Pseudoephedrine May Cause "Pigmenting" Fixed Drug Eruption

Esen Özkaya; Meryem Sevinç Elinç-Aslan

Disclosures

Dermatitis. 2011;22(3):e7-9. 

In This Article

Abstract and Introduction

Abstract

Fixed drug eruption (FDE) is a distinctive drug eruption characterized by recurrent well-defined lesions in the same location each time the responsible drug is taken. Two different clinical forms have been described: the common classic pigmenting form and the rare nonpigmenting form. Nonpigmenting FDE is mainly characterized by symmetrical large erythematous plaques and the dermal histopathologic reaction pattern. Pseudoephedrine is known as the major inducer of nonpigmenting FDE. Pigmenting FDE from pseudoephedrine has not been reported previously. Here, the first case of pseudoephedrine-induced pigmenting FDE is reported, showing the characteristic features of classic pigmenting FDE such as asymmetry, normal-sized lesions, and the epidermodermal histopathologic reaction pattern. Moreover, a positive occlusive patch-test reaction to pseudoephedrine could be demonstrated on postlesional FDE skin for the first time.

Introduction

Fixed Drug Eruption (FDE) is a distinctive drug eruption characterized by recurrent well-defined lesions in the same location each time the responsible drug is taken. Two different clinical forms have been described: the common classic pigmenting form and the rare nonpigmenting form.[1] Pseudoephedrine is known as the major inducer of nonpigmenting FDE.[2–8] Pigmenting FDE induced by pseudoephedrine has not been reported previously. Here, the first case of classic pigmenting FDE induced by pseudoephedrine is reported with positive topical and systemic provocation test results.

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