Disease directory
Fixed pigmentary erythema
Published: September 18, 2026Updated: September 18, 2026
Important: Informational content intended for healthcare professionals. It does not replace clinical evaluation or establish a doctor-patient relationship.
Overview
- Synonyms. Fixed drug eruption (FDE). Anderson 2021 .
- First description. Described at the end of the 19th century (Brocq) and consolidated as a clinical entity in the 20th century. Anderson 2021 .
- Epidemiology. It occurs at any age; generalized bullous variants (GBFDE) most frequently affect older adults and may require hospitalization. Lipowicz 2013 , Perron 2021 .
- Codes:
- ICD-10: L27.1 (localized drug rash) / L27.0 (generalized drug rash).
- ICD-11: EH66 (Fixed drug eruption)
- Diagnostic checklist (quick):
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Essential clinical findings: fixed erythematous-violaceous plaque that recurs with the same drug; residual hyperpigmentation (except NPFDE).
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Required data: chronology of drug intake (initial days-weeks; hours upon re-exposure), number of sites, mucous membranes, severity/pain.
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Key tests: active border punch biopsy ; DIF if in doubt with autoimmune bullous lesions; lesion patch test ≥6 weeks after resolution if not GBFDE; avoid re-challenge in severe cases. Andrade 2011 , Perron 2021 .
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