Neutrophilic fixed drug eruption, a histopathologic variant or an expected finding?-A report of two cases and review of the literature

Fixed drug eruption (FDE) is an adverse drug reaction characterized by recurrent circumscribed lesions at the same location upon re-exposure to the culprit medication, resulting in distinct postinflammatory hyperpigmentation. Histopathologically, FDE demonstrates a predominantly lymphocytic interfac...

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Bibliographic Details
Published in:Journal of cutaneous pathology 2023-10, Vol.50 (10), p.884-889
Main Authors: Theroux, Zachary, Gardner, Jerad, Ortiz, Eduardo, Kosik, Grace, Junkins-Hopkins, Jacqueline
Format: Article
Language:English
Subjects:
Apoptosis
Dermis
Dyskeratosis
Eruptions
Hyperpigmentation
Inflammation
Leukocytes (neutrophilic)
Literature reviews
Skin eruptions
Sweet's syndrome
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Summary:Fixed drug eruption (FDE) is an adverse drug reaction characterized by recurrent circumscribed lesions at the same location upon re-exposure to the culprit medication, resulting in distinct postinflammatory hyperpigmentation. Histopathologically, FDE demonstrates a predominantly lymphocytic interface or lichenoid infiltrate with basal cell vacuolar changes and keratinocyte dyskeratosis/apoptosis. The term "neutrophilic fixed drug eruption" has been used to describe cases in which the inflammatory infiltrate is predominantly neutrophilic. The infiltrate can extend deeper in the dermis, potentially mimicking a neutrophilic dermatosis such as Sweet syndrome. We present two cases and review the literature to discuss the possibility that a neutrophilic inflammatory infiltrate may be an expected finding in FDE, rather than a histopathologic variant.
ISSN:0303-6987
1600-0560
DOI:10.1111/cup.14487