Paracetamol-induced fixed drug eruption with positive immunofluorescence findings

A 93-year-old woman with an 8-year history of episodes of fixed drug eruption due to paracetamol is described. The rash was characterized by bullae, crusted lesions, hyperpigmented and erythematous patches as well as lesions resembling toxic epidermal necrolysis. Direct immunofluorescence revealed deposition of IgG and C3 in the epidermal intercellular cement substance of lesional skin only; the pathogenetic significance of this finding is discussed.