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Mercury‐induced acute generalized exanthematous pustulosis misdiagnosed as a drug‐related case

Mercury‐induced acute generalized exanthematous pustulosis misdiagnosed as a drug‐related case Acute generalized exanthematous pustulosis (AGEP) is characterized by the acute onset of fever with a generalized erythematous pustular eruption (1, 2) . It is drug induced in more than 90% of cases (1, 2) . However, it can be caused in rare cases by other agents such as mercury (2, 3) . We report a case of mercury‐induced AGEP that was misdiagnosed as a drug‐related one. Case Story An 18‐year‐old girl was treated with fluconazole (Funzol ® ; SAIPH, Sfax, Tunisia) 150 mg once a week for onychomycosis. 17 days after starting fluconazole, she developed a generalized eruption with fever (38.5 celsius). Physical examination showed several non‐follicular pustules occurring on a diffuse, oedematous erythema distributed all over the body with marked lesions on the trunk and folds. The patient denied any intake of other medications during the previous weeks and had no history of mercury exposure. Laboratory investigations showed a total white blood cell count at 11 000/μl with 70% neutrophils and 10% eosinophils. Blood and pustule cultures were negative. The mycological examination of a pustule was negative. A skin biopsy showed spongiform subcorneal pustules and perivascular infiltrates with neutrophils and eosinophils. The diagnosis of AGEP was made, http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Contact Dermatitis Wiley

Mercury‐induced acute generalized exanthematous pustulosis misdiagnosed as a drug‐related case

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References (19)

Publisher
Wiley
Copyright
© Blackwell Munksgaard 2008
ISSN
0105-1873
eISSN
1600-0536
DOI
10.1111/j.1600-0536.2007.01306.x
pmid
18598307
Publisher site
See Article on Publisher Site

Abstract

Acute generalized exanthematous pustulosis (AGEP) is characterized by the acute onset of fever with a generalized erythematous pustular eruption (1, 2) . It is drug induced in more than 90% of cases (1, 2) . However, it can be caused in rare cases by other agents such as mercury (2, 3) . We report a case of mercury‐induced AGEP that was misdiagnosed as a drug‐related one. Case Story An 18‐year‐old girl was treated with fluconazole (Funzol ® ; SAIPH, Sfax, Tunisia) 150 mg once a week for onychomycosis. 17 days after starting fluconazole, she developed a generalized eruption with fever (38.5 celsius). Physical examination showed several non‐follicular pustules occurring on a diffuse, oedematous erythema distributed all over the body with marked lesions on the trunk and folds. The patient denied any intake of other medications during the previous weeks and had no history of mercury exposure. Laboratory investigations showed a total white blood cell count at 11 000/μl with 70% neutrophils and 10% eosinophils. Blood and pustule cultures were negative. The mycological examination of a pustule was negative. A skin biopsy showed spongiform subcorneal pustules and perivascular infiltrates with neutrophils and eosinophils. The diagnosis of AGEP was made,

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Contact Dermatitis – Wiley

Published: Jul 1, 2008

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