drug eruption, fixed

A fixed drug eruption represents a skin reaction to a particular drug that erupts every time the drug is taken, in the same place on the body. The skin rash is usually preceded by itching or burning, then erupts as a raised dusky red or purple-tinged patch of skin (plaque). The affected skin may blister as well. Common locations are the hands and feet, lips, and genitalia.

The first time the rash appears, it will occur one or two weeks after the drug ingestion. Subsequent attacks will appear in exactly the same spot within 24 hours or so of the drug exposure. The rash fades in a week or two, but leaves the affected area a dark blue-black color.

Common drugs that produce fixed drug eruptions are

  • ibuprofen and other non-steroidal anti-inflammatory drugs (NSAIDs) (Motrin®, Advil®)
  • trimethoprim-sulfa (Septra®, Bactrim®)
  • acetaminophen (Tylenol®)
  • tetracyclines (doxycyline, minocycline - commonly used for acne)

The only treatment is avoidance of the culprit drug, and the sensitivity is probably life-long.

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