A 35-year-old woman was seen with skin lesions that had developed over the past 48 hours. She had 5 erythematous, highly pruriginous oval patches, 4 to 6 cm in diameter, localized on her neck, trunk, and arms. Some lesions showed incipient blistering and acquired an intense erythematous, nearly purpuric color (Figure 1). Three of the 5 macules appeared over a hyperpigmented area from a previous episode secondary to metronidazole intake. A fixed drug eruption (FDE) was diagnosed.
Hermida MD, Consalvo L, Lapadula MM, Della Giovanna P, Cabrera HN. Bullous Fixed Drug Eruption Induced by Intravaginal Metronidazole Ovules, With Positive Topical Provocation Test Findings. Arch Dermatol. 2011;147(2):250-251. doi:10.1001/archdermatol.2010.419