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European Journal of Dermatology

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A three-year-analysis of fixed drug eruptions in hospital settings in France Volume 20, numéro 4, July-August 2010

Auteurs
Department of Dermatology, Bichat Hospital, APHP, 46 rue Henri-Huchard, 75877 Paris, Henri Mondor Hospital, Créteil, Saint Eloi Hospital, Montpellier, Charles Nicolle Hospital, Rouen, Nancy Hospital, Nancy, Hôtel-Dieu Hospital, Clermont-Ferrand, Tours Hospital, Tours, Tenon Hospital, Paris, Metz-Thionville Hospital, Metz, Morvan Hospital, Brest, Caen Hospital, Caen, Robert-Debré Hospital, Reims, Saint-Louis Hospital, Paris, Pointe-à-Pitre Hospital, Guadeloupe, Dupuytren Hospital, Limoges, Saint-André Hospital, Bordeaux, Haut-Lévêque Hospital, Pessac, Pasteur Hospital, Paris, Pitié-Salpétriêre Hospital, Paris

Fixed drug eruption (FDE) is one of the most typical cutaneous drug adverse reactions. This localized drug-induced reaction is characterized by its relapse at the same sites. Few large series of FDE are reported. The aim of this study was to retrospectively collect and analyse well informed cases observed in a hospital setting. This study involved 17 academic clinical centers. A French nation-wide retrospective multicentric study was carried out on a 3-year-period from 2005 to 2007 by collecting data in seventeen departments of dermatology in France. Diagnosis of FDE was based essentially on clinical findings, at times confirmed by pathological data and patch-testing. Records were reviewed for demographics, causative drugs, localization, severity, and patch-tests, when available. Fifty nine cases were analysed. Patients were 59-years-old on average, with a female predilection. The most common drug was paracetamol, followed by the non-steroidal anti inflammatory drugs. The time between drug intake and skin symptoms was, on average, two days. Beside these classical characteristics, some original findings were found including, a frequent non pigmentation course and a sex-dependent pattern of distribution. Women often had lesions on the hands and feet, and men on the genitalia. Given the fact that skin pigmentation is an inconstant feature of FDE, its French name (erythème pigmenté fixe) should be reconsidered. The sex-dependent distribution could help our understanding of the pathophysiology of fixed drug eruption.