Abstract
Acute generalized exanthematous pustulosis (AGEP) is a rare yet well-known cutaneous reaction pattern, mostly caused by drugs. Acute localized exanthematous pustulosis (ALEP) is a localized variant of AGEP. A 42-year-old female presented with multiple erythematous pustules on the face, which appeared three days after the intramuscular injection of piroxicam. Histopathology revealed subcorneal pustules, epidermal spongiosis, and mixed inflammatory cell infiltration in the dermis. The pustules resolved within several days once the patient had discontinued the drug. Herein, we report the first case, as far as we know, of a female with a cutaneous drug reaction consistent with ALEP caused by piroxicam.
Highlights
Acute localized exanthematous pustulosis (ALEP) is a localized variant of acute generalized exanthematous pustulosis (AGEP), which is characterized by the eruption of multiple scattered pustules following drug administration
There have been no reported cases of ALEP caused by the oxicam family in the literature
We report the first case of ALEP induced by piroxicam
Summary
Acute localized exanthematous pustulosis (ALEP) is a localized variant of acute generalized exanthematous pustulosis (AGEP), which is characterized by the eruption of multiple scattered pustules following drug administration. A dermatological examination revealed the presence of multiple small, non-follicular pustules on edematous erythema affecting only the face and neck The patient had no complaints, especially no fever or general status alteration She had no personal or family history of dermatological diseases. This pustular eruption developed three days after the intramuscular injection of 20 mg of piroxicam for gonalgia. Compounds of this family that have been implicated in acute exanthematous pustulosis in its generalized form are meloxicam, lornoxicam, and piroxicam [4]. Patch testing was not done in our patient, the causative effect of piroxicam was certain due to the course of the affection (the acute onset and the improvement after the withdrawal of the drug). Its sensitivity is around 50% and negative tests do not allow a final conclusion, positive results are of great value [5]
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