Toxic epidermal necrolysis with prominent facial pustules: a case with reactivation of human herpesvirus 7.
A 37-year-old Japanese man presented with confluent erythemas and progressive erosive lesions on the almost entire body including the oral mucosa and genitalia. This was accompanied with prominent facial pustules. Although a lymphocyte stimulation test was positive only for acetaminophen, he took other agents including carbamazepine for his depression. He was diagnosed as having toxic epidermal necrolysis with prominent facial pustules and treated by methylprednisolone pulse therapy, which resulted in a good response. During the course, human herpesvirus 7 (HHV-7) DNA was detected in his peripheral blood. The HHV-7 reactivation might be related to facial pustulosis, which is occasionally observed in drug-induced hypersensitivity syndrome/drug rash with eosinophilia and systemic symptoms.
Honma
Masaru
M
Department of Dermatology, Asahikawa Medical College, Asahikawa, Japan. wanwan@asahikawa-med.ac.jp
Tobisawa
Shinichi
S
Iinuma
Shin
S
Shibuya
Takashi
T
Komatsu
Shigetsuna
S
Takahashi
Ichiro
I
Ishida-Yamamoto
Akemi
A
Iizuka
Hajime
H
D000082:Acetaminophen / Q000009:adverse effects; D056150:Acute Generalized Exanthematous Pustulosis / Q000139:chemically induced / Q000473:pathology / Q000821:virology; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D002220:Carbamazepine / Q000009:adverse effects / Q000627:therapeutic use; D003863:Depression / Q000188:drug therapy; D004802:Eosinophilia / Q000139:chemically induced; D016199:Herpesvirus 7, Human / Q000187:drug effects / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000009:adverse effects / Q000627:therapeutic use; D019349:Roseolovirus Infections / Q000139:chemically induced / Q000473:pathology; D013262:Stevens-Johnson Syndrome / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology / Q000821:virology; D016896:Treatment Outcome; D014775:Virus Activation
D000893:Anti-Inflammatory Agents; D000928:Antidepressive Agents; D002220:Carbamazepine; D000082:Acetaminophen; D008775:Methylprednisolone