FIXED DRUG ERUPTION AFTER AN OVER-THE-COUNTER AYURVEDIC SUPPLEMENT (GOOD HEALTH) CONTAINING WITHANIASOMNIFERA AND ECLIPTA ALBA: A CASE REPORT
DOI:
https://doi.org/10.22159/ijpps.2026v18i2.57048Keywords:
Fixed drug eruption, Ashwagandha, Bhringraj, Herbal medicine, Ayurvedic supplement, Drug hypersensitivity, Adverse drug reactionAbstract
Fixed drug eruption (FDE) is a distinctive cutaneous adverse drug reaction that recurs at the same anatomical sites upon re-exposure to the offending agent. Although most cases are triggered by antibiotics and non-steroidal anti-inflammatory drugs, herbal and polyherbal formulations are increasingly being recognized as potential culprits. We report a 45 y old female who developed multiple erythematous to hyperpigmented patches on the trunk and extremities following the use of an over-the-counter Ayurvedic supplement, Good Health, containing Withania somnifera (Ashwagandha), Eclipta alba (Bhringraj), and other ingredients. The lesions subsided after discontinuation of the supplement and topical application of mometasone 0.1 % cream but reappeared at identical sites upon re-exposure, confirming the diagnosis of FDE. Causality assessment using WHO-UMC and Naranjo criteria categorized the event as “probable.” Confirmatory patch testing was not performed; hence, the exact culprit herb remains uncertain. This case highlights that even widely used herbal preparations can precipitate fixed drug eruptions and underscores the importance of herbal pharmacovigilance and patient counselling regarding over-the-counter Ayurvedic products.
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