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Am Fam Physician 2020 Mar;101(6):355-361

Georgetown University Medical Center, MedStar Georgetown University Hospital, Washington, DC, USA.

Genital ulcers may be located on the vagina, penis, and anorectal or perineal areas and may be infectious or noninfectious. Herpes simplex virus is the most common cause of genital ulcers in the United States. A diagnosis of genital herpes simplex virus infection is made through physical examination and observation of genital lesions. Read More

Case Rep Dermatol 2020 Jan-Apr;12(1):25-32. Epub 2020 Feb 4.

Department of Dermatology, Kyorin University School of Medicine, Tokyo, Japan.

Although hepatitis C virus (HCV) infection is often associated with extrahepatic cutaneous manifestations such as lichen planus, it is unclear whether HCV or HCV-specific immune responses play a pathophysiological role in the development of HCV-related cutaneous diseases. We recently treated a patient who developed parapsoriasis en plaque-like lesions after ingestion of various drugs. She showed hypersensitivity to multiple drugs after interferon therapy. Read More

Acta Derm Venereol 2020 02 12;100(5):adv00057. Epub 2020 Feb 12.

Dokumentationszentrum schwerer Hautreaktionen (dZh), Department of Dermatology, Medical Center - University of Freiburg, Hauptstrasse 7, DE-79104 Freiburg, Germany.

Bullous drug eruptions are infrequent, but because they pose a challenge both to affected patients and to treating physicians they are considered to be the most severe cutaneous adverse reactions (SCAR). It is important to recognize these conditions and to differentiate them from other clinical entities involving blister formation. There may be early signs and symptoms that indicate a severe bullous drug eruption even before blisters and erosions of the skin and mucous membranes become obvious. Read More

Am J Clin Dermatol 2020 Jun;21(3):393-399

Dermatology, Rutgers New Jersey Medical School, 185 South Orange Avenue, Medical Science Building H-576, Newark, NJ, 07103-2757, USA.

A fixed drug eruption (FDE) is a relatively common reaction associated with more than 100 medications. It is defined as a same-site recurrence with exposure to a particular medication. The primary approach and treatment for all types of FDEs are to identify and remove the causative agent, often accomplished by a thorough history of medication and other chemical exposures, and possibly prior episodes. Read More

J Dermatol 2020 Feb 12;47(2):178-180. Epub 2019 Dec 12.

Department of Dermatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.

Autoimmune progesterone dermatitis (APD) is a rare cutaneous disorder with cyclic skin eruptions during the luteal phase of the menstrual cycle. Patients can present with various clinical manifestations, including urticaria and angioedema, erythema multiforme, eczema, fixed drug eruption and centrifugal erythema annulare. In our case, however, the patient's skin lesions mimic necrotic migratory erythema (NME) which is most commonly associated with glucagonoma and rarely with liver disease, inflammatory bowel disease, malnutrition and other tumors. Read More

BMJ Case Rep 2019 Dec 1;12(11). Epub 2019 Dec 1.

Dermatology, Himalayan Institute of Medical Sciences, Dehradun, India.

Autoimmune progesterone dermatitis (APD) is a rare disorder that presents as recurrent cyclical cutaneous eruptions during the premenstrual period when progesterone level is elevated. It does not have a specific cutaneous manifestation of its own and presents with a multitude of common cutaneous conditions, thus making it a diagnostic challenge. We describe the case of a young woman who presented with a hyperpigmented patch on her left thigh, over which she developed recurrent erythema, pain and itching, starting 2 days before her menstrual cycle and resolving within 2 days after menstruation. Read More

Skinmed 2019 1;17(5):306-309. Epub 2019 Sep 1.

Dermatology Department, Habib Thameur Hospital, Research Unit "Genodermatoses and Cancers LR12SP03," Tunis, Tunisia.

Bullous fixed drug eruption (FDE) is a severe reaction due to drug intake and requires specific management in dermatology. The sites of predilection are the lips, trunk, genitalia, and perineal area. The aim of our study was to assess the features and outcomes of bullous FDE with genital involvement through a retrospective study of 18 years (2000-2017) conducted in the Dermatology Department of Habib Thameur Hospital. Read More

Einstein (Sao Paulo) 2020 25;18:eRC5002. Epub 2019 Nov 25.

Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.

