Is Generalized Bullous Fixed Drug Eruption Different from Stevens-Johnson Syndrome?

All patients with drug eruptions need careful treatment.

Fixed drug eruptions (FDEs) are defined by a limited number of lesions that heal with cessation of the drug or ingestant, often leaving residual hyperpigmentation. Occasionally, FDE might be manifest by bullae, and rarely, by widespread blistering. Distinguishing between generalized bullous FDE (GBFDE) and Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) is important, particularly if there are prognostic differences.

Authors used data from the European Severe Cutaneous Adverse Reaction (SCAR) database to compare severity and mortality in 58 validated cases of GBFDE and 170 cases of SJS or SJS/TEN. Of the GBFDE patients, 55 were adults (mean age, 78; 36 female). GBFDE diagnosis was based on four criteria: similar past reaction;…

Reviewing Author

Jeffrey P. Callen, MD

Disclosures

Consultant / Advisory board XOMA; Eli Lilly; Celgene

Equity Various trust accounts

Editorial boards JAMA Dermatology; UpToDate

Leadership positions in professional societies Association of Professors of Dermatology (President-Elect)