30th July 2026

Clinical manifestations

• Well-demarcated rash
• Solitary or small number of lesions 
• Round or oval 
• Colour varies between red to black
• Post-inflammatory hyperpigmentation
• Pruritus or burning is sometimes present 
• Common areas affected: lips, anogenital regions, hands and feet. If mucosal surfaces are affected, ulcers may develop. 
• Systemic symptoms are rare

A number of clinical variants exist:

• Generalised fixed drug eruption: multiple disseminated lesions affected the trunk and extremities. 
• Generalised bullous fixed drug eruption: usually occurs within 24 hours of the drug exposure with blistering rash affecting < 10% of the skin surface. Mucosal surfaces are not affected. Some systemic issues may occur such as fever, malaise and arthralgia but this is rare. Prognosis is good with resolution of symptoms shortly after discontinuation of the offending drug. 
• Non-pigmenting fixed drug eruption: symmetrical lessons that improve without post-inflammatory hyperpigmentation.