fixed drug eruption
Last reviewed 01/2018
- a drug eruption that occurs at the same site(s) each time the offending
drug is taken (1)
- causes include:
- phenolphthalein (present in many over the counter laxatives)
- barbiturates
- NSAIDs
- codeine
- paracetamol
- tetracyclines
- chlordiazepoxide
- sulphonamides (includes sulphonamide antibiotics, sulphonylureas, thiazide diuretics)
- lesions:
- usually appear within a couple of days to weeks after drug ingestion and resolves with the withdrawal of the offending drug
- often painful, pruritic or burning
- appear as clearly demarcated oval or round erythematous plaques
- become violaceous after 1-2 days
- typically 1-3 lesions
- common sites - hands, feet, glans penis, lips, sacral skin
- lesions fade after about 1 week and leave a hyperpigmented patch that may last for several months
- rare presentations include periorbital or generalized hypermelanosis (1)
- causes include:
Drug rechallenge can be used to find out the causative drug. Patch testing and intradermal skin testing can also be used in some patients (1)
Management options include
- identifying and discontinuing the offending drug
- systemic antihistamines with topical corticosteroids for the lesions
- systemic corticosteroids – for extensive lesions with bullae (1)
Reference: