Toxic pustuloderma. A drug induced pustulating glandular fever-like syndrome

A striking cutaneous eruption developed in a fifty-eight year old woman with bipolar affective disorder three weeks after starting carbamazepine therapy. She had an infectious mononucleosis-like systemic illness associated with myriads of cutaneous micropustules, erythroderma and a high eosinophil count. A similar eruption due to carbamazepine has been reported only twice before, but isolated cases ascribed to other medications exist. We believe that this reaction is a specific class of drug eruption best named Toxic Pustuloderma.