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Updated: Jan 8, 2026

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Published on: May 28, 2013
Doxycycline-induced fixed drug eruption: A case series highlighting a dermatological concern in antimicrobial
Clément Brun1, Marie Danset2, Romain Salle3
1Department of Allergology and Clinical Immunology, Hospices Civils de Lyon, Lyon Sud Hospital, University Claude Bernard Lyon 1, Lyon, France.
Objectives:
To describe a series of doxycycline-induced fixed drug eruptions (FDE) observed in sexual health clinics, in a context of increasing doxycycline use for sexually transmitted infection (STI) management and prophylaxis in France.
Methods:
We conducted a retrospective case series, combined with a doxycycline prescription audit and a sexual health clinician survey.
Results:
Thirteen male patients (mean age: 32.5 years) were diagnosed with doxycycline-induced FDE. Most were MSM (men who have sex with men, 84.6%) and received doxycycline for STI treatment (92.3%). Lesions were mainly genital (85%) and often misdiagnosed as ulcerative STIs. Doxycycline prescriptions increased by 345% between 2018 and 2024. When performed, allergy workups confirmed the diagnosis in 60% of cases.
Conclusions:
The sharp rise in doxycycline use for STI prophylaxis coincides with the identification of multiple FDE cases. Enhanced dermatological awareness is needed within antimicrobial stewardship programs to ensure safer implementation of doxycycline-based prevention strategies.
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