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]

Mowafak Hamodat, M.B.Ch.B., M.Sc.
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Cite this page: Hamodat M. Fixed drug reaction. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/skinnontumordrugreaction.html. Accessed October 28th, 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
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