Psoriasiform fixed drug eruption caused by nimesulide

Conflict of interest: none declared. Fixed drug eruption (FDE) is characterized by recurrence of an eruption at the same site whenever the offending drug is taken.1 FDEs may account for as much as 16–21% of all cutaneous drug reactions. FDE typically presents as round or oval, sharply demarcated, red to livid macules, evolving into oedematous plaques, which heal with residual pigmentation. Sites of predilection are the lips, hands, feet, genitals and perianal area. Several variants of FDE have been described including bullous, generalized bullous, eczematous, urticarial, papular, purpuric, targetoid, nonpigmenting, linear, reticular and giant.1 The most commonly implicated drugs are sulfonamides, tetracyclines and other antibiotics, barbiturate derivatives, nonsteroidal anti‐inflammatory drugs (NSAIDs), and various food substitutes and flavourings.1 A 64‐year‐old man presented with a solitary, slightly pruritic, erythematous plaque covered by silvery‐white scales on the right lateral thigh (Fig. 1a). The patient was under treatment for ankylosing spondylitis with nimesulide and, occasionally, with systemic corticosteroids.