Yuanyuan Wang,1,* Huan Xue,2,* Hejun Dai,1 Lianjuan Yang1 

1Department of Medical Mycology, Center of Infectious Skin Diseases, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China; 2Department of Dermatologic Surgery, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Lianjuan Yang, Email lianjuanyang@163.com

Abstract: A fixed drug eruption (FDE) is a recurring adverse drug reaction that manifests as lesions on the same cutaneous or mucosal sites after exposure to the causative drug. It is characterized by erythematous or violaceous, round-to-oval patches with a dusky center. With each recurrence, the number and size of lesions can increase, raising the risk for generalized bullous fixed drug eruption (GBFDE). GBFDE, a rare and severe variant, presents with widespread bullae accompanied by characteristic FDE lesions. Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the primary causes of FDE. Although cross-reactivity between different groups of NSAIDs has been rarely reported in FDE cases, in this report we present a case of paracetamol-induced GBFDE followed by FDE triggered by cross-reactivity with dipyrone (metamizole).

Keywords: generalized bullous fixed drug eruption, recurrence, paracetamol, dipyrone, cross-reactivity