Two Cases of Ingestion of Rhus Chicken Causing Acute Generalized Exanthematous Pustulosis / 대한피부과학회지

Rhus chicken is a common health food in Korea and is used as an herbal medicine to cure gastrointestinal diseases such as indigestion, loose stool, and peptic ulcers. Unfortunately, systemic contact dermatitis due to the ingestion of Rhus chicken occasionally occurs and its incidence is increasing. The clinical findings of systemic contact dermatitis induced by ingesting Rhus chicken are maculopapules, erythroderma, erythema multiforme-like lesions, vesicles, wheals, purpura, and pustules. Acute generalized exanthematous pustulosis (AGEP) is an acute generalized pustular eruption characterized by rash with sterile pustules, high fever, and neutrophilia. Most cases are caused by drugs, predominantly beta-lactams and macrolide antimicrobials, viral infections, and contact hypersensitivity. Rarely, intake of Rhus chicken can cause AGEP. Herein, we describe two cases of AGEP induced by ingestion of Rhus chicken.

A Case of Stevens-Johnson Syndrome with Acute Renal Failure Induced by Rhus-Chicken Ingestion / 대한내과학회지

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe, diffuse mucocutaneous reactions that can be elicited by drugs, infection, malignancy, and herbal supplements. A wide variety of mucocutaneous events, such as systemic contact dermatitis, have been reported to be elicited by Rhus chicken, although cases of SJS and TEN are rare. Here, we present a case of SJS caused by Rhus-chicken ingestion. A 48-year-old man who wanted to improve his health and treat a gastrointestinal problem ingested Rhus chicken in the traditional manner. Twenty-four hours later, he developed a multiple erythematous maculopapular skin rash with vesicles and bullaes on 30% of the body surface and multiple erosions on the lips. He was diagnosed with SJS/TEN and showed characteristic clinical findings induced by Rhus chicken. After the patient stopped Rhus-chicken ingestion and received methylprednisolone and antibiotics, his symptoms, signs, and laboratory findings improved. With this case, we emphasize that SJS and TEN can occur after ingesting Rhus chicken, although the incidence is very low.