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common drugs = NSAID's, tetracyclines, sulfa drugs, phenopthalein
Clinical:
| • | glans penis is most common site |
| • | usually develops within 30 minutes to 8 hours of drug administration |
| • | sometimes blister (subepidermal) |
| • | dusky in center because of necrosis |
| • | at the fixed drug site – will reproduce the lesion |
| • | another site – no reaction |
distinctive variant:
"Non-pigmenting Fixed Drug Eruption":
| • | large, tender, often symmetrical erythematous plaques |
| • | "baboon syndrome" = where buttocks, groin, and axillae are preferentially involved |
histology:
| • | dyskeratotic keratinocytes |
| • | ddx: EM (histology = superficial), GVHD |
| • | confident distinction among fixed drug, EM, and TEN based on biopsy alone, is not always possible |
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