Vasculitis in a fixed drug eruption due to paracetamol.

A 48-year-old man presented with a history of recurrent erythematous lesions on the trunk and limbs. Examination suggested a fixed drug eruption and this was confirmed by oral challenge with paracetamol. The histology was unusual as it showed a leucocytoclastic vasculitis. Patients may have difficulty avoiding the offending drug because many drugs bought over the counter have similar names but different constituents. In addition, it may be difficult to persuade the patient that a specific drug is responsible for their skin problem.