is concerned the bacteria can disseminate through blood and localise at the site of metal implant- which can act as a nidus- thus causing orthopedic complications like osteomyelitis including others, therefore it should be treated promptly with oral antibiotics however systemic dissemination is not an expected complication of cutaneous fungal infection, in otherwise healthy individuals, primarily because the fungus feeds on keratin which is present in skin or nail and would not disseminate unless the patient is severely immunocompromised e.g a organ transplant recipient. Therefore you need not take oral antifungals or worry about this superficial fungal infection on your toe regardless of metal implant.
Regards
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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