Mixed Zone between Drug-Induced Hyperpigmentation and Generalized Fixed Pigmented Erythema

Abstract

We report a particular case of fixed drug eruption (FDE), in its erythematous and pigmented form, as a fixed pigmented erythema (FPE), which manifests in a generalized form, evolving for three years, and discuss the imputability to piroxicam and the Ramipril/Hydrochlorothiazide combination. Indeed, chronological, semiological, bibliographic criteria, were imprecise and non-discriminatory. We ended up retaining the diagnosis of fixed pigmented erythema (FPE) of particular diffuse presentation induced probably by piroxicam, based on clinical, histological and evolutive criteria. However, it remains a mixed zone between drug-induced hyperpigmentation and generalized fixed pigmented erythema with diffuse hypermelanosis.