Methylphenidate
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Methylphenidate Pseudolymphoma: case report A 22-year-old woman with attention deficit hyperactivity disorder developed pseudolymphoma during treatment with methylphenidate. The woman started receiving methylphenidate [dosage not stated] and subsequently developed recurrent, mildly pruritic crops of painless lesions that were mostly localised to her proximal upper extremities and face [time to reaction onset not clearly stated]; before each eruption of the lesions, she developed a fever of up to 40°C. Two months after methylphenidate was initiated, the woman’s psychiatrist discontinued the drug due to her periodic spiking fevers. About 1 month later, methylphenidate was restarted and the woman’s skin eruption subsequently recurred. She subsequently presented with a 4-month history of the skin eruption. On examination, she had a few erosions and pink excoriated papules on her scalp, and many indurated, red, excoriated papulonodules of 0.2 to 0.6cm in size on her right upper arm, right buttock and face. At subsequent follow-up, the scalp erosions had healed, but multiple, indurated, red, excoriated papules continued to manifest on her face and upper arms. A punch biopsy from her arm revealed infiltrate consisting of mononuclear cells admixed with cells that contained fragmented nuclear material. She was diagnosed with a lymphomatoid drug reaction. Methylphenidate was finally withdrawn about 1 month after it was reinitiated. Her existing nodules slowly resolved and she had no further lesions or fever. Author comment: "Our case . . . is best classified as a methylphenidate hydrochloride-induced pseudolymphoma, though the patient did have spiking fevers." Welsh JP, et al. Lymphomatoid drug reaction secondary to methylphenidate 801104715 hydrochloride. Cutis 81: 61-64, No. 1, Jan 2008 - USA
0114-9954/10/1194-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 22 Mar 2008 No. 1194
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