Docetaxel-induced Flagellate Erythema - Case Report and Brief Review.

INTRODUCTION: Flagellate erythema is a distinctive morphologic reaction pattern recognized by whiplash-like pruritic erythematous eruption. It is usually encountered in patients receiving bleomycin. Only one case of docetaxel-induced flagellate erythema is reported in the literature. CASE REPORT: Herein, we report a rare case of docetaxel-induced flagellate erythema in a 53 years old woman with no particular medical history treated with docetaxel for metastatic adenocarcinoma of her right breast. Seven days after the third course, she developed multiple lineal and parallel pruritic erythematous streaks mainly on her chest and abdomen. The cutaneous erythema disappeared gradually over 10 days, leaving hyper-pigmented post-inflammatory linear scars lasting two weeks. The same reaction reappeared after the fourth and the fifth docetaxel course. CONCLUSION: Flagellate erythema has been reported as an adverse drug reaction secondary to several antineoplastic molecules, including docetaxel. Further studies are needed to discover its underlying mechanisms in order to figure out better treatment plans and prevention.

Antipsychotics Induced Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome: Literature Review and a Report of a Suspected Case Related to Chlorpromazine.

INTRODUCTION/BACKGROUND: Drug reaction with eosinophilia and systemic symptoms reaction (DRESS) syndrome is a serious, potentially life-threatening drug side effect associated with more and more drugs. However, antipsychotics have rarely been involved in such condition. CASE REPORT: We report here a suspected case of chlorpromazine induced DRESS syndrome in a 33-year-old woman with a history of allergic rhinitis and bipolar disorder who has reported an unexplored generalized skin eruption after taking chlorpromazine 10 years before. Only 24 hours after starting the therapy, the patient developed erythematous skin eruption on her limbs and her trunk with biological abnormalities, including liver enzyme elevation and eosinophilia. Skin eruption disappeared spontaneously within 3 days after therapy discontinuation and subsequently, biological abnormalities regressed. Patch tests were performed and were positive for chlorpromazine. At same time, we performed a literature review of the DRESS syndrome induced by antipsychotics. No patch tests were performed for those cases. CONCLUSION: Clinicians should be aware of such clinical features after starting patients on antipsychotics to withdraw the culprit drug as early as possible and avoid further complications.