Fixed eruption

► Fixed drug eruption

Fixed drug eruption. Scaly, red plaque on the glans penis

Pathogenesis

Probably results from an immunologically mediated inflammatory response to a given medication

Clinical manifestation

Develops 6-48 hours after administration of the causative drug; common etiologic agents: aspirin, barbiturates, co-trimoxa-zole, phenolphthalein, sulfonamides, and tetracycline; pruritus and burning, occasionally accompanied by fever; starts as a few sharply demarcated, erythematous macules that rapidly become erythematous plaques, usually on the lips, genitalia, and trunk; lesions heal hyperpigmentation; recurrence in the same site with readministration of the offending drug

Differential diagnosis

Contact dermatitis; herpes simplex virus infection; chemical burn; bullous pemphig-oid; lupus erythematosus; psoriasis; porphyria cutanea tarda; erythema multiforme; erythema migrans; bullous disease of diabetes mellitus; post-inflammatory hyperpigmentation; factitial disease

Therapy

Withdrawal of offending drug* References

Shiohara T, Mizukawa Y, Teraki Y (2002) Pathophysiology of fixed drug eruption: the role of

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