Author:
Mahajan Vikram,Singh Suman,Thakur Priyanka,Kukreja Amisha,Negi Rohit
Abstract
This paper describes an unreported case of a rifaximin-induced phototoxic reaction in an otherwise
healthy 24-year-old female (skin type: V). The patient developed malaise, chills, and facial swelling
with accompanying redness and itching that began within a day of initiating treatment with rifaximin
(200 mg twice daily), and progressively increased over the next 3–4 days. The patient revealed that
they had been lying in the sun for hours due to the chills they were experiencing. Over the next
10 days they developed an exaggerated, acute, sunburn-like phototoxic reaction, with blistering
over the exposed skin. A skin biopsy showed no evidence of vasculopathy, endothelial damage, or
extravasation of red blood cells. The patient was treated successfully with oral prednisolone (30 mg
per day for a week), topical mometasone furoate (0.1%) cream applied twice daily, levocetirizine (5
mg per day taken orally), zinc oxide (20.0%) cream applied every 3 hours during daytime, and strict
sun avoidance. The possible pathomechanism of rifaximin-induced sunburn is also discussed here.