The fixed drug eruption is a non-immediate hypersensitivity reaction to drug, characterized by recurrent erythematous or violaceous, rounded, well-defined border plaques, which always appear in the same location every time the culprit drug is administered. The usual practice is to avoid the drug involved and to use a structurally different drug. However, there are situations in which there is no safe and effective therapy. Read More

Curr Pharm Des 2019 ;25(36):3840-3854

Department of Pediatric Allergy and Immunology, University of Health Sciences, Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital, Ankara, Turkey.

Drug hypersensitivity reactions are clinically heterogenous ranging from mild to severe. Most drug hypersensitivity reactions are accompanied by cutaneous manifestations. Fever, mucous membrane involvement, large blisters, facial oedema, pustulosis and visceral involvement are clinical features that lead to suspicion of severe adverse drug reactions. Read More

Curr Pharm Des 2019 ;25(36):3881-3901

Department of Pediatric Allergy and Immunology, Mersin University, Faculty of Medicine, Mersin, Turkey.

Severe cutaneous drug hypersensitivity reactions involve of different mechanisms , some of which are life-threatening, such as Stevens-Johnson syndrome/toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms, acute generalized exanthematous pustulosis, generalized bullous fixed drug eruptions, serum sickness and serum sickness-like reaction and drug-induced vasculitis. These reactions may have substantial morbidity and mortality. In the past years, successive studies have provided new evidence regarding the pathogenesis of some of these severe reactions and revealed that underlying mechanisms are highly variable. Read More

Proc (Bayl Univ Med Cent) 2019 Oct 7;32(4):601-602. Epub 2019 Aug 7.

Department of Dermatology, Texas Tech University Health Sciences CenterLubbockTexas.

A 59-year-old woman with end-stage renal disease presented for suspected Stevens-Johnson syndrome that was ultimately diagnosed as generalized bullous fixed drug eruption (GBFDE) secondary to the administration of iodinated nonpolar radiocontrast. The patient had three previous episodes of a generalized bullous eruption after a thrombectomy, fistulogram, and an arteriovenous fistula revision, all requiring radiocontrast administration. Biopsies taken after previous eruptions demonstrated full-thickness epidermal necrosis, and she was diagnosed with Stevens-Johnson syndrome thought to be due to allopurinol. Read More

Rev Prat 2019 Jun;69(6):640

Département de dermatologie, Hôpital français de Hanoï, Hanoi, Vietnam.

Indian J Pharmacol 2019 Jul-Aug;51(4):279-281

Department of Pediatrics, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysore, Karnataka, India.

Various adverse drug reactions, including hypersensitivity skin reaction after the exposure to carmoisine colorant, have already been reported in the literature. This case report gives the details of a 5-year-old male child with a recurrent fixed drug eruption (FDE) over the neck and trunk after the use of paracetamol syrup containing carmoisine as a colorant. Patch test to the carmoisine colorant in the paracetamol syrup was positive. Read More

J Cosmet Dermatol 2020 May 21;19(5):1143-1145. Epub 2019 Sep 21.

Islamic Azad University of Medical Sciences, Sari, Iran.

Background: Fixed Drug Eruption (FDE) is a drug reaction involving the skin and less commonly the mucosal membranes. Tamsulosin is an alpha-1 adrenergic receptor blocker used to treat benign prostatic hyperplasia. Dizziness and headache are among its most common side effects (Singapore Med J, 2018;59:336). Read More

Recent Pat Inflamm Allergy Drug Discov 2019 ;13(2):144-157

Department of Biomedical Science and Human Oncology, Dermatological Clinic, University of Bari, Bari, Italy.

Background: Antifungal azoles are the first-line agents used to treat topical and, above all, systemic mycosis. The latter could be life-threating infections in immunocompromised patients. Chemotherapeutic antibiotics, including antifungal azoles, may induce hypersensitivity reactions; however, such immunologic adverse reactions have not been defined and carefully investigated. Read More

J Investig Allergol Clin Immunol 2019 Aug;29(4):307-309

Allergy Unit, Hospital La Paz, Madrid, Spain.

Contact Dermatitis 2020 Jan 21;82(1):56-57. Epub 2019 Aug 21.

Department of Dermatology, Course of Integrated Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan.

J Cutan Pathol 2019 Dec 21;46(12):979-981. Epub 2019 Aug 21.

Kaplan-Amonette Department of Dermatology, University of Tennessee Health Science Center, Memphis, Tennessee.

Contact Dermatitis 2019 Nov 7;81(5):336-340. Epub 2019 Aug 7.

University Hospital of Fattouma Bourguiba of Monastir, Department of Pharmacology, University of Monastir, Monastir, Tunisia.

