Acute generalized exanthematous pustulosis-like, folliculitic drug reaction pattern caused by celecoxib

Abstract

An extensive range of diseases or reactions can cause pustular eruptions of the skin. Drug-provoked cutaneous eruptions includes acute generalized exanthematous pustulosis (AGEP) and acneiform eruption. We report a 50-year-old man who developed fever and a sudden eruption of widespread pustules 12 days after ingestion of celecoxib prescribed for a prolapsed intervertebral disc. AGEP was diagnosed based on the typical history, characteristic features, and laboratory findings. However, histopathological findings were consistent with folliculitic drug reaction pattern without features of AGEP. We present, the first known reported case of folliculitic drug reaction pattern caused by celecoxib.

First report of mesalamine (5-aminosalicylic acid) as the causative agent in a case of acute generalized exanthamous pustulosis

“…Histology was consistent with AGEP and the lesions resolved soon after aspirin discontinuation [10]. Rastogi et al and Pakdeethai both presented cases of AGEP secondary to ibuprofen and celecoxib use, respectively [11,12]. These drugs are common antiinflammatory drugs that block cyclooxygenase and inhibit prostaglandin synthesis.…”

“…Although the pathophysiology of AGEP is not entirely clear, many researchers have agreed that it is an immune regulated disease process, most likely a T-cell dominated type IV hypersensitivity reaction [4,9,10,12]. Whether the cause relates to the decrease in prostaglandin synthesis or the deregulation of leukocyte function, mesalamine was the likely causative agent in this patient.…”

Hypersensitive Reaction of Oxidized Regenerated Cellulose Powder in Total Knee Arthroplasty

“…First, the possibility of a drug eruption of celecoxib was considered. However, many reports of celecoxib eruptions were not localized but rather generalized [ 9 , 10 ]. Second, the possibility of drug eruptions due to cefazolin and cefaclor was considered.…”

Lornoxicam‐induced acute generalized exanthematous pustulosis

“…[2][3][4][5] Newer in vivo photographic techniques have evolved and have their own advantages and disadvantages. [6][7][8] Macro-microscopy was used to study selected images in five patients with classical hypopigmented pityriasis versicolor and five patients with hypopigmented leprosy using Adobe Photoshop CS5, Version 12 (Adobe Systems, Inc., San Jose, CA, USA). Affected areas were compared with adjacent normal skin for relative luminosity, numbers, and widths of primary and secondary furrows, surface, size and arrangement of polygons, pilosebaceous openings and, where visible, eccrine openings.…”

“…The use of NSAIDs has been previously shown to cause generalized pustular eruptions, especially with celecoxib. [7][8][9] Meloxicam and piroxicam are the only two compounds in the oxicam family that have been documented to induce AGEP. Herein, we report the first case of AGEP induced by lornoxicam, an NSAID with a short half-life.…”