History:

An old patient has had knee osteoarthritis of many years duration. At last month he took Ibuprofen tablets for the first time, two days later he developed a widespread skin rash. On examination, a purpuric eruption was seen on both shins and dorsa of the feet, whereas on the thighs and forearms an erythema multiforme-like rash with some purpuric elements was found. The patient was diagnosed as purpuric drug eruption due to NSAID (Ibuprofen) and asked to stop this drug. A moderately potent topical corticosteroid twice daily was prescribed. Complete resolution of the rash was noticed 3 weeks later on follow up (see the last image for follow up).