Fixed Drug Eruption (FDE)is a type of cutaneous drug reaction that characteristically recurs in the same locations upon re-exposure to the offending drug.
FDE typically presents with well-demarcated, round to oval, dusky red to brown/black macules that may evolve into edematous plaques with or without vesiculation or blistering. Lesions are usually solitary, buy may occur in small groups.
Systemic symptoms, such as fever and malaise, are usually absent. Pruritus and a burning or stinging sensation are common. FDE may occur anywhere on the body. Sites of predilection include the lips, genitalia, perianal area, hands & feet, erosions & ulcers on mucosal areas.
Acute lesions generally appear 30 minutes to 8 hours after drug administration, but can occur up to two weeks after drug exposure. After discontinuation of the offending drug, lesions resolve spontaneously in 7 to 10 days, leaving a persistent gray/brown or slate gray post-inflammatory hyperpigmentation.
Upon re-exposure to the offending drug, lesions typically recur in the same site, but new lesions may develop elsewhere. After one or more localized eruptions, FDE rarely may evolve into a bullous generalized form mimicking Stevens-Johnson syndrome/toxic epidermal necrolysis.
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