Widespread bullous fixed drug eruption

A 53-year-old man developed a widespread erythematous eruption which rapidly evolved into fluid-filled bulla mostly involving the distal areas of all four limbs and erosions on the oral as well as anogenital mucosa. Based on clinical presentation, chronology of drug exposure, past events and histopa...

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Published inBMJ case reports Vol. 2014; p. bcr2013200584
Main Authors Patell, Rushad D, Dosi, Rupal V, Shah, Purav C, Joshi, Harshal S
Format Journal Article
LanguageEnglish
Published England BMJ Publishing Group LTD 07.02.2014
BMJ Publishing Group
SeriesCase Report
Subjects
Anti-Inflammatory Agents, Non-Steroidal - adverse effects
Asia
Biopsy
Blister - chemically induced
Blister - diagnosis
Blister - pathology
Dermatology
Diagnosis, Differential
Diclofenac - adverse effects
Drug Eruptions - diagnosis
Drug Eruptions - etiology
Drug Eruptions - pathology
Gangrene
Histopathology
Humans
Indian Sub-Continent
Male
Middle Aged
Reminder of Important Clinical Lesson
Side effects
Skin
Skin - pathology
Stevens-Johnson Syndrome - diagnosis
Ulcers
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Summary:A 53-year-old man developed a widespread erythematous eruption which rapidly evolved into fluid-filled bulla mostly involving the distal areas of all four limbs and erosions on the oral as well as anogenital mucosa. Based on clinical presentation, chronology of drug exposure, past events and histopathology as diagnosis of widespread bullous fixed drug eruption was made over Steven Johnson-toxic epidermal necrolysis syndrome. Steroids were deferred and the lesions healed with minimal pigmentation within a week. Differentiating between the two entities has been historically difficult, and yet can have significant therapeutic and prognostic implications.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2013-200584