Fixed drug eruption to trimethoprim-sulfamethoxazole.
Fixed drug eruption to tetracycline. Hyperpigmentation developed as solitary lesion evolved.
CLINICAL FEATURES
Fixed drug eruptions may present as single or multiple red macules that evolve over a few days into hyperpigmented macules. Occasionally, lesions are edematous or, rarely, bullous in appearance. The hyperpigmented areas may persist several months.
The most common drug causes are trimethoprim-sulfamethoxazole combinations, acetaminophen, barbiturates and sulfonamides. Rechallenge with the offending drug results in lesions at the original skin site(s) and, occasionally, new areas of involvement as well.
TREATMENT
The usual first therapeutic step is avoidance of the suspected drug. Potent topical steroids applied twice daily help shorten the course of fixed drug eruptions.
