title: Skin eruption following the use of two Chinese herbal preparations: a case report.
abstract: OBJECTIVE
  To describe a patient who developed a widespread skin eruption following the use of two Chinese herbal medications, Fang Feng Tong Sheng Wan and Bi Yan Pian.
  
  
  METHODS
  A 34-year-old man developed widespread erythematous papules that coalesced into plaques after five days of therapy with two Chinese herbal preparations. There was no lymphadenopathy or hepatosplenomegaly, and the patient denied any fever, chills or malaise. The skin biopsy was compatible with a drug eruption. When the patient's oral medications, including the herbal medications, were discontinued, the skin eruption resolved over the next few weeks. All of the regular long term medications were restarted without any sequalae.
  
  
  CONCLUSIONS
  This case, once again, emphasizes that, although herbal medications are marketed as natural products, these products can be associated with adverse drug effects. Other adverse effects that have been implicated with the use of Chinese herbal medications include interstitial fibrosis, renal failure, liver toxicity and severe dermatitis. In addition, there are several cases of adulteration of Chinese herbal products with synthetic medications.
  
  
  CONCLUSIONS
  Although rare, Chinese herbal medications can be associated with serious adverse effects. Clinicians should question patients about the use of herbal products whenever an adverse drug effect is suspected.
authors.affiliation: Sunnybrook Women's College Health Sciences Centre, and Glaxo Wellcome, Toronto, Ontario, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Mather
authors.forename: Sandra R
authors.initials: SR
authors.lastname: Knowles
authors.forename: Lori
authors.initials: L
authors.lastname: Shapiro
authors.forename: Karen
authors.initials: K
authors.lastname: Binkley
mesh_terms: D000328:Adult; D003875:Drug Eruptions / Q000209:etiology*; D004365:Drugs, Chinese Herbal / Q000009:adverse effects*; D006801:Humans; D008297:Male
chemical_list: D004365:Drugs, Chinese Herbal