Fixed Eruption in Deeply Pigmented Subjects: Clinical Observations on 350 Patients

Abstract

Fixed eruptions induced principally by dapsone and phenolphthalein are not uncommon in deeply pigmented African subjects, up to 3% of leprosy patients developing sulphone-induced eruptions. While the majority of fixed eruptions conform to the classical pattern, many show departures therefrom in symptomatology and natural history of the lesions. In particular, typical lesions may show no exacerbation with continued administration of the inducing drug, and may even regress and disappear. The commoner asymmetrical discrete lesions are contrasted with strictly symmetrical facial lesions and with a symmetrical diffuse hypermelanosis. Some examples of the latter merge imperceptibly into diffuse post-inflammatory hypermelanosis. Certain parallels are suggested between these two polar types of fixed eruption and the polar types of leprosy—tuberculoid and lepromatous. © 1964, British Medical Journal Publishing Group. All rights reserved.