Acute generalized exanthematous pustulosis as a manifestation of carbamazepine hypersensitivity syndrome

J Investig Allergol Clin Immunol. 2008;18(6):461-4.

Abstract

Anticonvulsant hypersensitivity syndrome (AHS) is a multisystemic disorder involving cutaneous changes and typical blood abnormalities that can be triggered by aromatic anticonvulsant drugs.The syndrome is commonly associated with a macular or papular rash or erythroderma. Acute generalized exanthematous pustulosis is a very rare cutaneous manifestation of AHS. A 41-year-old man was referred to our hospital for evaluation of a 3-day history of fever, leukocytosis, and generalized skin eruption. The patient had been taking carbamazepine for 1 month to treat hand tremor following surgery for intracerebral hemorrhage. Physical examination revealed facial edema and a large number of variable-sized pustules covering the body. Initial laboratory testing showed peripheral blood eosinophilia and abnormal liver function.A biopsy of pustular lesions revealed intraepidermal pustules, with perivascular lymphocytic infiltration. The skin lesions and laboratory results improved after withdrawal of carbamazepine and treatment with oral corticosteroids.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Anticonvulsants / adverse effects
  • Anticonvulsants / immunology*
  • Carbamazepine / adverse effects
  • Carbamazepine / immunology*
  • Drug Eruptions / diagnosis*
  • Drug Eruptions / drug therapy
  • Drug Eruptions / pathology
  • Humans
  • Male
  • Skin / drug effects*
  • Skin / pathology

Substances

  • Adrenal Cortex Hormones
  • Anticonvulsants
  • Carbamazepine