PMC4376512_01
Fixed drug eruption involving the trunk and extremities.
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Fig1
On muco-cutaneous examination, multiple circumscribed erythematous and hyperpigmented round macules were present over the lips, trunk and the extremities whereas the oral and genital mucosae showed the presence of well defined erosions (Figure 1).
Histopathology (H&E) showing band like inflammatory infiltrate, perivascular infiltrate and pigment incontinence.
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Fig2
A skin biopsy was performed and the histopathological examination revealed a dense band like lymphocytic infiltrate, perivascular inflammatory infiltrate, eosinophils and increased pigment incontinence suggestive of fixed drug eruption (Figure 2).
Increased erythema over pre-existing hyperpigmented lesions after oral provocation test.
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Fig3
After another two weeks, patient was administered Sitagliptin 50 mg and within six hours of administration, there was recurrence of lesions in the form of itching and erythema over the residual pigmented lesions (Figure 3).