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Noticed Dark Red Rash Under Lower Lip. Have Cold Sore. What Could Be This?

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Posted on Wed, 9 Jan 2013
Question: Hi. I'm a 54y/o female who never had a cold sore in her life, so I don't really know what they look like or feel like. I woke up this morning with a dark red XXXXXXX under my lower lip on the left side of my face. It doesn't hurt, doesn't itch, is flat on my face, no fluid at all. I tried to wash it off because it looked like "stain". It didn't wash off.

It's shortly after I posed my question. The red thing in question is now starting to slightly ache a little. It doesn't quite hurt but i am aware of a dull ache.
doctor
Answered by Dr. Sankaranantham Murugan (5 hours later)
Hi XXXXXXX,

Thanks for writing to us.

The dark red XXXXXXX on your face under your lower lip may be due to a type of drug eruption called as Fixed drug eruption.

I think that you had been exposed to some sort of medicine in the previous days for some other ailments. You may be allergic to this drug and could cause such a lesion on your face. It will fade 5-7 days after you stop the drug, but leaving a dark violaceous discoloration persisting for long time, say up to an year. If you are re- challenged with the same drug on any occasion, then once again the red patch appears or deepened at the same site sometimes with an extended site.

So you have to find the culprit drug and avoid the same forever and in due course the discoloration will fade completely. Drugs containing sulpha molecules or cotrimoxazole or analgesics commonly produce such lesions. I dont think you need to worry about the same.
Get well soon.
Dr S.Murugan

Above answer was peer-reviewed by : Dr. Aparna Kohli
doctor
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Follow up: Dr. Sankaranantham Murugan (2 hours later)
Dr. M,

Thanks for your quick response. With regard to this lesion being caused by a drug allergy, I have not been on any new drugs. I just stopped XXXXXXX last night after many months on it. The other meds I take are Gralise (900mg. at bedtime for fibro pain), Zetia, Paxil (10mg in am to control dys-autonmia), & Doxycycline (to fight side effects of very high doses of steroid, prescribed for fibro flare up starting last december/finished steroid in july). I hope you'll tell me not to worry again, but if this is not a drug allergy than what is it?

Thanks,
XXXXXXX
doctor
Answered by Dr. Sankaranantham Murugan (13 hours later)
Hi,

Pleased to answer your feed back question.
Doxycyclin is known to cause drug eruption. Other than drugs sometimes food colors and flavoring agents also can cause this type of drug eruption.

If it is not a fixed drug eruption, it may be an insect bite lesion. Cold sores will appear as grouped small vesicles which may be painful and leave ulceration afterwards usually near the angle of mouth and lasts for not more than a week or 10 days.

If you could upload the picture of your lesion, it will throw more information to tell about your problem.
You could also consult your dermatologist and he/she will be able to fix the diagnosis and treat the same.
Wish you a speedy recovery.
Dr S.Murugan
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Mohammed Kappan
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Answered by
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Dr. Sankaranantham Murugan

HIV AIDS Specialist

Practicing since :1974

Answered : 3110 Questions

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Noticed Dark Red Rash Under Lower Lip. Have Cold Sore. What Could Be This?

Hi XXXXXXX,

Thanks for writing to us.

The dark red XXXXXXX on your face under your lower lip may be due to a type of drug eruption called as Fixed drug eruption.

I think that you had been exposed to some sort of medicine in the previous days for some other ailments. You may be allergic to this drug and could cause such a lesion on your face. It will fade 5-7 days after you stop the drug, but leaving a dark violaceous discoloration persisting for long time, say up to an year. If you are re- challenged with the same drug on any occasion, then once again the red patch appears or deepened at the same site sometimes with an extended site.

So you have to find the culprit drug and avoid the same forever and in due course the discoloration will fade completely. Drugs containing sulpha molecules or cotrimoxazole or analgesics commonly produce such lesions. I dont think you need to worry about the same.
Get well soon.
Dr S.Murugan