title: [Severe cutaneous drug reactions to misused griseofulvin: 2 cases].
abstract: BACKGROUND
  Griseofulvin is an antifungal drug known to cause drug rash. However, it is widely prescribed outside its classic indications. Herein, we describe 2 cases in which griseofulvin was prescribed for off-label indications.
  
  
  METHODS
  Case No. 1. A 51-year-old woman was referred to the department of internal medicine for management of Stevens-Johnson Syndrome (SJS). The symptoms appeared 17 days after she had taken griseofulvin for inguinal intertrigo. Case No. 2. A 19-year-old female patient consulted for toxic epidermal necrolysis (TEN) affecting 30% of her body surface, with a positive Nikolsky sign and severe mucosal lesions. These symptoms appeared 9 days after she began taking griseofulvin, which had initially been prescribed for her husband for mycosis.
  
  
  CONCLUSIONS
  Toxic epidermal necrolysis, a condition chiefly of drug-related origin, is a severe mucocutaneous syndrome characterized by massive keratinocytic apoptosis. Although there are few scientific publications referring to griseofulvin-induced drug eruption, they deserve to be mentioned since this drug is widely used for purposes other than the approved indications and can cause life-threatening reactions.
  
  
  CONCLUSIONS
  We report two cases of toxic epidermal necrolysis related to the misuse of griseofulvin. It is important to bear in mind the precautions for use of oral antifungal drugs, which are strictly reserved for use against resistant or diffuse forms of mucocutaneous fungal infections.
authors.affiliation: Service de médecine interne, hôpital du Taaone, 98713 Papeete, Tahiti, Polynésie française.
authors.forename: A
authors.initials: A
authors.lastname: Le Guern
authors.affiliation: Pharmacie hospitalière, hôpital du Taaone, 98713 Papeete, Tahiti, Polynésie française.
authors.forename: I
authors.initials: I
authors.lastname: Kerrad
authors.affiliation: Service de médecine interne, hôpital du Taaone, 98713 Papeete, Tahiti, Polynésie française. Electronic address: erwan.oehler@cht.pf.
authors.forename: E
authors.initials: E
authors.lastname: Oehler
mesh_terms: D000935:Antifungal Agents / Q000009:adverse effects*; D005260:Female; D006118:Griseofulvin / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D063487:Prescription Drug Misuse; D012720:Severity of Illness Index; D013262:Stevens-Johnson Syndrome / Q000209:etiology*; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D006118:Griseofulvin
keywords: Drug eruption; Griseofulvin; Griséofulvine; Lyell; Lyell's syndrome; Nécrolyse épidermique toxique; Stevens-Johnson; Stevens-Johnson syndrome; Toxic epidermal necrolysis; Toxidermie