Fixed drug eruption

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Overview

Fixed drug eruption (FDE) is a type of adverse drug reaction that affects the skin. When a person takes a certain medication, they develop one or more round, well-defined patches on the skin that are often red, dark, or purplish in color. The key feature of this condition is that the skin reaction happens in the exact same spot every time the person takes the offending drug — hence the name "fixed." These patches can appear anywhere on the body, but common locations include the lips, face, hands, feet, and genital area. The affected skin may feel itchy or burning, and sometimes blisters can form. Once the medication is stopped, the patches usually heal over days to weeks, but they often leave behind a dark discoloration that can last for months or even longer. Fixed drug eruption is considered a type of delayed hypersensitivity reaction, meaning the immune system overreacts to a specific medication. Common culprits include certain antibiotics (like trimethoprim-sulfamethoxazole and tetracyclines), nonsteroidal anti-inflammatory drugs (NSAIDs such as ibuprofen and naproxen), barbiturates, and acetaminophen (paracetamol). The condition can occur at any age but is more commonly recognized in adults. Treatment primarily involves identifying and permanently avoiding the offending drug. Topical corticosteroids may be used to reduce inflammation, and antihistamines can help with itching. In rare severe cases called generalized bullous fixed drug eruption, widespread blistering can occur, which may require hospital care similar to treatment for burns. The prognosis is generally excellent once the triggering medication is identified and avoided.

Key symptoms:

Round, well-defined red or dark patches on the skinSkin patches that recur in the exact same location with each drug exposureBurning or stinging sensation at the affected areaItching at the site of the eruptionBlistering or peeling of the skin in the affected areaSwelling of the affected skinDark discoloration left behind after the patch healsPatches on the lips or around the mouthPatches on the genital areaPatches on the hands or feetMultiple patches appearing simultaneouslyPain or tenderness at the affected site

Clinical phenotype terms (18)— hover any for plain English
Regional abnormality of skinHP:0011356Adverse drug responseHP:0020172StomatitisHP:0010280Crusting erythematous dermatitisHP:0007473Lamina lucida cleavageHP:0003341Drug allergyHP:0410323Vaginal mucosal ulcerationHP:0032565Skin detachmentHP:0032156ChillsHP:0025143
Inheritance

Multifactorial

Caused by a mix of several genes and environmental factors

Age of Onset

Adult

Begins in adulthood (age 18 or older)

Orphanet ↗NORD ↗

Treatments

No FDA-approved treatments are currently listed for Fixed drug eruption.

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No actively recruiting trials found for Fixed drug eruption at this time.

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Search ClinicalTrials.gov ↗Join the Fixed drug eruption community →

Specialists

1 foundView all specialists →

Treatment Centers

8 centers
🏥 NORD

Baylor College of Medicine Rare Disease Center

Baylor College of Medicine

📍 Houston, TX

🏥 NORD

Stanford Medicine Rare Disease Center

Stanford Medicine

📍 Stanford, CA

🔬 UDN

NIH Clinical Center Undiagnosed Diseases Program

National Institutes of Health

📍 Bethesda, MD

🔬 UDN

UCLA UDN Clinical Site

UCLA Health

📍 Los Angeles, CA

🔬 UDN

Baylor College of Medicine UDN Clinical Site

Baylor College of Medicine

📍 Houston, TX

🔬 UDN

Harvard/MGH UDN Clinical Site

Massachusetts General Hospital

📍 Boston, MA

🏥 NORD

Mayo Clinic Center for Individualized Medicine

Mayo Clinic

📍 Rochester, MN

👤 Mayo Clinic Center for Individualized Medicine

🏥 NORD

UCLA Rare Disease Day Program

UCLA Health

📍 Los Angeles, CA

Travel Grants

No travel grants are currently matched to Fixed drug eruption.

Search all travel grants →NORD Financial Assistance ↗

Community

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Latest news about Fixed drug eruption

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Caregiver Resources

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Social Security Disability

Learn how rare disease patients may qualify for SSDI/SSI benefits.

Questions for your doctor

Bring these to your next appointment

  • Q1.Which specific medication is most likely causing my fixed drug eruption?,Are there other medications in the same drug family that I should also avoid?,What safe alternative medications can I use instead of the one causing the reaction?,How long will the dark marks on my skin take to fade, and is there anything I can do to speed this up?,Should I wear a medical alert bracelet or carry an allergy card?,Is there a safe way to test and confirm which drug is causing my reaction?,What should I do if I accidentally take the offending medication again?

Common questions about Fixed drug eruption

What is Fixed drug eruption?

Fixed drug eruption (FDE) is a type of adverse drug reaction that affects the skin. When a person takes a certain medication, they develop one or more round, well-defined patches on the skin that are often red, dark, or purplish in color. The key feature of this condition is that the skin reaction happens in the exact same spot every time the person takes the offending drug — hence the name "fixed." These patches can appear anywhere on the body, but common locations include the lips, face, hands, feet, and genital area. The affected skin may feel itchy or burning, and sometimes blisters can fo

How is Fixed drug eruption inherited?

Fixed drug eruption follows a multifactorial inheritance pattern. Genetic counseling can help families understand recurrence risk and testing options.

At what age does Fixed drug eruption typically begin?

Typical onset of Fixed drug eruption is adult. Age of onset can vary across affected individuals.

Which specialists treat Fixed drug eruption?

1 specialists and care centers treating Fixed drug eruption are listed on UniteRare, sourced from ClinicalTrials.gov principal investigators, published research, and the NPPES NPI registry.