Dimorphic exanthema manifested as reticular maculopapular exanthema and erythema multiforme major associated with pyrazolon derivatives.
The non-steroidal anti-inflammatory drugs, especially various pyrazole or pyrazolon derivatives, were one of the classes of drugs commonly implicated in erythema multiforme or Stevens-Johnson syndrome/toxic epidermal necrolysis. Reticular exanthem was a rare morphological pattern of maculopapular drug eruptions. Here we report a case of dimorphic exanthema presenting with partly reticular maculopapular exanthema and erythema multiforme-like lesions, associated with pyrazolon derivatives. Patch testing showed negative reaction to the suspected drugs. The possible mechanism underlying the association of dimorphic exanthema with NSAIDs is discussed.
Chen
Wenchieh
W
Department of Dermatology, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, 704 Tainan, Taiwan. wchen@mail.ncku.edu.tw
Hsieh
Fu-Sen
FS
D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D003533:Cyproheptadine / Q000008:administration & dosage; D003875:Drug Eruptions / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D004359:Drug Therapy, Combination; D004892:Erythema Multiforme / Q000139:chemically induced* / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D005076:Exanthema / Q000139:chemically induced* / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage; D010328:Patch Tests; D011720:Pyrazoles / Q000009:adverse effects* / Q000627:therapeutic use; D047069:Pyrazolones; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D011720:Pyrazoles; D047069:Pyrazolones; D003533:Cyproheptadine; C038362:pyrazolone; D008775:Methylprednisolone