title: Oral mucosal fixed drug eruption: characteristics and differential diagnosis.
abstract: BACKGROUND
  Little is known about the characteristic features of oral mucosal fixed drug eruption (FDE).
  
  
  OBJECTIVE
  To present the clinical highlights and the differential diagnosis of oral mucosal FDE in a relatively large group of patients from Turkey.
  
  
  METHODS
  This was a methodological, retrospective, cross-sectional study of 61 patients with oral mucosal FDE. The causative drug was established mainly by oral provocation test.
  
  
  RESULTS
  The age range of 61 patients (38 females, 23 males) was 7 to 62 years. Naproxen and cotrimoxazole were the main inducers. Fourteen patients (23%) had a solitary oral lesion predominantly located on the dorsum of the tongue, or on the hard palate, the former statistically significantly associated with cotrimoxazole. Bullous/erosive (n = 47), aphthous (n = 12), and erythematous (n = 2) morphology were observed. A considerable number of patients were referred with a prior clinical diagnosis of herpes simplex and Behçet's disease; some of them were already receiving long-term treatment with acyclovir and colchicine, respectively.
  
  
  CONCLUSIONS
  The main limitation of the present study resides in its retrospective design.
  
  
  CONCLUSIONS
  Isolated oral lesions, aphthous lesions, severe bullous/erosive lesions, and the absence of residual pigmentation are the main features that may cause difficulties in the differential diagnosis. It is important to differentiate dysmenorrhea-related monthly attacks of oral FDE in female patients caused by nonsteroidal anti-inflammatory drugs from menstruation-triggered attacks of herpes simplex infection, and isolated orogenital aphthous FDE from Behçet's disease, especially in countries with a high frequency of the disease in order to prevent irrelevant therapies.
authors.affiliation: Department of Dermatology and Venereology, Istanbul University, İstanbul Medical Faculty, Istanbul, Turkey. profeo@istanbul.edu.tr
authors.forename: Esen
authors.initials: E
authors.lastname: Özkaya
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001528:Behcet Syndrome / Q000175:diagnosis; D002648:Child; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D003875:Drug Eruptions / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D005500:Follow-Up Studies; D006561:Herpes Simplex / Q000175:diagnosis; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000187:drug effects* / Q000473:pathology; D009288:Naproxen / Q000009:adverse effects / Q000627:therapeutic use; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D013281:Stomatitis, Aphthous / Q000175:diagnosis; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000009:adverse effects / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D009288:Naproxen; D015662:Trimethoprim, Sulfamethoxazole Drug Combination