Fixed drug eruption in the genital area in 15 boys

Fixed drug eruption (FDE) is manifested as localized, circumscribed, round or oval plaques that characteristically recur in the same site with each use of the offending drug. The drugs most commonly implicated are phenolphthalein, barbiturates, antibiotics, salicylates, contraceptives, and anticonvulsants. FDE can appear on different parts of the body. The sites of predilection are the lips, genitalia, and sacral area. There are no reports of large series of pediatric patients with FDE involving the genitalia. We describe 15 boys with genital FDE associated with several drugs. Their average age at diagnosis was 3.2+/-2.2 years (range 6 months-8 years). The clinical presentation usually consisted of swelling and erythema of the penis and/or scrotum associated with pruritus, restlessness, urinary retention, and painful micturation. The diagnosis was supported by clinical history. The causative drugs were identified and confirmed by a provocation test, resolution after the drug was stopped, and a positive migration inhibiting factor (MIF) test. Genital FDE in children is uncommon, but the drugs associated with this entity are in such widespread use in pediatric practice that its recognition may be important, especially considering its easy treatability.