Non-Pigmenting Fixed Drug Eruption Due to Fluconazole Without Cross-Reactivity to Itraconazole

Abstract

Fixed drug eruption is an uncommon cutaneous skin reaction that is most frequently attributed to antibiotics, non-steroidal anti-inflammatories, and paracetamol. Localized hyperpigmentation often results after the resolution of acute inflammation. Rarely, do fixed drug eruptions resolve without hyperpigmentation. Non-pigmenting fixed drug eruption (NPFDE) is an uncommon subtype that is characterized by well-demarcated, tender erythematous plaques that resolve without post-inflammatory hyperpigmentation. NPFDE has most frequently been associated with pseudoephedrine and piroxicam, but we report a case of a 48-year-old female with repeated occurrences of fluconazole-induced non-pigmenting fixed drug eruption. Clinical diagnosis of non-pigmenting fixed drug eruption was made based on the correlation of the lesion appearing within 2 hours after fluconazole ingestion, and previous history of similar reactions after fluconazole intake with resolution without residual pigmentation.