Catherine Barker

Recognizing cutaneous drug eruptions is important for treatment and prevention of recurrence. Fixed drug eruptions (FDEs) typically are harmless but can have major negative cosmetic consequences for patients. In its more severe forms, patients are at risk for widespread epithelial necrosis with accompanying complications. We report 1 patient with generalized FDE and 2 with generalized bullous FDE. We also discuss the recognition and treatment of the condition.

An 83-year-old woman presented for evaluation of hyperkeratotic plaques on the medial and lateral aspects of the left heel (top). Physical examination also revealed onychodystrophy of the toenails on the halluces (bottom). A crusted friable plaque on the lower lip and white plaques with peripheral reticulation and erosions on the buccal mucosa also were present. The patient had a history of nummular eczema, stasis dermatitis, and hand dermatitis. She denied a history of cold sores.

Environmental Dermatology Publish date: April 8, 2024 Patients presenting with a linear, erythematous, blistering eruption may experience a sudden painful sunburn that seems to get worse rather than better with time. In warm climates, exposure to the common fig tree (Ficus carica) may be the culprit. Dermatologists should recognize fig phytophotodermatitis as a possible cause and help the patient connect their symptoms with the inciting agent as well as administer proper treatment.