Ann Dermatol.  2015 Aug;27(4):431-434. 10.5021/ad.2015.27.4.431.

Successful Treatment of Hydroxychloroquine-Induced Recalcitrant Acute Generalized Exanthematous Pustulosis with Cyclosporine: Case Report and Literature Review

• Yalcin B
• Cakmak S
• Yildirim B

• KMID: 2171501
• DOI: http://doi.org/10.5021/ad.2015.27.4.431

Abstract

Acute generalized exanthematous pustulosis (AGEP) is a cutaneous reaction principally induced by drugs. Spontaneous resolution is observed in most patients. However, severe cases required systemic corticosteroid administration. Hydroxychloroquine, which is used to treat some dermatologic and rheumatologic diseases because of its anti-inflammatory and immunosuppressive effects, is an uncommon cause of AGEP. A 67-year-old female patient presented with severe AGEP due to hydroxychloroquine treatment. She was recalcitrant to supportive care and systemic corticosteroid treatment butwas successfully treated with cyclosporine. Hydroxychloroquine-induced AGEP occurs in women with underlying rheumatologic diseases, has a longer latent period, and has a severe course usually requiring systemic treatment.

Keyword

Acute generalized exanthematous pustulosis; Cyclosporine; Hydroxychloroquine

MeSH Terms

Acute Generalized Exanthematous Pustulosis*
Aged
Cyclosporine*
Female
Humans
Hydroxychloroquine
Cyclosporine
Hydroxychloroquine

Figure

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  Fig. 1 Multiple pustular lesions on the erythematous and edematous plaque accentuated in the intertriginous area and axilla.

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  Fig. 2 Targetoid lesions on the thigh.

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