Abstract
Fixed drug eruption (FDE) is a cutaneous adverse drug reaction characterized by the onset of rash at a fixed location on the body each time a specific medication is ingested. With each recurrence, the eruption can involve additional sites. Lesions can have overlying vesicles and/or bullae, and when they cover a significant percentage of body surface area, the eruption is referred to as generalized bullous fixed drug eruption (GBFDE). Due to the widespread skin denudation that can be seen in this condition, GBFDE may be confused clinically with Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN). While treatments described for GBFDE include supportive care, topical and/or systemic steroids, and, recently, cyclosporine, the mainstay of management involves identifying and discontinuing the causative drug. This review article will provide an overview of FDE with an emphasis on its generalized bullous variant.
Highlights
Introduction a Special Focus on GeneralizedFixed drug eruption (FDE) was first described in 1889 by Bourns, and the term fixed drug eruption, or “éruption érythémato-pigmentée fixe” was coined by Brocq in 1894 [1,2].Brocq described “round or oval apparently edematous plaques, which varied in size from that of a coin to that of a palm; and which recurred on various parts of the body
FDEs presenting to a dermatology department in Tunisia over an 18-year period found that 44.4% of cases were localized and 55.6% of cases were generalized [6]
Epidemiology FDE can occur in all ages, including children and the elderly, but it most commonly occurs in young- to middle-aged adults, with reported median ages ranging between 35 and 60 [5,6,8,9,10,12]
Summary
Fixed drug eruption (FDE) was first described in 1889 by Bourns, and the term fixed drug eruption, or “éruption érythémato-pigmentée fixe” was coined by Brocq in 1894 [1,2]. Brocq described “round or oval apparently edematous plaques, which varied in size from that of a coin to that of a palm; and which recurred on various parts of the body. There remained in the affected areas, a pigmentation of variable shades and duration” [1]. While other variants have since been identified, this depiction of FDE as a localized, pigmented eruption that is subject to recurrence remains true today. Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations
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