Dr. Jerath V. P. and *Dr. Neha Talwar


Fixed drug eruption (FDE) usually appears as a solitary or a small number of pruritic, well circumscribed, erythematous macules that evolve into edematous plaques; these lesions typically recur at exactly the same sites. The lesions usually flare within 30 min to 8 h after drug intake. The sensation of burning often precedes the appearance of these lesions. The most commonly affected sites are the lip, palms, soles, glans penis, and groin areas. In some cases, the lesions become more widespread with bullous lesions and systemic manifestations, such as high fever and arthralgia, mimicking Stevens–Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN). FDE lesions occur more rapidly in patients intermittently receiving the causative drugs rather than those continuously receiving them. The previously involved sites do not necessarily flare with each exposure. We conducted a retrospective study over a period of 38 years which included 25000 patients. Out of these 25000 patients well recorded, 16% (4000) patients were of drug reactions. Out of these 4000 patients, 10% (400) patients were of FDE. Of these 400 patients, 8% (i.e. 32) had genetic origin in the immediate family member or cousins and other relatives; which speaks volumes for a genetic origin of FDE to various drugs and usually to the same drug in parents and siblings or brother’s siblings.

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