Fixed drug eruption due to ibuprofen

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Figure 1
An 8-cm violaceous plaque with surrounding mild erythema in the patient’s left inguinal fold.

TABLE 1

Differential diagnosis of fixed drug eruption and differentiating features

Causes	Differentiating features
Insect bite	Erythematous papule with surrounding erythema or pruritic urticarial lesion
Bullous pemphigoid	Large fluid-filled blisters on flexor surfaces
Bullous fixed drug eruption	Well-demarcated solitary erythematous or violaceous circular patches
Erythema multiforme	Recurrent papular, bullous, necrotic lesions, often with central clearing
Leukocytoclastic vasculitis	Erythematous macules with palpable purpura
Lichen planus	Pruritic violaceous papules and plaques on wrists, lower back, ankles
Large plaque parapsoriasis	Oval erythematous or hyperpigmented macules and patches with fine scales and atrophy
Fixed drug eruption	Annular oval red or violaceus patch, often with pruritus; well defined and can be blistering or erosive Clinical presentation may vary based on subtype, including mucosal, nonpigmenting, targetoid, and bullous variants Presentation may be localized or generalized
Sarcoidosis	Painless, firm, oval nodules that are flesh-colored or violaceous