Summary
We describe a patient who presented with large painful areas of cutaneous necrosis and in whom the presence of the lupus anticoagulant was demonstrated. This abnormality is associated with a tendency to spontaneous thrombosis but widespread cutaneous necrosis has not been reported previously. The response to systemic steroids was dramatic whereas heparin proved ineffective.
Severe drug eruptions may cause diagnostic and therapeutic difficulty when they mimic or provoke endogenous patterns of dermatosis. We report three patients with known psoriasis in whom use of bupropion (Zyban), prescribed to assist with cessation of smoking, led to severe pustular or erythrodermic exacerbation of psoriasis within 3-5 weeks. All patients were systemically unwell and required hospitalization to control the disease flare.
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