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[Acute generalized exanthematous pustulosis induced by drugs with low-digestive absorption: acarbose and nystatin].
Ann Dermatol Venereol. 2003 Apr; 130(4):439-42.AD

Abstract

INTRODUCTION

Acarbose and nystatin are usually well-tolerated drugs because of their minimal intestinal absorption. We report herein two cases of acute generalized exanthematous pustulosis induced by these two molecules.

CASES REPORT

A 43 year-old man with a history of insulin-deficient diabetes was admitted to our department for a febrile generalized cutaneous pustular erythema, that had appeared 48 hours after acarbose (Glucor) introduction. Acarbose was discontinued and the eruption resolved in one week. A 29 year-old man developed a flexural erythema twenty four hours after nystatin (Mycostatin) treatment, progressing towards a febrile pustular erythroderma, with elevated neutrophilic and eosinophilic counts. The lesions regressed rapidly with topical steroid treatment. The patch tests performed a few months later with Mycostatin and nystatin were positive.

DISCUSSION

The clinical presentation of these two patients was typical of acute generalized exanthematous pustulosis, according to the EuroSCAR group criteria and acarbose and nystatin were the most likely factors that caused the disease according to the French unexpected or toxic drug reaction assessment. The minimal intestinal absorption of these two molecules explains their usual good tolerance. However, some cases of toxiderma have already been reported. There is the first described case of acute generalized exanthematous pustulosis with acarbose. Our two observations underline the possibility of severe toxiderma induced by low-absorbed and low-blood concentration molecules and focus on the need to take them in account in the toxiderma anamnesis.

Authors+Show Affiliations

Poszepczynska-Guigné E
Service de Dermatologie I, Hôpital Saint-Louis, Paris.
Viguier M
No affiliation info available
Assier H
No affiliation info available
Pinquier L
No affiliation info available
Hochedez P
No affiliation info available
Dubertret L
No affiliation info available

MeSH

AcarboseAdultAntifungal AgentsCandidiasis, CutaneousDiabetes Mellitus, Type 2Diagnosis, DifferentialDrug EruptionsGenital Diseases, MaleHumansHypoglycemic AgentsIntestinal AbsorptionMaleNystatinPatch TestsSkin Diseases, Vesiculobullous

Pub Type(s)

Case Reports
English Abstract
Journal Article

Language

fre

PubMed ID

12843856

Citation

Poszepczynska-Guigné, E, et al. "[Acute Generalized Exanthematous Pustulosis Induced By Drugs With Low-digestive Absorption: Acarbose and Nystatin]." Annales De Dermatologie Et De Venereologie, vol. 130, no. 4, 2003, pp. 439-42.
Poszepczynska-Guigné E, Viguier M, Assier H, et al. [Acute generalized exanthematous pustulosis induced by drugs with low-digestive absorption: acarbose and nystatin]. Ann Dermatol Venereol. 2003;130(4):439-42.
Poszepczynska-Guigné, E., Viguier, M., Assier, H., Pinquier, L., Hochedez, P., & Dubertret, L. (2003). [Acute generalized exanthematous pustulosis induced by drugs with low-digestive absorption: acarbose and nystatin]. Annales De Dermatologie Et De Venereologie, 130(4), 439-42.
Poszepczynska-Guigné E, et al. [Acute Generalized Exanthematous Pustulosis Induced By Drugs With Low-digestive Absorption: Acarbose and Nystatin]. Ann Dermatol Venereol. 2003;130(4):439-42. PubMed PMID: 12843856.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Acute generalized exanthematous pustulosis induced by drugs with low-digestive absorption: acarbose and nystatin]. AU - Poszepczynska-Guigné,E, AU - Viguier,M, AU - Assier,H, AU - Pinquier,L, AU - Hochedez,P, AU - Dubertret,L, PY - 2003/7/5/pubmed PY - 2003/9/27/medline PY - 2003/7/5/entrez SP - 439 EP - 42 JF - Annales de dermatologie et de venereologie JO - Ann Dermatol Venereol VL - 130 IS - 4 N2 - INTRODUCTION: Acarbose and nystatin are usually well-tolerated drugs because of their minimal intestinal absorption. We report herein two cases of acute generalized exanthematous pustulosis induced by these two molecules. CASES REPORT: A 43 year-old man with a history of insulin-deficient diabetes was admitted to our department for a febrile generalized cutaneous pustular erythema, that had appeared 48 hours after acarbose (Glucor) introduction. Acarbose was discontinued and the eruption resolved in one week. A 29 year-old man developed a flexural erythema twenty four hours after nystatin (Mycostatin) treatment, progressing towards a febrile pustular erythroderma, with elevated neutrophilic and eosinophilic counts. The lesions regressed rapidly with topical steroid treatment. The patch tests performed a few months later with Mycostatin and nystatin were positive. DISCUSSION: The clinical presentation of these two patients was typical of acute generalized exanthematous pustulosis, according to the EuroSCAR group criteria and acarbose and nystatin were the most likely factors that caused the disease according to the French unexpected or toxic drug reaction assessment. The minimal intestinal absorption of these two molecules explains their usual good tolerance. However, some cases of toxiderma have already been reported. There is the first described case of acute generalized exanthematous pustulosis with acarbose. Our two observations underline the possibility of severe toxiderma induced by low-absorbed and low-blood concentration molecules and focus on the need to take them in account in the toxiderma anamnesis. SN - 0151-9638 UR - https://www.unboundmedicine.com/medline/citation/12843856/[Acute_generalized_exanthematous_pustulosis_induced_by_drugs_with_low_digestive_absorption:_acarbose_and_nystatin]_ DB - PRIME DP - Unbound Medicine ER -