Recurrent dusky lesions: would you recognise this dermatosis?

摘要

A 10-year-old otherwise healthy boy had a 4-day history of a dusky-red plaque on his right thigh, measuring 10x6 cm, with an erythematous periphery. Later, bullae developed on top of the plaque, and other lesions appeared on the trunk, limbs and penis (figure 1). Previously he had manifested an identical plaque in the same area (right thigh), with residual hyperpig-mentation, that lasted 3 weeks. Due to the appearance of the skin lesion and recurrence in the same location, parents were questioned about any medications previously used and disclosed that it had started 48 h after the ingestion of a non-steroidal anti-inflammatory (NSAID), in both episodes, confirming therefore the diagnosis of fixed drug eruption (FDE). FDE is a benign reaction triggered by exposure to drugs, most commonly NSAIDs and antibiotics, characterised by a sudden onset of violaceous oval plaques or patches, which heal usually with residual hyperpigmentation.