Fixed drug eruption in Infant/Neonate
See also in: Cellulitis DDx,Anogenital,Oral Mucosal LesionAlerts and Notices
Synopsis

FDE is most commonly solitary, but some individuals may develop multiple patches. There may be an increasing number of patches seen with each exposure. Healing with postinflammatory hyperpigmentation is common.
Numerous drugs have been implicated in causing FDE. The most commonly associated drug classes include antibiotics (in particular sulfonamides, trimethoprim, fluoroquinolones, and tetracyclines), NSAIDs (including naproxen, ibuprofen, and celecoxib), and barbiturates. Other specifically implicated drugs include amoxicillin, erythromycin, metronidazole, fluconazole, paracetamol (acetaminophen), cetirizine, hydroxyzine, methylphenidate, oral contraceptives, quinine, and phenolphthalein. Biologic agents including ustekinumab, adalimumab, and abatacept have been reported to cause fixed drug eruptions. A nonpigmenting variant is seen with pseudoephedrine.
Codes
ICD10CM:L27.1 – Localized skin eruption due to drugs and medicaments taken internally
SNOMEDCT:
73692007 – Fixed drug eruption
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Erythema multiforme
- Contact dermatitis
- Acute febrile neutrophilic dermatosis (Sweet syndrome)
- Cellulitis or erysipelas
- Stevens-Johnson syndrome / toxic epidermal necrolysis
- Insect bite reaction
- Postinflammatory hyperpigmentation
- Lichen planus
- Bullous impetigo
- Tinea corporis
- Erythema migrans
- Recurrent herpes simplex virus (HSV) infection
Best Tests
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.Subscription Required
References
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Last Reviewed:02/02/2021
Last Updated:02/02/2021
Last Updated:02/02/2021
Fixed drug eruption in Infant/Neonate
See also in: Cellulitis DDx,Anogenital,Oral Mucosal Lesion