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Fixed drug eruption in Infant/Neonate
See also in: Cellulitis DDx,Anogenital,Oral Mucosal Lesion
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Fixed drug eruption in Infant/Neonate

See also in: Cellulitis DDx,Anogenital,Oral Mucosal Lesion
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Contributors: Rajini Murthy MD, Elizabeth B. Wallace MD, Belinda Tan MD, PhD, Susan Burgin MD
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Synopsis

Fixed drug eruption : Lips, Tongue, Feet, Hands
Fixed drug eruption (FDE) is a cutaneous drug reaction manifested by cutaneous and/or mucosal lesions recurring at the same body site each time an individual is re-exposed to the culprit drug. FDE accounts for less than 15% of cutaneous drug reactions in the pediatric population. One or more sharply demarcated, red or violaceous patches that are typically round develop within minutes to hours of exposure to the inciting drug. These may vary from 0.5 to several centimeters in size. They are usually asymptomatic, although burning, pain, or pruritus may occur. While any cutaneous surface may be affected, the oral and anogenital mucosa are most frequently involved.

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

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

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.

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References

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Last Reviewed:02/02/2021
Last Updated:02/02/2021
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Fixed drug eruption in Infant/Neonate
See also in: Cellulitis DDx,Anogenital,Oral Mucosal Lesion
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A medical illustration showing key findings of Fixed drug eruption : Lips, Tongue, Feet, Hands
Clinical image of Fixed drug eruption - imageId=1453376. Click to open in gallery. caption: 'A close-up of a round bright red plaque with a central darker color.'
A close-up of a round bright red plaque with a central darker color.

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