Background: Fixed drug eruption (FDE) represents a drug-related cutaneous reaction. Many drugs been associated with this clinical entity, with continually evolving documentation of implicated agents and clinical presentations. A bullous form can occur although it is rare. Read More

Pancreas 2019 08;48(7):927-930

Division of Hematology and Oncology, Department of Medicine, UCSF Medical Center, San Francisco, CA.

Objective: Determine whether a regimen of fixed dose rate gemcitabine plus capecitabine is effective and tolerable for advanced pancreatic adenocarcinoma.

Methods: We performed a retrospective analysis of 62 patients with locally advanced or metastatic pancreatic adenocarcinoma treated at the University of California San Francisco between 2008 and 2016. Treatment was an alternate week schedule of fixed dose rate 1000 mg/m gemcitabine and capecitabine 1000 mg/m (58 patients), 1200 mg/m (12 patients), or 650 mg/m (1 patient) for intended 12 cycles. Read More

Contact Dermatitis 2019 Nov 9;81(5):388-389. Epub 2019 Jul 9.

Dermatology Department, Hospital Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal.

Hautarzt 2019 Nov;70(11):883-887

Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Leipzig, Philipp-Rosenthal-Str. 23, 04103, Leipzig, Deutschland.

We present four clinicopathological correlated cases of young patients with cryothermic dermatitis artefacta. They were initially misdiagnosed as primary bullous dermatoses or fixed drug eruptions. Cryothermic dermatitis artefacta can imitate authentic dermatoses such as linear IgA bullous dermatosis, herpes virus infection, bullous pemphigoid or fixed drug eruption. Read More

Clin Exp Dermatol 2019 Dec 4;44(8):844-860. Epub 2019 Jun 4.

Department of Dermatology, King's College Hospital, London, UK.

Contrast media (CM) are an indispensable part of modern medical imaging. Adverse reactions to CM are uncommon, but frequently involve cutaneous symptoms. This two-part article reviews adverse events secondary to CM that are relevant to the practising dermatologist. Read More

Periodontol 2000 2019 06;80(1):105-125

UCL Eastman Dental Institute, University College London, London, UK.

Oral lichen planus and lichenoid lesions comprise a group of disorders of the oral mucosa that likely represent a common reaction pattern to 1 or more unknown antigens. The coexistence of hyperkeratotic striation/reticulation, varying degrees of mucosal inflammation from mild erythema to severe widespread ulceration, and a band-like infiltrate of mononuclear inflammatory cells including activated T lymphocytes, macrophages, and dendritic cells, are considered suggestive of oral lichen planus and lichenoid lesions. Several classification systems of oral lichen planus and lichenoid lesions have been attempted, although none seem to be comprehensive. Read More

Postgrad Med J 2019 Jun 13;95(1124):340-341. Epub 2019 May 13.

Internal Medicine, Civil Hospital, Baddi, Himachal Pradesh, India.

Therapie 2019 Oct 31;74(5):527-530. Epub 2019 Mar 31.

Dermatology Department, Habib Thameur Hospital, 1089 Tunis, Tunisia.

Background: Bullous fixed drug eruption (BFDE) is a rare and particular adverse drug reaction characterized by localized or generalized blisters and erosions, which can be confused with Stevens-Johnson syndrome, toxic epidermal necrolysis, major erythema multiforme and autoimmune bullous dermatosis.

Objective: The aim of our study was to assess the epidemiological, clinical and therapeutic features and outcome of BFDE.

Methods: A retrospective and descriptive study collecting all observations of BFDE was conducted in the dermatology department of Habib Thameur Hospital in Tunisia, over an 18-year period (2000-2017). Read More

Acta Derm Venereol 2019 Jun;99(7):689-690

Department of Dermatology, Toho University Ohashi Medical Center, 2-22-36 Ohashi, Meguro-ku, Tokyo 153-8515, Japan.

Clin Exp Dermatol 2019 Dec 11;44(8):944. Epub 2019 Apr 11.

Department of Dermatology, Suqian First Hospital, Suqian, Jiangsu, China.

Pediatr Ann 2019 Mar;48(3):e135-e138

Rash is a common chief complaint for patients presenting to their physician, especially within the pediatric field. The ability to distinguish characteristics of a rash, including morphology, distribution, and configuration, is critical to forming the differential diagnosis. This is the second article of a 2-part review that discusses the common rashes that present in an annular configuration. Read More

Oral Surg Oral Med Oral Pathol Oral Radiol 2019 May 6;127(5):393-398. Epub 2019 Feb 6.

