Fixed Drug Eruption

Aka: Fixed Drug Eruption

1. See Also
   1. Adverse Drug Reaction
2. Causes: Antimicrobials
   1. Antibiotics
      1. Sulfonamides (e.g. Bactrim) - most common
      2. Tetracycline - most common
      3. Cephalosporins
      4. Macrolides (e.g. Erythromycin, Clarithromycin)
      5. Clindamycin
      6. Fluoroquinolones
      7. Penicillins (e.g. Amoxicillin)
   2. Antifungals
      1. Fluconazole
      2. Ketoconazole
      3. Griseofulvin
   3. Miscellaneous
      1. Antimalarials
      2. Dapsone
3. Causes: Miscellaneous
   1. Cardiovascular agents
      1. Beta Blockers
      2. ACE Inhibitors
      3. Flecainide
   2. Analgesics
      1. Acetaminophen
      2. NSAIDs or Aspirin
      3. Allopurinol
      4. Colchicine
      5. Opiates (e.g. Codeine)
   3. Neuropsychiatric agents
      1. Barbiturates
      2. Gabapentin
      3. Carbamazepine
      4. Lamotrigine
      5. Benzodiazepines
      6. Lithium
   4. Antihistamines
      1. Hydroxyzine
      2. Laratodine
   5. Miscellaneous
      1. Finasteride
4. Symptoms
   1. Lesion with pruritic or burning pain
   2. Lesion timing
      1. Onset within days to weeks of medication use
      2. Lesion resolves once medication is withdrawn
      3. Lesions recur at same site on reexposure to drug
5. Signs
   1. Lesion distribution
      1. Face or ears
      2. Genital region
      3. Sacral area
      4. Hands or feet
   2. Lesion characteristics
      1. Annular Lesions
         1. Round erythematous patch with sharp borders
      2. May also present as bullae or ulcers
      3. Hyperpigmentation may occur on healing after withdrawal of causative agent
6. Management
   1. Withdraw suspected medication
   2. Consider Corticosteroids (topical or systemic)
   3. Consider Antihistamine for Pruritus
   4. Observe open lesions for secondary infection
7. References
   1. Crowson (2003) Am J Clin Dermatol 4:407-28