Exfoliative dermatitis following ingestion of phenylbutazone (butazolidin).

Abstract

Phenylbutazone (Butazolidin) is the pyrazole derivative 4-butyl-l,2-diphenyl-3,5-pyrazolidinedione sodium. It is being used extensively in the treatment of rheumatoid arthritis, ankylosing spondylitis, arthritis with psoriasis, degenerative joint disease, acute peritendinitis, and gout. Over 10% of patients have been reported unable to tolerate the drug. Reported toxic manifestations include morbilliform rash, edema, nausea, activation of peptic ulcer, vertigo, stomatitis, insomnia, nervousness, thrombocytopenia, and agranulocytosis. It has been said that a rash occurs in only 3 to 4% of patients, that it subsides rapidly on discontinuance of medication, and that desensitization with minute doses of phenylbutazone has made possible continuation of therapy in some of those who show rashes. As we were unable to find any reference in the literature to exfoliative dermatitis attributable to the drug and as we feel that our case indicates that continued use of the drug may be definitely dangerous and absolutely contraindicated after a rash has been