Scrotal Abscess Mimicking Fixed Drug Eruption Under Ibuprofen Therapy: A Diagnostic Pitfall

Area of Science:

• Urology
• Pharmacology
• Dermatology

Background:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used for pain relief.
• NSAID use can sometimes lead to adverse drug reactions.
• Scrotal abscesses present with inflammatory signs.

Purpose of the Study:

• To investigate the potential of NSAID therapy to mask the clinical presentation of early scrotal abscess.
• To differentiate between fixed drug eruption and scrotal abscess in patients on NSAIDs.

Main Methods:

• Case analysis of patients presenting with symptoms suggestive of fixed drug eruption while on NSAID therapy.
• Review of clinical, historical, and laboratory findings.
• Correlation with scrotal ultrasound results.

Main Results:

• Concurrent NSAID use, specifically ibuprofen, can pharmacologically mask early scrotal abscess.
• The presentation may fulfill criteria for fixed drug eruption due to suppressed inflammatory signs.
• Normal inflammatory markers and lack of fluctuation do not exclude an underlying abscess.

Conclusions:

• NSAID therapy can obscure the diagnosis of scrotal abscess, leading to misdiagnosis as fixed drug eruption.
• Early scrotal ultrasound is a mandatory diagnostic tool to exclude abscess in suspicious cases.
• Clinicians must maintain a high index of suspicion for scrotal abscess in patients on NSAIDs presenting with atypical symptoms.