Fixed Drug Eruption Etiology and Clinical Presentations

Abstract

ABSTRACT
Background: Fixed drug eruption is one of the most common cutaneous disorders
encountered by the dermatologist. Some drug eruptions, although trivial, may cause
cosmetic embarrassment. The diagnostic hallmark is its recurrence at previously affected
sites when drug taken again.
Objective: To recognize the common offending drugs cause fixed drug eruption. And
describe the different clinical presentations of the disease.
Methods: A prospective study of patients with fixed drug eruption were studied in the
Department of Dermatology and Venereology, Ramadi Teaching Hospital, Anbar, Iraq
from July 2010 to January 2013, they were observed and evaluated clinically. Detailed
history of drugs and disease beside thorough clinical examination was done.
Results: A total of 77 patients, with male to female ratio of 1.7:1. A residual hyper
pigmented lesion was observed in 24.6% of patients, while 75.4 % give history of
complete healing. Lesions characterized by bluish-black or red patches, the bullous
lesions and erosions seen in 15.8% of patients, the condition associated with burning
sensation and sometimes asymptomatic. Cellulitis like fixed drug eruption described in
3.9% of patients. All body areas were affected with predominance to genital area and lips.
It was observed that cotrimoxazole is responsible for fixed drug eruption in 35% of
patients, while the griseofulvin, acetaminophen, ciprofloxacin, piroxicam in 1.2% of
patients.
Conclusion: Cotrimoxazole was the most common cause of fixed drug eruption.
Physicians should be aware of the risk of the occurrence of cutaneous adverse reactions
under acetaminophen. FDE may have cellulitis like presentations.