Photolocalized purpura during ciprofloxacin therapy

Photosensitivity reactions reported with ciprofloxacin mimic those of sunburn, with erythema and edema in the milder forms, and painful blistering with subsequent peeling when severe. Purpuric eruptions during treatment with ciprofloxacin have been rarely reported. We describe a 30-year-old man who was given a 15-day course with ciprofloxacin 500 mg twice a day for a prostatitis. Coinciding with sun exposure, he developed a purpuric, pruriginous eruption on his lower extremities, consisting of erythematous, petechial lesions located on the anterior aspect of his thighs and legs, clearly delimited by his bathing suit. The lesions cleared completely after the discontinuation of the drug and treatment with topical clobetasol. The acute reaction observed in our patient differed from a classical sunburn, consisting of confluent petechias, strictly limited to sunlight-exposed areas, and accompanied by pruritus. Photoexposed purpuric eruptions should be considered as another side effect of ciprofloxacin therapy in addition to phosensitivity rashes.