[A fixed drug eruption caused by paracetamol].

Fixed drug eruption is a hypersensitive skin response to drugs, which can present itself in different ways. The skin lesions are usually solitary, but can also appear as a maculopapular rash, Stevens-Johnson syndrome or toxic epidermal necrolysis. While fixed drug eruptions can be caused by various drugs, paracetamol is responsible in 1.5% of cases.

A 58-year-old man was seen in general practice with a five-year-old exanthema on his torso, arms and legs. A biopsy from one of the lesions revealed a fixed drug eruption. When asked, the patient admitted using paracetamol for the last five years on a near-daily basis to ease headaches. After cessation of paracetamol, the exanthema gradually disappeared.

It continues to be important to ask patients with a rash of unclear origin about the use of any medicines. Particularly over-the-counter drugs with relatively few side-effects, such as paracetamol, should be considered.