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

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 Three weeks after starting HCQ therapy, the pustular skin lesion developed and then this resolved after the HCQ was withdrawn and steroid treatment was started.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.

A Case Of Intermediate Toxic Epidermal Necrolysis (Lyell Syndrome) Induced By Hydroxychloroquine Sulfate: A Report

“…Generally, as is true in our case, TEN occurs 1 to 4 weeks after the administration of the drug (Lebrun-Vignes et al, 2015). HCQ is a synthetic antimalarial drug whose side effects, as reported by various authors, are: Severe Acute Generalized Exanthematous Pustulosis (AGEP) (Naziha et al, 2010;Assier-Bonnet et al, 1996;Park et al, 2010), photoinduced toxidermia (Metayer et al, 2001), Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) (Schmutz et al, 2008), and TEN (Plaquenil (hydroxychloroquine sulphate) tablets; 2006). Cases of Lyell syndrome are rare.…”

A case of prolonged generalized exanthematous pustulosis caused by hydroxychloroquine—Literature review

“…We also reviewed the literature in English since 2008 to 2018 and found nine other cases . The details of the cases are summarized in Table .…”

“…7 We also reviewed the literature in English since 2008 to 2018 and found nine other cases. [7][8][9][10][11][12][13] The details of the cases are summarized in Table 1. The cases have been cleared within 8-91 days.…”

AGEP overlap induced by hydroxychloroquine: a case report and literature review

“…AGEP in association with administration of Hydroxychloroquine has been infrequently reported in the literature, with a total of twenty-one cases following a PubMed search using the terms 'Hydroxychloroquine' and 'Pustolosis.' Typically, this disease process is self-limited and requires basic supportive measures [7][8][9]. Rarely, AGEP can present in an atypical fashion with the development of blisters and vesicles that can coalesce, desquamate and form superficial erosions in an AGEP/SJS Overlap Syndrome [3,10,11].…”