Sexually active males comes with complaints of recurrent ulcers over the glans which heals with hyperpigmentation probable diagnosis is
Fixed drug eruptions Fixed drug eruptions Fixed drug eruptions are a unique form of drug allergy that produces red plaques or blisters that recur at the same cutaneous or mucosal site each time the drug is ingested. Clinical manifestations:? "The lesions appear at the same cutaneous or mucosal site each time the drug is ingested". - Single or multiple, round sharply demarcated, dusky red plaques appear soon after drug exposure and reappear in exactly the same location each time the drug is taken. Most common site for fixed drug eruptions is male genitalia0 - Lesions can occur on any pa of the skin, mucous membranes lips, hands, genitalia (especially male genitalia) and occasionally oral mucosa are oured sites. Reactivation and refractory phase - The length of the time from the reexposure to a drug and the onset of symptoms is 30 'ninnies to 8 hours following each exacerbations. Some patients demonstrate a refractory period (weeks to several months) during which the offending drug does not activate the lesions. Cross sensitivity - Ingestion of drugs with similar chemical nature may precipitate exacerbations. - This phenomenon has been repoed with tetracycline and sulfonamides. Diagnosis - Taking a careful history is impoant because patients often do not relate their complaints to the use of a drug. - Provoking the lesion with the suspected drug confirms the diagnosis. Treatment - Topical steroids are useful. Drugs associated with fixed drug eruptions :- - Tetracycline - Phenolphthalein - Sulphonamides - Barbiturates - Quinine
Aphthous ulcer
Fixed drug eruptions
Herpes-genitalis
Chlamydial infection