Objective: To report a case of erythrodermia that appears to be related to the intake of omeprazole (OMP) for treatment of gastroesophageal reflux disease.
Case summary: We describe a case of erythrodermia associated with OMP therapy in a 58-year-old white woman with no predisposing factors. In 1995, at the Rheumatology Outpatients' Clinic, she was diagnosed as having scleroderma (CREST subgroup) and Sjögren's syndrome associated with corticoid osteoporosis and multiple crushed vertebrae, Raynaud's disease and joint pain. In March 1998, treatment with OMP 20 mg/d p.o. was started for treatment of gastroesophageal reflux disease. She came to our hospital emergency room in October 1999 because of a severe cutaneous reaction and poor general health. The dermatology service diagnosed the erythrodermia as a skin reaction to medication. We suspected that the causative agent was OMP. Examination of a skin biopsy specimen demonstrated that it was compatible with a toxicodermic reaction to medication. Administration of OMP was suspended and the skin lesions and the patient's general state of health improved. She was discharged without symptoms.
Conclusions: Our case reports, and others from the literature, suggest the importance of recognizing of the possibility of cutaneous adverse drug reactions even with medications, such as OMP, which has a good safety profile. Caution is recommended with the use of OMP, especially in elderly patients, in patients with renal insufficiency or decompensating liver disease and in patients who receive drugs that affect OMP metabolism.