A 39-year-old woman presented with a purple-red macula, 2 cm in diamet
er, on the back of her right hand. She had had similar maculae at this
location several times before and residual pigmentation had persisted
for 6 months. Histopathological examination showed slight acanthosis
of the epidermis and perivascular round-cell infiltration and melanoph
ages in the dermis. Oral provocation tests with five drugs that the pa
tient had received as common-cold treatments on different occasions we
re positive only in the case of tosufloxacin; after an hour the skin l
esion reappeared. To our knowledge this is the first published report
of a fixed drug eruption caused by tosufloxacin, although such eruptio
ns have previously been reported for several other fluoroquinolones.