Skin ulcers as a complication of short-term use of phenazopyridine in an old man: A case report

• Published in: Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 2022-12, Vol.28 (12), p.1654-1657
• Main Authors: Zarei, Batool, Tavanaee Sani, Ashraf, Elyasi, Sepideh
• Format: Article
• Language: English
• Subjects: Blister; Phenazopridine; Skin eruption; Skin ulcer
• ISSN: 1341-321X; 1437-7780
• DOI: 10.1016/j.jiac.2022.08.005

Phenazopyridine is an azo dye, which exerts local anesthetic or analgesic action on urinary tract mucosa through an unknown mechanism. Besides its common complications including orange discoloration of the urine and gastrointestinal problems, it may have rare side effects like hemolytic anaemia, methemoglobinemia, renal failure, and skin changes. We reported a paraplegic man with skin ulcers on scretom and right foot after about 3 days of phenazopyridine use A 62-year-old man presented with flesh shaped deep ulcers in lower parts of the body. He declared that at first a bluish discoloration was developed in the lower extremities and scrotum skin after use of eight phenazopyridine tablets (200 mg) and then these lesions turned to blisters and ulcers and they were prurient. The patient underwent sonography and CT-angiography; however, no pathologic findings were found. He just received losartan for many years as past drug history. According to the history, a delayed drug hypersensitivity reaction was suspected and the patient wounds healed after using special type of dressings and antibiotic therapy regarding positive wound cultures. Phenazopyridine severe skin changes are hardly reported. We described a case who experienced severe skin reactions and ulcers following phenazopyridine use not related to other complications including renal dysfunction, methemoglobinemia, and hemolytic anemia.