Photoclinic Diagnosis: Fixed Drug Eruption

A 35-year-old male was admitted on October 20, 2009, tremulous and anxious, following longstanding alcoholism. Antecedent: bariatric surgery, hyperuricemia and gouty arthritis during the previous three years. He denied a history of allergy or atopic dermatitis. Admission examination was unremarkable, except for resting fine tremors of his hands. Blood counts showed leukocytes: 7.1 (×109/L), 60% neutrophils, 36% lymphocytes and 4% monocytes; erythrocytes: 3.99 (×1012/L); hemoglobin: 13.6 g/dL; hematocrit: 39.7%; MVC: 99 fL; MCHC: 34 g/dL; and platelets: 171 (×109/L). Serum determinations revealed glucose: 84 mg/dL; urea: 21.7 mg/dL; creatinine: 0.7 mg/ dL; albumin: 3.9 g/dL; globulins: 2.0 g/dL; uric acid: 10.2 mg/dL; ionized calcium: 1.28 mmol/L; magnesium: 2.0 mg/dL; sodium: 141 mEq/L; potassium: 3.5 mEq/L; ALT: 18.9 U/L; AST: 13.4 U/L; alkaline phosphatase: 73.4 U/L; gama-GT: 35.7 U/L; prothrombin activity: 89%; RNI: 1.05; bilirubin: 0.9 mg/dL; cholesterol: 106 mg/dL; LDL: 47 mg/ dL; HDL: 34 mg/dL; VLDL: 25 mg/dL; triglycerides: 90 mg/dL; folic acid: 12.3 nmol/L; TSH: 0.62 U/mL; free T4: 0.76 ng/dL.