A predominantly left-sided skin reaction to pristinamycin in a patient with right hemiplegia

A 49-year-old man developed maculopapular exanthema (MPE) during treatment with pristinamycin for erysipelas of the right leg.The man, who had a 18 month history of right hemiplegia as a result of ischaemic stroke, was started on pristinamycin 1g 3 times a day [route not stated]. After 7 days of pristinamycin treatment, he developed left-sided MPE on the trunk and the upper and lower limbs. His skin eruption was less sprayed on right lower and upper limbs. The Naranjo score was 4, suggestive of a possible adverse reaction by pristinamycin. His laboratory tests revealed hypereosinophilia (0.6g/l) with no other abnormalities. The skin biopsy showed eczema-like patterns with few necrotic keratinocytes and perivascular, eosinophilic, and dermal infiltration. These findings were consistent with a diagnosis of left-sided MPE-type adverse skin reaction, caused by pristinamycin.Pristinamycin was discontinued and the man's eruptions resolved within 10 days; without any recurrence or requirement of other treatment.Author comment: "We diagnosed a predominantly leftsided, MPE-type adverse reaction of the skin due to pristinamycin." Delcroix F, et al. A predominantly left-sided skin reaction to pristinamycin in a patient with right hemiplegia.

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Engelures unilatérales associées à une monoparésie : 2 observations

Couture¹,

Moguelet

Chasset

et al. 2019

Annales de Dermatologie et de Vénéréologie

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A predominantly left-sided skin reaction to pristinamycin in a patient with right hemiplegia

Cited by 3 publications

References 9 publications

Efficacy and safety of first- and second-line antibiotics for cellulitis and erysipelas: a network meta-analysis of randomized controlled trials

Efficacy and safety of first- and second-line antibiotics for cellulitis and erysipelas: a network meta-analysis of randomized controlled trials

Pristinamycin

Engelures unilatérales associées à une monoparésie : 2 observations

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