Trauma-Localized Fixed Drug Eruption: Involvement of Burn Scars, Insect Bites and Venipuncture Sites

Abstract

Little is known about why fixed drug eruption (FDE) lesions initially appear in a particular area of predilection. We describe 2 cases in whom the FDE lesions initially appeared exactly at the same sites of a previous trauma, such as burn scars and insect bites, and at a venipuncture site. The interval between the original trauma and the initial onset of FDE ranged from 2 days to 22 years. These ‘trauma-localized’ FDE lesions are helpful for our understanding of the mechanisms of FDE and other skin diseases, which often appear in their particular areas of predilection, a finding known as ‘recall phenomenon’.

Fixed drug eruption: A prototypic disorder mediated by effector memory T cells

“…In this regard, we previously demonstrated that FDE lesions initially appeared at exactly the same site of a previous trauma, such as burn scars, insect bites, previous venipuncture sites, or viral infection sites [4]. Migration of innate immune cells and/or T cells to sites of microbial infections or trauma is particularly valuable in mediating protective immune responses (Fig.…”

“…These FDE lesions become more numerous and more severe with repeated exposure. New lesions often occur at the same sites as the previously traumatized or infl amed skin, such as insect bite, burn, and venipuncture sites [4]. Systemic symptoms such as fever and malaise are usually absent.…”

Fixed Drug Eruption: Easily Overlooked but Needing New Respect

“…In the current issue of Dermatology , we show that some multiple FDE lesions initially appeared at previously traumatized skin sites, such as burn scars and insect bites [3]. This case report provides insights into the pathogenesis of FDE with important implications for its etiology.…”

Café-au-Lait Macules: Are These Markers of Neoplasia of Genetic Origin?

“…Rarely, these may represent an incomplete or monosymptomatic form of NF-1 or get associated with epidermal nevus syndrome, nevus lipomatoides superficialis, Fanconi's syndrome, Cowden's disease and juvenile xanthogranuloma [2,3]. When present in normal individuals (10%), their size and number are usually restricted.…”