Lateralized exanthem mimicking figurate inflammatory dermatosis of infancy after methimazole therapy.
We reported a case of an 11-year-old girl admitted to our hospital for goiter, tachycardia, sweating, and visible and palpable thyroid. Thyroid function tests revealed a low thyrotropin level (<0.004 mIU/L) and elevated free thyroxine level (3.4 ng/ dL) diagnosed with Graves' disease and treated with methimazole. This anti-thyroid drug is recommended as first-line treatment in children with Graves' disease because it produces minor adverse effects with respect to propylthiouracil. She developed a lateralized exanthem mimicking figurate inflammatory dermatosis of infancy after methimazole therapy. The symptoms resolved after discontinuation of methimazole and treatment with an antihistamine and a corticosteroid. Furthermore, the treatment was changed to propylthiouracil without any adverse effects. According to current literature this is the first case of cutaneous figurate erythema related to methimazole, different from other well-known reactions such as skin eruption or urticaria.
Department of Human Pathology of Adult and Developmental Evolutive Age, University of Messina, Messina, Italy.
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Arrigo
Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy.
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Cutroneo
Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy mario.vaccaro@unime.it.
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Vaccaro
Department of Human Pathology of Adult and Developmental Evolutive Age, University of Messina, Messina, Italy.
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Impollonia
Department of Human Pathology of Adult and Developmental Evolutive Age, University of Messina, Messina, Italy.
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Squadrito
Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy.
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Mecchio
Department of Human Pathology of Adult and Developmental Evolutive Age, University of Messina, Messina, Italy.
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Salpietro
Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy.
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Altavilla
D002648:Child; D005076:Exanthema / Q000139:chemically induced*; D005260:Female; D006111:Graves Disease / Q000188:drug therapy; D006801:Humans; D007249:Inflammation / Q000139:chemically induced*; D008713:Methimazole / Q000009:adverse effects* / Q000627:therapeutic use; D012871:Skin Diseases / Q000139:chemically induced*; D013961:Thyroid Gland / Q000187:drug effects
D008713:Methimazole
Graves’ disease; adverse drug reactions; cutaneous figurate erythema; methimazole