Mizukawa Y, Shiohara T
Department of Dermatology, Kyorin University School of Medicine, Tokyo, Japan.
Dermatology. 1998;197(4):383-5. doi: 10.1159/000018037.
Fixed drug eruption (FDE) can present as multiple pigmented macules that flare at fixed sites even when the patient has taken no medications. Although this presentation is not characteristic of FDE, it must be borne in mind in order to make a correct diagnosis. We describe such a patient whose condition was initially diagnosed as erythema dyschromicum perstans (EDP). Immunohistochemically intraepidermal T cells were distributed between basal and suprabasal keratinocytes in the lesional skin, a finding suggestive of FDE. A flare occurred not only with exposure to theophylline but also without exposure. A flare has never recurred and pigmented macules faded gradually after avoiding theophylline. On the basis of these findings, we recommend that patients with an EDP-like presentation be examined completely for causes such as drugs before labeling the cutaneous lesions.
固定性药疹（FDE）可表现为多个色素沉着斑，即使患者未服用任何药物，这些斑也会在固定部位复发。尽管这种表现并非FDE的特征性表现，但为了做出正确诊断，必须牢记这一点。我们描述了这样一位患者，其病情最初被诊断为持久性色素异常性红斑（EDP）。免疫组化显示，在皮损中，表皮内T细胞分布于基底角质形成细胞和基底上层角质形成细胞之间，这一发现提示为FDE。不仅在接触茶碱时出现复发，在未接触茶碱时也出现了复发。在避免接触茶碱后，复发从未再次出现，色素沉着斑也逐渐消退。基于这些发现，我们建议，对于表现为类似EDP的患者，在对皮肤病变进行诊断之前，应全面检查是否存在药物等病因。
