TABLE 1

Differential diagnosis of fixed drug eruption and differentiating features

CausesDifferentiating features
Insect biteErythematous papule with surrounding erythema or pruritic urticarial lesion
Bullous pemphigoidLarge fluid-filled blisters on flexor surfaces
Bullous fixed drug eruptionWell-demarcated solitary erythematous or violaceous circular patches
Erythema multiformeRecurrent papular, bullous, necrotic lesions, often with central clearing
Leukocytoclastic vasculitisErythematous macules with palpable purpura
Lichen planusPruritic violaceous papules and plaques on wrists, lower back, ankles
Large plaque parapsoriasisOval erythematous or hyperpigmented macules and patches with fine scales and atrophy
Fixed drug eruptionAnnular 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
SarcoidosisPainless, firm, oval nodules that are flesh-colored or violaceous
  • Based on information from reference 2.