Fluconazole and Fixed Drug Eruption

Lareb received 13 reports of fixed drug eruptions (FDE) in association with fluconazole. Fluconazole is used in fungal infections, including Candida.

A Fixed Drug Eruption (FDE) is a sharply demarcated erythema, oval or circular in shape, which recurs in exactly the same place after following exposure to a specific drug. The size varies from a few millimeters to 10-20 cm in diameter. Initially it is a lesion of dusky erythema and edema, sometimes followed by development of blisters. The lesions may itch, but burning sensations are also common. Healing takes place with pigmentation in most cases. The FDE may be localized on skin and mucous membranes.

It is of importance to acknowledge the possible role of fluconazole in a patient with fixed drug eruption, especially when it is located on the lip, where it mimics a herpes lesion. In this situation antiviral treatment should not be initiated, but discontinuation of fluconazole results in a substantial improvement in symptoms.

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