eMedicine Specialties > Dermatology > Allergy & Immunology

Fixed Drug Eruptions: Follow-up

Author: David F Butler, MD, Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic, Northside Clinic
Coauthor(s): Jordan R Ilse, MD, Staff Physician, Scott and White Internal Medicine Residency Program, Temple, Texas
Contributor Information and Disclosures

Updated: Aug 24, 2009

Follow-up

Deterrence/Prevention

Avoid the offending drug. Patch testing may be used to help identify agents that pose a risk of cross-sensitivity.37

Complications

Hyperpigmentation is the most likely complication of a fixed drug eruption (FDE). The potential for infection exists in the setting of multiple, eroded lesions. Generalized eruptions have been reported following topical and oral provocation testing.19,38

Prognosis

The prognosis is very good, and an uneventful recovery should be expected. No deaths due to fixed drug eruption have been reported. Residual hyperpigmentation is very common, but this is less likely with the nonpigmenting variant.

Patient Education

Patients should be counseled on medication avoidance and possible cross-reactions of similar medications. Patients should notify their physicians of all drug allergies they have experienced.

Miscellaneous

Medicolegal Pitfalls

Drug reactions account for a large proportion of medical malpractice claims. Inadequate disclosure of potential adverse effects and failure to identify a drug as the cause of the patient's problem could be sources of legal action.

 


More on Fixed Drug Eruptions

Overview: Fixed Drug Eruptions
Differential Diagnoses & Workup: Fixed Drug Eruptions
Treatment & Medication: Fixed Drug Eruptions
Follow-up: Fixed Drug Eruptions
Multimedia: Fixed Drug Eruptions
References
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References

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  34. Zedlitz S, Linzbach L, Kaufmann R, Boehncke WH. Reproducible identification of the causative drug of a fixed drug eruption by oral provocation and lesional patch testing. Contact Dermatitis. Jun 2002;46(6):352-3. [Medline].

  35. Kelso JM, Keating RM. Successful desensitization for treatment of a fixed drug eruption to allopurinol. J Allergy Clin Immunol. May 1996;97(5):1171-2. [Medline].

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  37. Tornero P, De Barrio M, Baeza ML, Herrero T. Cross-reactivity among p-amino group compounds in sulfonamide fixed drug eruption: diagnostic value of patch testing. Contact Dermatitis. Aug 2004;51(2):57-62. [Medline].

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Further Reading

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Keywords

fixed drug eruption, fixed drug reaction, FDE, adverse drug reaction, adverse cutaneous drug reaction, drug-induced hypersensitivity, drug-induced pigmentation, postinflammatory hyperpigmentation, post-inflammatory hyperpigmentation

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Contributor Information and Disclosures

Author

David F Butler, MD, Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic, Northside Clinic
David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Coauthor(s)

Jordan R Ilse, MD, Staff Physician, Scott and White Internal Medicine Residency Program, Temple, Texas
Jordan R Ilse, MD is a member of the following medical societies: American Medical Association and Texas Medical Association
Disclosure: Nothing to disclose.

Medical Editor

Robert A Schwartz, MD, MPH, Professor and Head, Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, UMDNJ-New Jersey Medical School
Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, and Sigma Xi
Disclosure: Nothing to disclose.

Pharmacy Editor

Richard P Vinson, MD, Assistant Clinical Professor, Department of Dermatology, Texas Tech University School of Medicine; Consulting Staff, Mountain View Dermatology, PA
Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association
Disclosure: Nothing to disclose.

Managing Editor

Jeffrey P Callen, MD, Professor of Medicine, Chief, Division of Dermatology, University of Louisville School of Medicine
Jeffrey P Callen, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, and American College of Rheumatology
Disclosure: Amgen Honoraria Consulting; Abbott Honoraria Consulting; Electrical Optical Sciences Honoraria Consulting; Centocor Honoraria Consulting; Medicis Honoraria Consulting; Celgene Honoraria Consulting

CME Editor

Catherine Quirk, MD, Clinical Assistant Professor, Department of Dermatology, Brown University
Catherine Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology
Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

 
 
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