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Permanent drug erythema (Erythema fixum) is a change that appears on the skin, always in the same place, and is associated with taking certain medications.

Permanent drug erythemaoccurs as single or few, well-defined, brown spots on the skin. Sometimes the spots become red or there is a slight swelling that appears after taking the next dose of the drug.

People affected by this condition do not always associate the appearance of spots with taking a drug, especially when they rarely take the drug, e.g. in the case of headaches or painful menstruation.

Permanent drug erythema - after what medications?

The group of drugs that most often cause erythema include preparations containing:

  • fanacitin
  • aminophenazone
  • acetylsalicylic acid
  • barbiturates
  • sulfonamides

Drug-induced erythema can appear on the skin after taking various pharmaceuticals, but statistically most often it is caused by antibiotics, sulfa drugs, hormonal agents and antiallergic agents. However, erythema cannot be ruled out also after taking other medications. The appearance of erythema may be related to individual drug intolerance.

Permanent drug erythema - diagnosis

Usually a doctor has no problem making a diagnosis. To make sure that the erythema is caused by the drug, the patient is given one tablet of the drug and the blot is observed. When redness appears within the skin discoloration, you can be sure that the drug is the cause of the skin changes.

Permanent erythema is usually single patches of brown color, clearly marked on the skin. The lesions usually appear in the same places, most often on the extremities, around the genitals and anus. However, they can appear anywhere on the skin. They are usually not accompanied by other changes or general symptoms. Discontinuation of the drug that caused the changes leads to the reduction of erythema, but skin discoloration remains, which may persist for a long time.

In case of reddening on mucous membranes, it may appear in the form of blisters.

Important!Systemic provocations following oral administration of the drug are very sensitive, but various systemic reactions may occur.

Permanent drug-induced erythema can also be attempted to be diagnosed on the basis of local provocation, i.e. on the basis of, for example, patch or epidermal tests. In these tests, the patient is administered a cutaneous drug at a concentration of 10% in petroleum jelly or ethanol, mainly in the area of ​​discoloration from the previous incident. The test results are read once a day, but this method is not very sensitive.

Permanent drug erythema - treatment

Topical treatment is pointless and ineffective. The only way to get rid of skin discoloration is to stop taking the drug that causes it. The doctor must also choose another drug that will have the same effect, but will not provoke the formation of discoloration. It should be emphasized that even after the complete discontinuation of medications, spots on the skin may persist for several months.

Unfortunately, the exact mechanism of drug reactions is not known. Scientists suspect that it is based on the hapten theory (drugs are unable to stimulate an immune response without first attaching to a carrier, e.g. a protein in blood or tissues).

Dermal drug reactions:

  • immediate reactions: urticaria, angioedema;
  • delayed reactions: purpura, erythema, contact eczema, maculopapular rash, phototoxic and photoallergic reactions, drug-induced autoimmune diseases, skin reactions to drugs with immunomodulatory effects.

Severe drug-induced skin reactions include:

  • erythema multiforme,
  • Stevens-Johnson syndrome,
  • toxic epidermal necrolysis (TEN),
  • DRESS band,
  • acute generalized pustular eruption (AGEP),
  • Drug-induced erythroderma.
About the authorAnna Jarosz A journalist who has been involved in popularizing he alth education for over 40 years. Winner of many competitions for journalists dealing with medicine and he alth. She received, among others The "Golden OTIS" Trust Award in the "Media and He alth" category, St. Kamil awarded on the occasion of the World Day of the Sick, twice the "Crystal Pen" in the national competition for journalists promoting he alth, and many awards and distinctions in competitions for the "Medical Journalist of the Year" organized by the Polish Association of Journalists for He alth.

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