Résumé
Durante la pandemia por COVID-19 se observaron diversas reacciones adversas a fármacos. Esto pudo haber estado relacionado con una mayor susceptibilidad inmunológica de los pacientes con SARS-CoV-2 a presentar este tipo de cuadros, así como también con la exposición a múltiples medicamentos utilizados en su tratamiento. Comunicamos el caso de un paciente con una infección respiratoria grave por COVID-19, que presentó 2 reacciones adversas graves a fármacos en un período corto de tiempo. (AU)
During the COVID-19 pandemic, various adverse drug reactions were observed. This could have been related to a greater immunological susceptibility of patients with SARS-CoV-2 to present this type of symptoms, as well as exposure to multiple drugs used in their treatment. We report the case of a patient with a severe respiratory infection due to COVID-19, who presented 2 serious adverse drug reactions associated with paracetamol in a short period of time. (AU)
Sujets)
Humains , Mâle , Adulte , Syndrome de Stevens-Johnson/diagnostic , Effets secondaires indésirables des médicaments/diagnostic , Exanthème/diagnostic , Pustulose exanthématique aigüe généralisée/diagnostic , COVID-19/complications , Traitements médicamenteux de la COVID-19/effets indésirables , Équipe soignante , Gammaglobulines/administration et posologie , Méthylprednisolone/administration et posologie , Incidence , Facteurs de risque , Syndrome de Stevens-Johnson/traitement médicamenteux , Résultat thérapeutique , Ciclosporine/effets indésirables , Effets secondaires indésirables des médicaments/traitement médicamenteux , Exanthème/traitement médicamenteux , Pustulose exanthématique aigüe généralisée/traitement médicamenteux , Acétaminophène/effets indésirablesRésumé
Abstract Acute generalized exanthematous pustulosis is a rare drug-induced eruption that is characterized by acute, nonfollicular sterile pustules on an erythematous and edematous base. The most frequently implicated drugs are beta-lactam antibiotics. Hydroxychloroquine has been widely used to treat dermatologic and rheumatologic diseases and has been reported as a rare cause of acute generalized exanthematous pustulosis. A 42-year-old female presented with pustular lesions on the skin surface with erythema, facial edema, and occasional atypical target-like lesions after 21 days of treatment with 200mg/day hydroxychloroquine for rheumatoid arthritis, diagnosed one month previously. We report a case with acute generalized exanthematous pustulosis induced by hydroxychloroquine and treated with dapsone and systemic corticosteroid.
Sujets)
Humains , Femelle , Adulte , Antirhumatismaux/effets indésirables , Pustulose exanthématique aigüe généralisée/étiologie , Hydroxychloroquine/effets indésirables , Polyarthrite rhumatoïde/traitement médicamenteux , Antirhumatismaux/usage thérapeutique , Pustulose exanthématique aigüe généralisée/diagnostic , Hydroxychloroquine/usage thérapeutiqueRésumé
La pustulosis exantemática generalizada aguda (PEGA) es una erupción cutánea severa de escasa frecuencia, caracterizada por la aparición de pústulas estériles no foliculares sobre una base eritemato-edematosa, asociada a fiebre y neutrofilia. La hidroxicloroquina (HCQ), una droga antimalárica ampliamente utilizada en enfermedades dermatológicas, ha sido asociada como una causa poco frecuente de PEGA. Presentamos un paciente de sexo femenino de 20 años de edad, que desarrolló PEGA secundaria a la ingesta de hidroxicloroquina.
Acute generalized exanthematous pustulosis (AGEP) is an uncommon severe skin rash characterized by the appearance of non-follicular sterile pustules on an erythematous background, associated with fever and neutrophilia. It ́s characterized by an acute onset and spontaneous resolution within 2 weeks. Hydroxychloroquine (HCQ), an antimalarial drug widely used in dermatological diseases, has been associated as a rare cause of PEGA. We present a 20 years old woman who developed AGEP secondary to HCQ.
Sujets)
Humains , Femelle , Jeune adulte , Hydroxychloroquine , Pustulose exanthématique aigüe généralisée/étiologie , Hormones corticosurrénaliennes , Exanthème , Pustulose exanthématique aigüe généralisée/diagnosticRésumé
Acute generalized exanthematous pustulosis (AGEP) is a rare skin eruption most commonly caused by medications. It is characterized by an acute eruption of sterile pustules and it is accompanied by an episode of fever, which regresses a few days after discontinuation of the drug that caused the condition. We report a case 23 year-old woman without history of psoriasis, that consults for fever and an acute generalized pustular eruption after amoxicillin, with clavulanic acid administration in a mononucleosis infection context, which resolved spontaneously. The microbiologic culture was negative for pathogenic germens.
La pustulosis exantemática aguda generalizada (PEAG) es una rara afección de hipersensibilidad, inducida principalmente por drogas y se manifiesta por una erupción aguda de pústulas estériles, acompañada de fiebre, que regresa en pocos días luego de discontinuar el fármaco causante. Se comunica el caso de una paciente de 23 años de edad, sin antecedentes de psoriasis que consulta por fiebre y una erupción pustulosa generalizada, asociada a la ingesta previa de amoxicilina y ácido clavulánico en el contexto de una mononucleosis infecciosa, con resolución espontánea del cuadro. El cultivo microbiológico no objetivó gérmenes patógenos.