Ann Dermatol.  2010 Feb;22(1):102-105. 10.5021/ad.2010.22.1.102.

A Case of Hydroxychloroquine Induced Acute Generalized Exanthematous Pustulosis Confirmed by Accidental Oral Provocation

• Park JJ
• Yun SJ
• Lee JB
• Kim SJ
• Won YH
• Lee SC

• KMID: 2172052
• DOI: http://doi.org/10.5021/ad.2010.22.1.102

Abstract

Acute generalized exanthematous pustulosis (AGEP) is a clinical reaction pattern that is principally drug induced and this is characterized by acute, nonfollicular sterile pustules on a background of edematous erythema. Hydroxychloroquine (HCQ) has been widely used to treat rheumatic and dermatologic diseases and HCQ has been reported to be an uncommon cause of AGEP. A 38-year-old woman with a 1-year history of dermatomyositis and polyarthralgia was treated with HCQ due to a lack of response to a previous medication. Three weeks after starting HCQ therapy, the pustular skin lesion developed and then this resolved after the HCQ was withdrawn and steroid treatment was started. A similar pustular eruption developed after HCQ was accidentally readministered.

Keyword

Acute generalized exanthematous pustulosis; Adverse drug reactions; Hydroxychloroquine; Provocation test

MeSH Terms

Acute Generalized Exanthematous Pustulosis
Adult
Arthralgia
Dermatomyositis
Drug Toxicity
Erythema
Female
Humans
Hydroxychloroquine
Skin
Hydroxychloroquine

Figure

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  Fig. 1 Numerous erythematous, nonfollicular pustules on the whole body and note the diffuse superficial desquamation. (A) Face, (B) Trunk, (C) Arm.

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  Fig. 2 Spongiform intraepidermal pustules and a perivascular infiltrate in the upper dermis (H&E, A: ×40, B: ×100, C: ×200).

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