Associate Professor, Department of Oral Medicine and Pathology, Faculty of Dentistry, National and Kapodistrian University of Athens, Athens, Greece. Electronic address:

Objective: The aim of this study was to describe 2 patients with piroxicam-associated fixed drug eruption on the tongue and to review the literature.

Study Design: Two females presented with recurrent ulcers after taking piroxicam for dysmenorrhea and pelvic pain. The English language literature was reviewed for cases of piroxicam-induced fixed drug eruptions, with a report on the site of occurrence. Read More

Dermatitis 2019 Mar/Apr;30(2):174-175

Department of Dermatology Hospital General Universitario de Alicante Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL)Alicante, Spain Department of Dermatology Complejo Hospitalario Universitario de Albacete Albacete, Spain Department of Dermatology Hospital General Universitario de Alicante Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL) Alicante, Spain.

QJM 2019 Jun;112(6):429-435

Department of Pathology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, India.

Background: Histoid leprosy is a subtype of leprosy with distinct clinical presentation and histologic features. It accounts for <4% of leprosy cases. The exact location of histoid leprosy along the immune spectrum and its relation to other subtypes is unclear. Read More

Contact Dermatitis 2019 Jul 4;81(1):24-26. Epub 2019 Mar 4.

Faculty of Medicine, Department of Pharmacology, EPS Fattouma Bourguiba, University of Monastir, Monastir, Tunisia.

Background: Non-steroidal anti-inflammatory drugs constitute a main cause of fixed drug eruption (FDE). A few cases of piroxicam-induced FDE have been reported; however, the cross-reactivity among oxicams has rarely been evaluated.

Objectives: To describe a series of patients with piroxicam-induced FDE, mostly confirmed by a positive patch test reaction, in whom cross-reactivity to meloxicam was assessed. Read More

Sultan Qaboos Univ Med J 2018 Aug 19;18(3):e402-e404. Epub 2018 Dec 19.

Department of Dermatology, Thriasio General Hospital, Athens, Greece.

A fixed drug eruption consists of erythematous patches that appear on the skin and/or mucous membranes following administration of a drug which, once healed, leaves residual hyperpigmentation. We report a 76-year-old male who presented to the Thriasio General Hospital, Athens, Greece, in 2016 with erythema, oedema and blistering of the lower lip and penis following the administration of silodosin for benign prostatic hyperplasia. The eruption regressed two weeks after silodosin was discontinued. Read More

Clin Exp Dermatol 2019 Apr 21;44(3):358-359. Epub 2018 Dec 21.

Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland.

J Allergy Clin Immunol 2019 01 17;143(1):66-73. Epub 2018 Dec 17.

Dermatology and Allergy Department, Tenon Hospital, Medecine Sorbonne University, Paris, France; Assistance publique-hopitaux de Paris, Paris, France.

Controversies exist with regard to in vivo approaches to delayed immunologically mediated adverse drug reactions, such as exanthem (maculopapular eruption), drug reaction with eosinophilia and systemic symptoms, acute generalized exanthematous pustulosis, Stevens-Johnson syndrome/toxic epidermal necrolysis, and fixed drug eruptions. In particular, widespread differences exist between regions and practice on the availability and use of intradermal and patch testing, the standard drug concentrations used, the use of additional drugs in intradermal and patch testing to help determine cross-reactivity, the timing of testing in relation to the occurrence of the adverse drug reaction, the use of testing in specific phenotypes, and the use of oral challenge in conjunction with delayed intradermal and patch testing to ascertain drug tolerance. It was noted that there have been advances in the science of delayed T cell-mediated reactions that have shed light on immunopathogenesis and provided a mechanism of preprescription screening in the case of HLA-B*57:01 and abacavir hypersensitivity and HLA-B*15:02 and carbamazepine Stevens-Johnson syndrome/toxic epidermal necrolysis in Southeast Asian subjects. Read More

J Dermatol 2019 Jun 19;46(6):e222-e224. Epub 2018 Dec 19.

Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Indian J Pharmacol 2018 Jul-Aug;50(4):192-196

Department of Pharmacology and Dermatology, SCB Medical College, Cuttack, Odisha, India.

Objectives: To identify the association of cutaneous adverse drug reactions (CADRs) with use of fixed-dose combinations (FDCs) and to compare the occurrence of preventable CADRs between self-medication and prescribed medication of FDCs.

