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Toxic pustuloderma induced by ofloxacin

S Tsuda1, K Kato, T Karashima

  • 1Department of Dermatology, Kurume University School of Medicine, Japan.

Insights

A patient developed toxic pustuloderma, a rare skin reaction, after taking ofloxacin for infections. This adverse drug event, characterized by pustules and fever, was confirmed by re-administering the antibiotic.

Area of Science:

  • Dermatology
  • Pharmacology
  • Internal Medicine

Background:

  • Toxic pustuloderma is a rare but severe skin reaction.
  • Drug-induced skin reactions require careful identification and management.
  • Ofloxacin is a commonly prescribed fluoroquinolone antibiotic.

Observation:

  • A patient with asthma developed intense erythemas and subcorneal pustulation after receiving ofloxacin for bronchitis and pharyngitis.
  • The patient also experienced fever and neutrophil leukocytosis, indicative of an inflammatory response.
  • The adverse reaction was confirmed via oral re-administration of ofloxacin, which successfully induced pustular eruptions.

Findings:

  • Ofloxacin can induce toxic pustuloderma, a previously unreported adverse drug reaction.
  • The clinical presentation included fever and leukocytosis, consistent with a systemic inflammatory response.
  • Re-challenge with ofloxacin confirmed its causative role in the patient's pustular eruption.

Implications:

  • This case highlights the importance of considering ofloxacin as a potential cause of toxic pustuloderma.
  • Clinicians should be vigilant for this rare adverse drug reaction, especially in patients with pre-existing inflammatory conditions.
  • Further investigation may be warranted to understand the specific mechanisms underlying ofloxacin-induced toxic pustuloderma.

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