title: [Fluindione-induced acute generalised exanthematous pustulosis confirmed by patch testing].
abstract: BACKGROUND
  Fluindione is an oral anticoagulant belonging to the vitamin K antagonist class. Although fluindione is very widely prescribed in France, few cases of cutaneous drug reactions have been reported. Below we describe a case of acute generalised exanthematous pustulosis due to fluindione as confirmed by patch-testing.
  
  
  METHODS
  A 70-year-old woman was hospitalised for diffuse erythematous and pustular rash 48hours after initiation of fluindione treatment for cardiac arrhythmia. A diagnosis of fluindione-induced acute generalised exanthematous pustulosis was made. After withdrawal of fluindione, the eruption cleared up within eight days. Warfarin was then used without skin reaction. Subsequent patch-tests were positive for fluindione.
  
  
  CONCLUSIONS
  These signs were consistent with fluindione-induced acute generalised exanthematous pustulosis. A causative role of fluindione is very likely in view of the rapid onset after initiation, improvement after withdrawal and positive patch tests. Skin patch-testing, which is easily performed, can be extremely helpful in determining a causal relationship with medication.
authors.affiliation: Service de dermatologie, hôpital Ambroise-Paré, Assistance publique-Hôpitaux de Paris, 9, avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France.
authors.forename: M
authors.initials: M
authors.lastname: Chtioui
authors.forename: F
authors.initials: F
authors.lastname: Cousin-Testard
authors.forename: U
authors.initials: U
authors.lastname: Zimmermann
authors.forename: A
authors.initials: A
authors.lastname: Amar
authors.forename: P
authors.initials: P
authors.lastname: Saiag
authors.forename: E
authors.initials: E
authors.lastname: Mahé
mesh_terms: D000368:Aged; D003875:Drug Eruptions / Q000209:etiology* / Q000473:pathology; D005076:Exanthema / Q000139:chemically induced* / Q000473:pathology; D005260:Female; D006801:Humans; D010328:Patch Tests; D010630:Phenindione / Q000009:adverse effects / Q000031:analogs & derivatives*; D012872:Skin Diseases, Vesiculobullous / Q000139:chemically induced* / Q000473:pathology
chemical_list: D010630:Phenindione; C017673:fluindione