Patients And Methods: All cases of suspected CADRs with the use of FDCs were collected, and causality assessment was carried out using the WHO UMC scale. The burden of CADRs on self-medication and prescribed medication was found out. Read More

J Allergy Clin Immunol Pract 2019 04 1;7(4):1253-1260.e3. Epub 2018 Dec 1.

Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, Mass; Department of Medicine, Harvard Medical School, Boston, Mass. Electronic address:

Background: Hypersensitivity reactions (HSRs) are immunologic responses to drugs. Identification of HSRs documented in the electronic health record (EHR) is important for patient safety.

Objective: To examine HSR epidemiology using longitudinal EHR data from a large United States health care system. Read More

An Bras Dermatol 2018 Nov/Dec;93(6):874-877

Department of Pathology, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.

Autoimmune progesterone dermatitis is an uncommon, poorly recognized and under-diagnosed catamenial dermatosis associated with hypersensitivity reactions to progestagens. Most cases manifest as urticaria, eczema or erythema multiforme-like. A 26-year-old woman developed violaceous plaques on the groin and abdomen, 4 days after a spontaneous abortion resolved with uterine curettage. Read More

Contact Dermatitis 2019 Mar 21;80(3):184-186. Epub 2018 Nov 21.

Dermatology, Allergology and Photobiology Department, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France.

Turk J Gastroenterol 2019 03;30(3):299-302

Department of Pathology, Necmettin Erbakan University School of Medicine, Konya, Turkey.

Fixed drug eruption (FDE) is a type of drug reaction characterized by localized erythema, hyperpigmentation, and bullous at the same site(s), generally observed following every intake of a causative drug. Delayed-type cellular hypersensitivity (Type IVC) is considered to play a role in FDE etiology. Several antibiotics, barbiturates, oral contraceptives, nonsteroidal anti-inflammatory drugs, laxative-containing phenolphthalein, metronidazole, and quinine are known to be the primary drugs responsible for FDE. Read More

Contact Dermatitis 2019 Apr 19;80(4):238-239. Epub 2018 Dec 19.

Department of Dermatovenereology, Hospital de Braga, Braga, Portugal.

Contact Dermatitis 2019 Mar 12;80(3):172-173. Epub 2018 Nov 12.

Department of Dermatology, Medical University of Vienna, Vienna, Austria.

Indian J Ophthalmol 2018 Nov;66(11):1627-1629

Department of Pediatrics, Dr Shroff's Charity Eye Hospital, New Delhi, India.

Fixed drug eruption (FDE) is a type of drug-induced cutaneous disorder that characteristically presents with recurrence of similar lesion at the same skin or mucosal site as a result of systemic exposure to a drug. Paracetamol is commonly prescribed analgesic-antipyretic agent in all age group of patients. FDE due to paracetamol is not very common but it is well reported in literature for all age groups. Read More

J Cutan Pathol 2019 Feb 14;46(2):134-137. Epub 2018 Nov 14.

University of Washington Division of Dermatology, Seattle, Washington.

We present a case of a widespread fixed drug eruption histologically mimicking CD8 positive cutaneous T-cell lymphoma (CTCL). CTCL has several potential histological and clinical mimics, and accurate diagnosis relies on a combination of clinicopathological correlation and molecular studies. We add generalized fixed drug eruption to the list of possible CTCL mimics. Read More

Contact Dermatitis 2019 Jan 24;80(1):56-57. Epub 2018 Sep 24.

Department of Allergy, University Hospital of Salamanca, Salamanca, Spain.

Am Fam Physician 2018 09;98(5):283-291

Thomas Jefferson University Hospital, Philadelphia, PA, USA.

Annular lesions can present in a variety of diseases. Knowledge of the physical appearance and history of presentation of these skin findings can help in the diagnosis. A pruritic, annular, erythematous patch that grows centrifugally should prompt evaluation for tinea corporis. Read More

J Allergy Clin Immunol Pract 2019 02 8;7(2):651-652. Epub 2018 Sep 8.

Department of Adult Allergy, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.

J Med Case Rep 2018 Sep 11;12(1):254. Epub 2018 Sep 11.

School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia.

Background: Cutaneous adverse reactions to medications are extremely common and display characteristic clinical morphology. A fixed drug eruption is a cutaneous adverse drug reaction due to type IV or delayed cell-mediated hypersensitivity. Ivermectin, a broad-spectrum anti-parasitic compound, has been an essential component of public health campaigns targeting the control of two devastating neglected tropical diseases: onchocerciasis (river blindness) and lymphatic filariasis. Read More