Reactions 1479, p27 - 23 Nov 2013

Paroxetine

Acute generalised exanthematous pustulosis: casereport

A 16-year-old girl developed acute generalisedexanthematous pustulosis (AGEP) while receiving paroxetine.

The girl, who had anorexia nervosa, began receiving oralparoxetine 20mg daily [therapeutic indication not stated].Twelve days later, she developed erythematous pustules andpapules on her neck and face; they spread to her trunk andextremities over 3 days. On physical examination, she hadconfluent symmetrical erythematous patches on her arms,legs, abdomen and back, with numerous non-follicularpustules. Laboratory investigations found neutrophilicleukocytosis, and biopsy and histology revealed spongiformpustulation, subcorneal pustules, dermal infiltrate and mildoedema. She had an AGEP validation score of 10; the cut-offscore for definitive diagnosis is 8.

Paroxetine was withdrawn, and the girl received prednisone.Her skin eruption gradually improved and resolved in 2 weeks.

Author comment: "Considering the clinical andhistopathological features, and given the temporal associationwith paroxetine administration, in the absence of othertriggering factors, a diagnosis of AGEP attributable toparoxetine was made."Mameli C, et al. Acute generalized exanthematous pustulosis induced byparoxetine in an adolescent girl. Acta Dermato-Venereologica 93: 733-734, No. 6,23 Oct 2013. Available from: URL: http://dx.doi.org/10.2340/00015555-1559 -Italy 803095844

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Reactions 23 Nov 2013 No. 14790114-9954/13/1479-0001/$14.95 Adis © 2013 Springer International Publishing AG. All rights reserved