ABSTRACT
INTRODUCTION: Drug hypersensitivity syndrome is a severe life-threatening drug reaction. An association between this syndrome and HHV6 reactivation has been hypothesized. CASE-REPORT: A 45 year-old women was treated with sulfasalazine for polyarthralgia. One month after beginning the treatment, she developed a drug hypersensitivity syndrome with severe acute hepatic failure. HHV6 serology and serum PCR revealed a primary HHV6 infection. DISCUSSION: We report the second case of drug hypersensitivity syndrome associated with a primary HHV6 infection. An immunological disorder may explain such an association by increasing viral replication. Detection and titration of anti-HHV6 antibodies in each case of drug hypersensitivity syndrome should help to confirm this association and possibly modify treatment strategy.
Subject(s)
Antirheumatic Agents/adverse effects , Chemical and Drug Induced Liver Injury/etiology , Drug Eruptions/complications , Drug Eruptions/etiology , Drug Hypersensitivity/complications , Herpesvirus 6, Human , Roseolovirus Infections/complications , Sulfasalazine/adverse effects , Adrenal Cortex Hormones/administration & dosage , Adrenal Cortex Hormones/therapeutic use , Chemical and Drug Induced Liver Injury/complications , Chemical and Drug Induced Liver Injury/drug therapy , Drug Hypersensitivity/etiology , Female , Humans , Middle Aged , Syndrome , Time Factors , Treatment OutcomeABSTRACT
We report a localized form of lymphomatoid papulosis (LyP) presenting as pustular papules of the hands. The histopathology revealed a moderate inflammatory infiltrate composed of atypical pleomorphic large lymphocytes with atypical mitosis and large nuclei. Epidermotropism could be observed. These atypical cells expressed CD4 and CD30. Laboratory examinations and bone marrow explorations remained negative. The clinical presentation of this case of LyP is unusual. Only histopathological features allowed to diagnose LyP. The knowledge that LyP may be associated with neoplasia or lymphoma underlines the need for a long-term follow-up of these patients.