Fixed Drug Eruptions Treatment & Management

Updated: Oct 09, 2020
  • Author: David F Butler, MD; Chief Editor: Dirk M Elston, MD  more...
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Treatment

Medical Care

The main goal of treatment is to identify the causative agent and avoid it. Treatment for fixed drug eruptions (FDEs) otherwise is symptomatic. Systemic antihistamines and topical corticosteroids may be all that are required. In cases in which infection is suspected, antibiotics and proper wound care are advised. Desensitization to medications has been reported in the literature, but this should be avoided unless no substitutes exist. [64] In severe cases, cyclosporine has been used. [65]

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Consultations

Consultation with a dermatologist is warranted if the diagnosis is in doubt. If patch testing is needed to determine which drug may be involved, a dermatologist with such experience may be required. If Stevens-Johnson syndrome or toxic epidermal necrolysis is suspected, hospitalization and possible referral to the intensive care unit or burn unit may be appropriate.

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Diet

A regular diet is usually acceptable. However, food may be an exacerbating factor; reactivation has been reported with cashews, liquorice, lentils, and strawberries. [13, 31, 34]

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Activity

Generally, no limits on activities are imposed. Multiple studies have sited male genital lesions occurring following intercourse with female partners taking trimethoprim-sulfamethoxazole. [66] Therefore, patients may consider avoiding sexual activity while a partner is taking a medication that has resulted in a prior fixed drug eruption. If open lesions are present, general wound care precautions are recommended.

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Prevention

Avoid the offending drug. Patch testing may be used to help identify agents that pose a risk of cross-sensitivity. [67]

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