Acute generalised exanthematous pustulosis and other severe drug eruptions from over the counter medications: A case report and review of the literature

Abstract

We present a case of acute generalised exanthematous pustulosis in an 11-year-old girl who used Duro-Tuss, an over-the-counter cough mixture containing pholcodine, and present a comprehensive review of the literature on severe drug reactions resulting from using non-prescription medications. This case reinforces the importance of taking a complete medication history.

A bad cough: Delayed cutaneous hypersensitivity caused by pholcodine

“…Delayed type hypersensitivity, including severe cutaneous adverse reactions (SCAR) to PHO, have only rarely been reported and poorly documented. Two case reports describe an acute generalized exanthematous pustulosis (AGEP) (8)(9), and in these cases patch tests, although feasible, were not performed. The related opiates codeine and morphine may also cause delayed type hypersensitivity, such as generalized dermatitis and AGEP, and patch tests may also be valuable in these cases (10)(11).…”