Fixed drug eruption in a cribriform pattern: an atypical presentation

Fixed drug eruption (FDE) is a distinct adverse drug reaction characterized by a well-defined, dusky, violaceous to erythematous patch that recurs at the same site upon re-exposure to causative drugs and resolves with hyperpigmentation. This unique reaction is a type IV hypersensitivity reaction mediated by memory CD8⁺ T cells that reside in the basal layer of the epidermis of the resting FDE lesion. Variants of FDE described in the literature include bullous, generalized bullous, nonpigmenting, linear, papular, erythema multiforme-like, transitory giant, annular, psoriasiform, erythema dyschromicum perstans-like and cellulitis-like. We present the case of a 12-year-old boy with FDE in a cribriform pattern that has not been defined so far.