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Fixed drug eruption FDE is a distinctive variant of drug-induced cutaneous reactions. A year-old Korean male presented with recurrent erythematous patches on the trunk and extremities. Multiple erythematous to dusky red, round to oval-shaped patches had appeared on the left chest, right back, suprapubic area, left knee, left upper inner arm, and fingers Fig. The subjective symptom was mild pruritus. Headache presented one day before the skin lesions appeared. Two years prior, the patient had been taking sildenafil citrate 50 mg once or twice a month. The lesions were revealed in two days to a week after taking the medicine.

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Residual pulmonary hypertension is the most important risk factor for death and disability after successful correction of the valvular lesion. Pulmonary hypertension refers to increased blood pressure in the pulmonary artery. In patients with long-standing valvular disease, the high pressure in the left side of the heart is transmitted backwards to the lung vessels which react by thickening. This process may not revert after valve treatment, resulting in persistent pulmonary hypertension. Sildenafil is a potent vasodilator with a strong effect on blood flow. Sildenafil is believed to be safe and well tolerated and is frequently prescribed as an off-label indication in patients with retrograde pulmonary hypertension.

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