Skin eruption following the use of two Chinese herbal preparations: a case report

To describe a patient who developed a widespread skin eruption following the use of two Chinese herbal medications, Fang Feng Tong Sheng Wan and Bi Yan Pian.

A 34-year-old man developed widespread erythematous papules that coalesced into plaques after five days of therapy with two Chinese herbal preparations. There was no lymphadenopathy or hepatosplenomegaly, and the patient denied any fever, chills or malaise. The skin biopsy was compatible with a drug eruption. When the patient's oral medications, including the herbal medications, were discontinued, the skin eruption resolved over the next few weeks. All of the regular long term medications were restarted without any sequalae.

This case, once again, emphasizes that, although herbal medications are marketed as natural products, these products can be associated with adverse drug effects. Other adverse effects that have been implicated with the use of Chinese herbal medications include interstitial fibrosis, renal failure, liver toxicity and severe dermatitis. In addition, there are several cases of adulteration of Chinese herbal products with synthetic medications.

Although rare, Chinese herbal medications can be associated with serious adverse effects. Clinicians should question patients about the use of herbal products whenever an adverse drug effect is suspected.