Fluconazole
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Acute generalised exanthematous pustulosis: case report A 7-year-old boy developed acute generalised exanthematous pustulosis (AGEP) during treatment with fluconazole for tinea capitis. The boy, who had been suffering from tinea capitis, started receiving oral fluconazole [dosage not stated]. One day after initiation of fluconazole, he presented with a diffuse, rapidly progressing rash (trunk, limbs and face) and fever. The fever was treated with paracetamol [acetaminophen]. The boy’s personal or familial medical history was insignificant for any skin diseases. Physical examination revealed multiple generalised non-follicular-based pinhead pustules on a background of wide spread erythema. Pustular lakes were evident in some areas. The scalp was evident with multiple boggy purulent plaques with abscess and associated alopecia. The Wood’s lamp examination was negative. A Punch biopsy revealed spongiform subcorneal and intraepidermal pustules with mixed superficial and perivascular inflammatory cells containing neutrophils, lymphocytes and eosinophils. Necrotic keratinocytes were observed within the epidermis. Laboratory studies were significant for leucocytosis with neutrophilia. A swab culture performed from the scalp showed the growth of Microsporum gypseum. Eventually, he was diagnosed with AGEP, which was suspected to be due to fluconazole. Therefore, he was treated with clobetasol, griseofulvin and unspecified anti-fungal shampoo. Four weeks after clobetasol initiation, the rash resolved. At the 4 weeks follow up, full hair growth was noted. Saliba E, et al. Fluconazole-induced acute generalized exanthematous pustulosis. American Journal of Emergency Medicine : 28 Jun 2020. Available from: URL: http:// 803499242 doi.org/10.1016/j.ajem.2020.06.061
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Reactions 5 Sep 2020 No. 1820
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