A 69-year-old Malay woman presented with a widespread painful blistering rash, which had first begun over her neck and trunk, a few hours after a computed tomography scan performed with 90 mL of iohexol contrast for surveillance of sigmoid adenocarcinoma. Examination was notable for multiple circular hyperpigmented patches with inlying blisters and well-demarcated erosions involving her upper lip, neck, abdomen, and lower extremities (Figures 1 and 2). The total area of detachable epidermis was approximately 25%. Despite extensive cutaneous involvement, she was otherwise systemically well and clinical parameters were within normal limits. Further probing elicited a history of similar eruptions in the past, localized to a few spots on her thighs, which were also involved this time. Strikingly, each of these episodes occurred within 24 hours following iodinated contrast media administration and was self-limiting in nature.
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- Generalized bullous fixed drug eruption is distinct from Stevens-Johnson syndrome/toxic epidermal necrolysis by immunohistopathological features.J Am Acad Dermatol. 2014; 70: 539-548https://doi.org/10.1016/j.jaad.2013.11.015
- Generalized bullous fixed drug eruption imitating toxic epidermal necrolysis: a case report and literature review.Dermatol Online J. 2017; 23https://doi.org/10.5070/D3237035734
- Stevens–Johnson syndrome and toxic epidermal necrolysis: an update.Am J Clin Dermatol. 2015; 16: 475-493https://doi.org/10.1007/s40257-015-0158-0
- Fixed-drug eruption: a retrospective study in a single referral center in northern Taiwan.Dermatol Sin. 2012; 30: 11-15https://doi.org/10.1016/j.dsi.2012.02.002
- Bullous fixed drug eruption masquerading as recurrent Stevens Johnson syndrome.J Emerg Med. 2015; 48: 551-554https://doi.org/10.1016/j.jemermed.2014.09.049
- Contrast-induced generalized bullous fixed drug eruption resembling Stevens-Johnson syndrome.Proc Bayl Univ Med Cent. 2019; 32: 601-602https://doi.org/10.1080/08998280.2019.1644147
- Fixed drug eruptions: an update, emphasizing the potentially lethal generalized bullous fixed drug eruption.Am J Clin Dermatol. 2020; 21: 393-399https://doi.org/10.1007/s40257-020-00505-3
- Toxic epidermal necrolysis in a burns centre: A 6-year review.Burns. 1996; 22: 275-278https://doi.org/10.1016/0305-4179(95)00140-9
- Recurrence and Outcomes of Stevens-Johnson syndrome and toxic epidermal necrolysis in children.Pediatrics. 2011; 128: 723-728https://doi.org/10.1542/peds.2010-3322
- Cutaneous adverse drug reactions.Asian Skin. 2015; : 479-481
- Prognosis of generalized bullous fixed drug eruption: comparison with Stevens–Johnson syndrome and toxic epidermal necrolysis.Br J Dermatol. 2013; 168: 726-732https://doi.org/10.1111/bjd.12133
- Severe generalized bullous fixed drug eruption treated with cyclosporine: a case report and literature review.Case Rep Dermatol. 2021; 13: 154-163https://doi.org/10.1159/000513469
- Patch testing in fixed drug eruptions-a 20-year review.Contact Dermatitis. 2011; 65: 195-201https://doi.org/10.1111/j.1600-0536.2011.01946.x
Published online: July 24, 2022Uma Paniker, MD, Section Editor
Publication stageIn Press Journal Pre-Proof
Conflicts of Interest: None.
Authorship: All authors had access to the data and a role in writing this manuscript.
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