Fixed drug eruption (FDE) is a well-defined, circular, hyperpigmenting plaque that recurs as one or a few lesions always in fixed locations upon ingestion of a drug. FDE commonly occurs on the genitals, lips, trunk, and hands. Although the lesions are distinctive, the diagnosis of FDE often is missed because it shares none of the characteristics of more common morbilliform drug rashes. The diagnosis can be confirmed by histopathologic examination of a small punch biopsy specimen. Drug avoidance is the mainstay of treatment, and antihistamines can reduce associated pruritus. Raising awareness of this condition will increase the likelihood of prompt diagnosis leading to resolution within days to weeks after the offending drug is discontinued.

An adolescent female with long-standing, difficult-to-control ulcerative colitis developed leukocytoclastic vasculitis, a rare cutaneous extra-intestinal manifestation of the inflammatory bowel disease. The authors provide a literature review on leukocytoclastic vasculitis complicating ulcerative colitis. Furthermore, the clinical features of leukocytoclastic vasculitis are compared and contrasted with the more common cutaneous extra-intestinal manifestations of inflammatory bowel disease, erythema nodosum, and pyoderma gangrenosum.

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