[Toxic dermatitis caused by tramadol].
BACKGROUND
Tramadol chlorhydrate (Topalgic) is a powerful analgesic recently introduced in France where its use has spread rapidly. We report a case where this drug induced a maculopapulous toxic skin reaction with secondary erythrodermia.


METHODS
A 47-year-old man was treated for lower back pain with tramadol chlorhydrate (50 mg b.i.d.). Otherwise, he was in good general health and was taking no other medications. Shortly after beginning the treatment, he developed a highly pruriginous maculopapulous eruption involving the entire skin surface, hyperthermia and general degradation. There was no skin exfoliation, mucosal involvement nor nodal enlargement. Tramadol was withdrawn and the patient was given corticosteroid therapy. Secondary erythrodermia developed after termination of the corticosteroids. The lesions regressed after tramadol withdrawal.


CONCLUSIONS
Tramadol-induced skin reactions are uncommon and usually benign. In our case, the delay from onset of tramadol and the development of the maculopapulous eruption was very short (four days). The patient was taking no other medication. We hypothesize that the patient had been sensitized by cross-reaction with another compound and recall the fundamental aspects of tramadol and opiate drugs.
Ghislain
P D
PD
Service de Dermatologie, Centre Hospitalier Saint-Philibert, Université Catholique de Lille.
Wiart
T
T
Bouhassoun
N
N
Legout
L
L
Alcaraz
I
I
Caron
J
J
Modiano
P
P
D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects*; D003937:Diagnosis, Differential; D003875:Drug Eruptions / Q000175:diagnosis*; D006801:Humans; D017116:Low Back Pain / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D014147:Tramadol / Q000008:administration & dosage / Q000009:adverse effects*
D000701:Analgesics, Opioid; D014147:Tramadol