MCQ – 4186

Sexually active males comes with complaints of recurrent ulcers over the glans which heals with hyperpigmentation. The probable diagnosis is

Correct Answer » B Explanation

Fixed drug eruption
– Classic triad:
• Recurs at same site
• Triggered by drug exposure
• Heals with hyperpigmentation (hallmark)
– Commonly affects genitalia, especially glans penis

Explanation of Other Options:
A. Aphthous ulcer
– Usually oral mucosa, genital rare
– Heals without pigmentation

C. Herpes genitalis
– Recurrent, starts as vesicles → ulcers
– Heals without hyperpigmentation

D. Chlamydial infection
– Causes urethritis or lymphogranuloma venereum (LGV)
– Not characterized by recurrent pigmented ulcers

Fixed Drug Eruption:
– Type: delayed hypersensitivity reaction
– Key feature: recurrence at same site + pigmentation
– Common drugs: sulfonamides, NSAIDs, tetracyclines

Genital Ulcer Differentiation:
– Herpes: painful vesicles, no pigmentation
– Syphilis: painless chancre
– Chancroid: painful soft ulcer
– Fixed drug eruption: recurrent, same site, pigmented (key clue)