Fixed drug eruptions (FDE) are a distinct type of drug eruptions that appear as pruritic, well circumscribed, round or oval-shaped, erythematous macules or edematous plaques, and characteristically recur at the same sites upon re-exposure to the offending drug. They usually resolve spontaneously with hyperpigmentation.

Treatment for fixed drug eruptions (FDEs) otherwise is symptomatic. Systemic antihistamines and topical corticosteroids may be all that are required. In cases in which infection is suspected, antibiotics and proper wound care are advised.

Fixed drug eruptions may account for as much as 16-21% of all cutaneous drug eruptions.

Drug reactions related to multivitamins are rare and very few cases have been reported. This is a case of a young woman who developed bullous fixed drug eruption to multivitamins.

The major categories of causative agents of fixed drug eruption include antibiotics, antiepileptics, nonsteroidal anti-inflammatory agents, sildenafil, and phenothiazines, although numerous other agents and certain foods such as cashews and licorice have also been reported as causative agents.

Hyperpigmentation is the most likely complication of a fixed drug eruption (FDE). The potential for infection exists in the setting of multiple, eroded lesions. Generalized eruptions have been reported following topical and oral provocation testing. [ 17, 57]

Fixed drug reaction. Fixed drug reactions, are common and so named because they recur at the same site with each exposure to a particular medication. Medications inducing fixed drug eruptions are usually those taken intermittently.

Drug eruption. In medicine, a drug eruption is an adverse drug reaction of the skin. Most drug-induced cutaneous reactions are mild and disappear when the offending drug is withdrawn. These are called “simple” drug eruptions.