Fixed Drug Eruption

Work in Progress Updated Jun 22, 2026

Common Culprit Drugs: - Antibiotics (eg sulfamethoxazole, tetracyclines) - NSAIDs - Acetaminophen - Barbituates - Antimalarials (quinine) - Anti-epileptic drugs (carbamazepine)

Clinical Features - No systemic symptoms (ie fever malaise) - No lab abnormalities - Targetoid lesions that can have bullous or non-bullous appearance - Mucosal symptoms can occur (oral)

Can occur anywhere but lesions localize to lips, genitalia, hands, feet. Often localizes to sites of prior HSV or herpes zoster infection. Sites of prior trauma (venipuncture, insect bite, burn) can also be a driver of localization.

Differential Diagnosis: - Herpes simplex virus (HSV) infection - Bechet’s disease

Clinical Manifestations:

Management: - Single or few lesions: topical corticosteroids - Multiple lesions or mucosal lesions: systemic corticosteroids (e.g. prednisone 0.5-1 mg/kg/day for 3-5 days)

Patch Testing or Delayed IDT at site of prior lesion may be helpful for identifying culprit drug, but sensitivity is low

References: PMID: 23044075