Skin nontumor
Lichenoid and interface reaction patterns
Fixed drug reaction
Topic Completed: 1 July 2011
Minor changes: 10 November 2020
Copyright: 2002-2021, PathologyOutlines.com, Inc.
PubMed Search: Drug reaction [title]
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 April 19th, 2021.
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
Contributed by Mark R. Wick, M.D.
Breast skin
Images hosted on other servers:
14 year old boy with reaction to sulfasalazine
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
Contributed by Mark R. Wick, M.D.
Breast skin
Images hosted on other servers:
Lichenoid drug reaction
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
