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Fluconazole-induced acute generalized exanthematous pustulosis.
Vito Di Lernia1, Cinzia Ricci1
1Department of Internal Medicine and Medical Specialities, Dermatology Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy.
Indian Journal of Dermatology
|March 28, 2015
Summary
Acute generalized exanthematous pustulosis (AGEP), a severe drug reaction, can be triggered by antifungals. This case highlights fluconazole as a potential cause, confirmed by a positive patch test.
Area of Science:
- Dermatology
- Pharmacology
- Toxicology
Background:
- Acute generalized exanthematous pustulosis (AGEP) is a severe cutaneous adverse drug reaction.
- It typically presents with fever, malaise, and widespread sterile pustules.
- Antifungal medications are known triggers for AGEP, with terbinafine being a high-risk agent.
Purpose of the Study:
- To report a rare case of AGEP induced by fluconazole.
- To investigate the association between fluconazole and AGEP through diagnostic testing.
- To contribute to the understanding of drug-induced AGEP and antifungal-related risks.
Main Methods:
- Case report of a 70-year-old male patient.
- Clinical observation of AGEP onset following fluconazole initiation.
- Diagnostic evaluation including a fluconazole patch test.
Main Results:
- The patient developed AGEP shortly after starting fluconazole.
- The fluconazole patch test was positive, supporting drug causality.
- This represents the first reported case of AGEP with a positive fluconazole patch test.
Conclusions:
- Fluconazole can be a causative agent of AGEP.
- Positive patch test results can confirm fluconazole-induced AGEP.
- Clinicians should consider fluconazole in the differential diagnosis of AGEP, especially in patients using antifungal agents.
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