Table of Contents
Definition / general | Sites | Treatment | Clinical images | Microscopic (histologic) description | Microscopic (histologic) images | Differential diagnosis | Additional referencesCite this page: Hamodat M. Fixed drug reaction. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/skinnontumordrugreaction.html. Accessed February 5th, 2023.
Definition / general
- May cause urticaria, erythema multiforme, erythema nodosum, folliculitis, pustules, purpura, hyperpigmentation or vasculitis
- Procainamide may induce SLE-like disease
- Anti-cancer drugs may cause acute necrotizing changes in sweat glands (neutrophilic eccrine hidradenitis or syringosquamous metaplasia)
- Drug induced coma may cause necrosis of eccrine sweat coils and other adnexae, also epidermis
- Other drugs causing cutaneous reactions include gold salts, thiazides, antimalarial drugs, color film developers, tetracycline, barbiturates, phenolphthalein
- Fixed drug reaction: repeated administration causes recurrence of red-brown patch in same location, variable bullae
Sites
- Genitalia and face
Treatment
- Discontinue drug
Clinical images
Microscopic (histologic) description
- Eosinophils and marked vascular wall thickening
- May cause granulomatous infiltrate
- Also vacuolar interface changes and often lymphocytic exocytosis, dyskeratotic keratinocytes, parakeratosis with eosinophils and plasma cells in dermis
Microscopic (histologic) images
Differential diagnosis
- Lichen planus: different sites (flexor arms / legs, glans penis and mucous membranes), lasts 1 - 2 years, not associated with drug administration, no prominent eosinophils (Indian J Dermatol Venereol Leprol 2011;77:418)
Additional references