Fixed-drug eruption caused by ashwagandha (Withania somnifera): a widely used Ayurvedic drug.
A 28-year-old man with decreased libido received ashwagandha in the usual daily dosage of 5 g for 10 days. During this period, he experienced a burning and/or itching sensation as well as discoloration of the skin/mucous membrane confined to the penis. He had a similar type of eruption at the same site 6 months prior while taking ashwagandha. Examination of the skin surface was conspicuous and marked by the presence of a dusky, erythematous, oval, eroded plaque of 3 cm, affecting the glans penis and prepuce (Figure). The drug was withdrawn and topical 0.05% clobetasol propionate cream was administered along with cetrizine dihydrochloride, an H1-receptor blocker, 10 mg daily for 1 month. There was a perceptible amelioration of the lesion, resulting in residual greyish white pigmentation. He was prescribed oral drug provocation with 1 g of ashwagandha powder. Within 12 hours, a flare-up developed at the earlier site, confirming the causality.
Dermato-Venereology (Skin/VD) Center, Sehgal Nursing Home, Panchwati-Delhi, India. drsehgal@ndf.vsnl.net.in
Virendra N
VN
Sehgal
Prashant
P
Verma
Sambit N
SN
Bhattacharya
D000328:Adult; D017332:Cetirizine / Q000627:therapeutic use; D002990:Clobetasol / Q000008:administration & dosage / Q000627:therapeutic use; D003875:Drug Eruptions / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008297:Male; D008515:Medicine, Ayurvedic; D010409:Penile Diseases / Q000139:chemically induced* / Q000473:pathology; D008517:Phytotherapy / Q000009:adverse effects / Q000379:methods; D010936:Plant Extracts / Q000009:adverse effects / Q000627:therapeutic use; D032341:Withania / Q000009:adverse effects*
D010936:Plant Extracts; D002990:Clobetasol; C030693:Ashwagandha; D017332:Cetirizine