Generalized bullous fixed drug eruption from vincristine and cyclophosphamide in a patient undergoing chemotherapy for gestational trophoblastic neoplasia

Authors: Felix Paolo J,. Lizarondo, MD, Charmaine Vanessa S. Chamberlin, MD, Francisca DC Roa MD, FPDS

Abstract

Introduction: Generalized bullous fixed drug eruption (GBFDE) is a rare presentation of fixed drug eruption. Fixed drug eruption can present with bullae but can present in a widespread distribution as GBFDE.

Case Summary: A 30 year old female undergoing chemotherapy for gestational trophoblastic neoplasia presented with generalized bulla. A day after giving vincristine and etoposide, burning sensation was noted on the gluteal area, lower back, posterior lower legs and face eventually noting erythematous patches. Lesions rapidly developed violaceous discoloration which progressed to bullae formation with serosanguinous content and eventually erosions. There was no mucosal involvement. Lesions did not progress and started to improve with local wound care and topical corticosteroids. This was the main reason why vincristine and cyclophosphamide were the most likely etiologic agents since improvement was noted once it was discontinued while the other medications were still being given. However differentiating between vincristine and cyclophosphamide as the etiologic agent of the GBFDE is difficult since both were administered around the same time.

Conclusion: This case demonstrates chemotherapeutic drugs, specifically vincristine and cyclophosphamide can cause GBFDE.

 

Citation

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Keywords

generalized bullous fixed drug eruption, vincristine, cyclophosphamide

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