Clinicopathologic Study of Pustular Drug Eruption

Kim, Soo Jung; Lee, Seung Hun; Ahn, Sung Ku; Lee, Won Soo; Lee, Beom Joo

Abstract

BACKGROUND: Pustular eruptions due to drugs are uncommonly reported. We studied the characteristics of clinical and histopathologic findings of pustular drug eruption.
OBJECTIVE
We observed th.e causative agents, clinical featurs and histopathologic findings of pustular drug eruption and identified differential points of generlized pustular eruption.
METHODS
We evaluated t,he clinical and histopathologic findings of 8 patients with pustular drug eruption and reviewed the literatures reported cases of pustular drug eruption.
RESULTS
All patients diagnosed pustular drug eruption suffered from generalized pustular eruption associated with systemic symptoms such as fever, headachened myagia one to three days after treatment with causative agents. The causative agents of putular drug eruption are antibiotics such as ceftriaxone, analgesics and antipyretics. The pustule resolved after a few days of treatment with systemic corticosteroids and antihistamines. Laboratory findings revealed leukocytosis, neutrophilia, and analevated erythrocyte sedimentation rate, On histopatologic findings, we observed subcorneal pustuls containing neutrophils, eosinophils and some lymphocytes and spongiosis, exocytosis of acute iiflammatory cells. Perivascular infiltration of lymphocyte ancl edema of papillary dermis was also bserved in the dermis.
CONCLUSION
Pustular drug eruption is characterized by generalized pustular eruption associated with systemic symptoms and histopathologic findings of that are sterile subcorneal pustules. Therefore differential diagnosis of other generalized pustular erupticns are relatively easy by careful history of medication, clinical and histopathologic findings.