fixed drug eruption

From Aaushi
Jump to navigation Jump to search

Introduction

Red to red-brown macules that appear on a certain area of the patient's skin secondary to a drug.

Etiology

Pathology

Clinical manifestations

  • red to red-brown macules localized to a certain area
  • can be anywhere on the body
    • lips, face, genitals & hands commonly involved[2]
    • lesions commonly bilateral or symmetric
  • most commonly characterized by a solitary, round to oval violaceous patch on the skin or mucosa[4]
    • multiple patches may rarely occur[4]
    • patches sharply demarcated
  • no pruritus
  • occasional fever
  • resolution often with postinflammatory hyperpigmentation
  • if offending agent is administered again, rash will often recur at the same localization[4]
    • re-exposure may result in new lesion(s) in addition to the original lesion[2]

* images[5]

Management

More general terms

References

  1. Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 30-31, 170
  2. 2.0 2.1 2.2 2.3 2.4 Medical Knowledge Self Assessment Program (MKSAP) 17, American College of Physicians, Philadelphia 2015
  3. 3.0 3.1 3.2 Mizukawa Y, Shiohara T Fixed drug eruption: a prototypic disorder mediated by effector memory T cells. Curr Allergy Asthma Rep. 2009 Jan;9(1):71-7 PMID: https://www.ncbi.nlm.nih.gov/pubmed/19063828
  4. 4.0 4.1 4.2 4.3 NEJM Knowledge+ Question of the Week. Nov 8, 2016 http://knowledgeplus.nejm.org/question-of-week/1452/
  5. 5.0 5.1 Elston CA, Elston DM Identifying Lesions on Skin of Color. Medscape. October 25, 2022 https://reference.medscape.com/slideshow/identifying-lesions-6007985