Inclisiran-Induced Fixed Drug Eruption in a Patient With Refractory Hypercholesterolemia

We report the case of a 72-year-old man with a history of atrial fibrillation, hypertension, and refractory hypercholesterolemia who developed a fixed drug eruption following treatment with inclisiran, a small interfering RNA (siRNA) targeting proprotein convertase subtilisin/kexin type 9 (PCSK9). The patient had documented statin intolerance and inadequate response to ezetimibe and bempedoic acid, prompting initiation of inclisiran. Following the second injection, he developed a persistent pruritic erythematous rash affecting the lower abdomen and legs. Dermatologic assessment, including skin biopsy, confirmed a drug eruption. Symptoms improved with topical therapy and antihistamines. Due to the ongoing need for lipid control, bempedoic acid was reintroduced without recurrence of the rash. This case highlights a rare cutaneous adverse reaction to inclisiran and underscores the importance of monitoring for dermatologic complications associated with novel lipid-lowering therapies.