A Clinicopathological Study of Fixed Drug Eruptions / 대한피부과학회지

ABSTRACT

BACKGROUND: Fixed drug eruptions(FDE) are a cutaneous reaction characterized by one or more circumscribed lesions that recur at the same site in response to a given medication. OBJECTIVE: The purpose of this study was to find the clinical and histopathological characteristics of FDE and to compare early FDE with late FDE histopathologically. METHOD: We clinically investigated 54 cases of FDE that visited the department of dermatology at the Kyunghee medical center from January 1993 to December 1996. Among them, 31 patients had skin biopsies and were evaluated histopathologically on the basis of duration. RESULTS: The results were summarized as follows 1. Development of FDE did not show any difference according to sex and was evenly distributed over all the ages. 2. The latent periods of FDE were diverse in appearance from 30 minutes to 10 days, but mostly, the skin lesions erupted within 4S hours. 3. The most common skin lesions were erythematous macules. 4. Distribution of the lesions came out as solitary 20.4%, multiple 79.6%. S3.7% of the multiple lesions were localized to a part of body, and 16.3% were distributed over the whole body. 5. The areas in which the eruptions developed were (in descending order) upper extremity(37.0%), hand(31.5%), trunk(24.1%), face(24.1%). 6. In most cases(68.6%), the size and the number of lesions were greater in recurrente, rather than in first attacks. 7. The histopathological findings commonly showed perivascular mononuclear cell(MNC) infiltration (100%), pigmentary incontinence(77.4%), basal hydrophic degeneration(71.0%), eosinophil infiltration in dermis(61.3%), etc. 8. The epidermal histopathological findings such as spongiosis, exocytosis of MNC, basal hydrophic degeneration, keratinocyte necrosis and subepidermal vesicles could be seen more frequently in early lesions than in late ones. CONCLUSION: In our study, we were able to obtain meaningful results based on data from the combination of clinical and histopathological investigations. This study may give help to understand the characteristics of fixed drug eruptions and to plan future studies.