ABSTRACT
A 50-year-old woman presented to our dermatology clinic with pruritic lesions on her hands that had appeared 24 hours earlier. The clinical manifestations had started 24 hours after taking 100 mg of doxycycline for acute bronchitis. She had no history of allergic disease or allergic reactions to drugs. The dermatologic examination revealed multiple erythematous, purplish annular patches with overlying bullae with hemorrhagic content on both palms (Figure 1). The patient had no fever, and the rest of the physical examination did not reveal any abnormalities. Results of laboratory tests were within normal limits. A skin biopsy was performed, showing hydrophic degenerations of the basal membrane, a superficial perivascular infiltrate consisting of lymphocytes and eosinophils, and red blood cells in the dermis (Figure 2). A pharmacovigilance investigation was conducted, and doxycycline was confirmed as the agent responsible for the bullous fixed drug eruption (FDE) in our patient.
Subject(s)
Anti-Bacterial Agents/adverse effects , Doxycycline/adverse effects , Drug Eruptions/diagnosis , Drug Eruptions/etiology , Skin Diseases, Vesiculobullous/chemically induced , Skin Diseases, Vesiculobullous/pathology , Female , Humans , Middle Aged , Skin Diseases, Vesiculobullous/therapyABSTRACT
Pemetrexed is an anti-metabolite that targets multiple enzymes in folate pathway. The main toxicities associated with pemetrexed are asthenia, nausea, diarrhea, myelosuppression, and rash. Few cases of pemetrexed induced cutaneous adverse event have been reported, mainly periorbital-facial edema and edema of the limbs. We report a case of pemetrexed-induced edema of the eyelid and feet in a patient with adenocarcinoma of the lung.
Subject(s)
Antineoplastic Agents/adverse effects , Edema/chemically induced , Edema/diagnosis , Eyelids/pathology , Foot/pathology , Pemetrexed/adverse effects , Female , Humans , Middle AgedABSTRACT
The spectrum of cutaneous eruptions associated with dihydropyridines is extensive, varying from exanthemas to severe adverse events. We report a case of bullous eruption, one month after starting nicardipine and lercanidipine. The same symptoms recurred few days after taking nitrendipine.
Subject(s)
Dihydropyridines/adverse effects , Nicardipine/adverse effects , Skin Diseases, Vesiculobullous/chemically induced , Adult , Antihypertensive Agents/administration & dosage , Antihypertensive Agents/adverse effects , Antihypertensive Agents/immunology , Cross Reactions , Dihydropyridines/administration & dosage , Dihydropyridines/immunology , Drug Eruptions/diagnosis , Drug Eruptions/immunology , Drug Interactions , Female , Humans , Hypertension/drug therapy , Hypertension/immunology , Nicardipine/administration & dosage , Nicardipine/immunology , Skin Diseases, Vesiculobullous/diagnosis , Skin Diseases, Vesiculobullous/immunologyABSTRACT
The Drug rash with hypereosinophilia and systemic symptoms (DRESS) syndrome, or hypersensitivity syndrome, is a severe drug-induced hypersensitivity syndrome. It has been exceptionally described with ciprofloxacin. We report a 47-year-old-woman who developed DRESS syndrome, 2 days after taking ciprofloxacin for a urinary infection. She had a generalized maculopapular rash, severe rhabdomyolysis, liver involvement, renal failure and hypereosinophilia. Clinical symptoms had completely resolved after ciprofloxacin withdrawal. Renal failure has decrease after short corticosteroid treatment.
Subject(s)
Anti-Bacterial Agents/adverse effects , Ciprofloxacin/adverse effects , Drug Hypersensitivity Syndrome/etiology , Female , Humans , Middle AgedABSTRACT
Acute generalized exanthematous pustulosis (AGEP) is a severe cutaneous adverse reaction, mostly induced by drugs. Hydroxychloroquine have been rarely reported in literature as a causative drug of this reaction. We report a case of AGEP induced by hydroxychloroquine with systemic involvement and confirmed by positive patch testing.
Subject(s)
Acute Generalized Exanthematous Pustulosis/etiology , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Hydroxychloroquine/adverse effects , Acute Generalized Exanthematous Pustulosis/diagnosis , Adult , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Arthralgia/etiology , Arthralgia/prevention & control , Chloroquine/adverse effects , Chloroquine/therapeutic use , Drug Monitoring , Drug Resistance , Drug Therapy, Combination/adverse effects , Female , Humans , Hydroxychloroquine/therapeutic use , Lupus Erythematosus, Systemic/drug therapy , Lupus Erythematosus, Systemic/physiopathology , Patch Tests , Prednisolone/adverse effects , Prednisolone/therapeutic useABSTRACT
The disseminated BCG infection is a rare and serious complication of bacillus Calmette-Guerin (BCG) vaccine. We report a case of probable disseminated BCG infection in a 10-month-old child who had been vaccinated by BCG vaccine at birth. No incident was noted on the first days of vaccination. At the age of 40 days, she developed left supra clavicular and axillar abcessed lymph nodes. She was treated by surgical flattening of the lymph adenopathy. The same lymph node recurred at the age of 6 months and was treated with surgery. Few weeks after the second episode, cutaneous ulcerative lesions appeared. Cutaneous biopsy was performed and showed lesions compatible with tuberculosis. X-rays showed osteolysis of P1 of the middle finger in the left hand. She was treated by anti-tuberculosis antibiotics.
Subject(s)
BCG Vaccine/administration & dosage , BCG Vaccine/adverse effects , Mycobacterium bovis/isolation & purification , Tuberculosis/diagnosis , Tuberculosis/microbiology , Bone and Bones/diagnostic imaging , Bone and Bones/pathology , Female , Humans , Infant , Radiography , Skin/pathology , Tuberculosis/pathologyABSTRACT
We report an exceptional case of bullous lichen induced by metformin in a patient with diabetes mellitus.
Subject(s)
Drug Eruptions/etiology , Hypoglycemic Agents/adverse effects , Lichenoid Eruptions/chemically induced , Metformin/adverse effects , Diabetes Mellitus, Type 2/drug therapy , Drug Eruptions/pathology , Female , Humans , Hypoglycemic Agents/therapeutic use , Lichenoid Eruptions/pathology , Metformin/therapeutic use , Middle AgedABSTRACT
Meprobamate is usually a safe drug prescribed for anxiety disorders. Fixed drug eruption (FDE) is an exceptional cutaneous adverse effect of this drug. We report a case of FDE induced by meprobamate with positive patch test. A 22-year-old woman was prescribed for depression meprobamate, aceprometazine, valpromide and lorazepam. On the second day of treatment, the patient presented red erythematous and pruriginous plaques in the limbs and the face. After stopping the previous treatment, the patient's lesions resolved completely within 3 weeks with residual pigmentation. One month later, patch tests were performed and were positive to meprobamate. Exceptional cases of FDE were reported in literature with meprobamate. None has reported the use of patch test to confirm the diagnosis.
Subject(s)
Drug Eruptions/etiology , Meprobamate/adverse effects , Adult , Female , Humans , Patch TestsABSTRACT
Many drugs may induce psoriatic lesions or exacerbate preexisting psoriasis. We report an exceptional case of psoriasis vulgaris probably induced by clarithromycin. A 37-year-old man was prescribed for pharyngitis clarithromycin 500mg twice a day. On the third day of treatment, he presented a non pruriginous erythemato-squamous eruption, of trunk and limbs. Skin biopsy showed a typical aspect of psoriasis vulgaris. The drug was interrupted and the patient was treated by topical corticoids with rapid improvement.
