Erythroderma Suspected to be Caused by Allopurinol Drug Reaction: Case Report

Case Report

Authors

  • Pradissa Avia Emeralda Department of Dermatovenereology, dr. Moch. Ansari Saleh General Hospital Banjarmasin, South Borneo, Indonesia
  • Dwiana Savitri Departement of Dermatovenereology, dr.Moch.Ansari Saleh General Hospital Banjarmasin, South Borneo Indonesia

DOI:

https://doi.org/10.55175/cdk.v52i9.1513

Keywords:

Allopurinol, erythroderma, DRESS, case report, drug reaction

Abstract

Introduction: Erythroderma is a condition of generalized erythema and scaling of the skin. It has been associated with DRESS (drug reaction with eosinophilia and systemic symptoms) syndrome and is potentially life-threatening. Case: A 55-year-old female with generalized erythema, pruritus, malaise, and edema of her face for 7 days. She had a history of type 2 diabetes mellitus and was in oral allopurinol treatment for the last 2 weeks. Extensive generalized erythematous plaques and hyperkeratotic scales were observed on the face, neck, chest, arms, legs, back, and glutea. Laboratory workup revealed eosinophilia, mild hypoalbuminemia, hyperglycemia, and elevated liver enzyme level. Discussion: Erythroderma is an emergency case in dermatovenereology and needs hospitalization. A patient with drug-induced erythroderma with internal organ involvement has been associated with DRESS syndrome and needs further observation of cardiac, liver, and kidney status. Conclusion: Allopurinol is a potential trigger for erythroderma. Drug-induced erythroderma is closely related to DRESS syndrome. Allopurinol use requires caution to avoid complications and prevent recurrence.

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Author Biography

Dwiana Savitri, Departement of Dermatovenereology, dr.Moch.Ansari Saleh General Hospital Banjarmasin, South Borneo Indonesia

Dermatovenerelogist, Departement of Dermatovenereology, dr.Moch.Ansari Saleh General Hospital Banjarmasin, South Borneo Indonesia

References

Cuellar-Barboza A, Ocampo-Candiani J, Herz-Ruelas M. A practical approach to the diagnosis and treatment of adult erythroderma. Actas Dermosifiliogr. 2018;109:777-90. doi: 10.1016/j.ad.2018.05.011.

Miyashiro D, Sanches JA. Erythroderma: a prospective study of 309 patients followed for 12 years in a tertiary center. Sci Rep. 2020;10:9774. doi: 10.1038/s41598-020-66040-7.

Hoxha S, Fida M, Malaj R, Vasili E. Erythroderma: a manifestation of cutaneous and systemic diseases. EMJ Allergy Immunol [Internet]. 2020 [cited 2024 Aug 14]. Available from: https://www.emjreviews.com/allergy-immunology/article/erythroderma-a-manifestation-of-cutaneous-and-systemic-diseases/?site_version=EMJ.

Avandi B, Ghahartans M, Kashkooli NM, Ahramiyanpour N, Parvizi MM. Epidemiological and clinical features of hospitalized erythroderma patients: a cross-sectional study. Iran J Dermatol. 2022;25(1):60-5. doi: 10.22034/ijd.2021.283487.1361.

Botella-Estradas R, Sanmartin O, Oeiver V, Febrer I, Aliaga A. Erythroderma – a clinical pathological study of 56 cases. Arch Dermatol. 1994;130:1503–7. doi: 10.1001/archderm.130.12.1503.

Mistry N, Gupta A, Alavi A, Sibbald RG. A review of the diagnosis and management of erythroderma (generalized red skin). Advances in Skin and Wound Care 2015;28(5):228-36. doi: 10.1097/01.ASW.0000463573.40637.73.

Ozuguz P, Kacar D, Ozuguz U, Karaca S, Tokyol C. Erythroderma secondary to glicazide: a case report. Cutan Ocul Toxicol. 2014 Dec;33(4):342-4. doi: 10.3109/15569527.2013.870188.

World Health Organization. The use of the WHO-UMC System for standardised case causality assessment [Internet]. Geneva: WHO; 2018 [cited 2024 Aug 12]. Available from: http://www.who-umc.org/Graphics/24734.pdf.

Naranjo CA, Busto U, Sellers EM, Sandor P, Ruiz I, Roberts EA, et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther. 1981;30:239–45. doi: 10.1038/clpt.1981.154.

Jobarteh R, Peng YE, Soni A, Gelber AC, O’Rourke PD. Generalized erythroderma with fever. Am J Med. 2020;133(7):805-9. doi: 10.1016/j.amjmed.2019.10.044.

Di Prinzio A, Torre AC, Cura MJ, Puga C, Bastard DP, Mazzuoccolo LD. Adverse drug reactions are the main causes of erythroderma in an Argentinian teaching hospital: a retrospective study of 70 patients. ACTAS Dermo-Sifiliograficas 2022;8:765-72. doi: 10.1016/j.ad.2022.03.017.

Harper-Kirksey K. Erythroderma. In: Rose E, editor. Life-threatening rashes. New York, USA: Springer; 2018 .p. 265–77.

Sharma G, Govil DC. Allopurinol induced erythroderma. Indian J Pharmacol. 2013;45:627-8. doi: 10.4103/0253-7613.121381.

Yaseen W, Auguste B, Zipursky J. Allopurinol hypersensitivity syndrome. CMAJ. 2013; 195(13):483. doi: 10.1503/cmaj.221575.

Stamp LK. Day RO. Yun J. Allopurinol hypersensitivity: investigating the cause and minimizing the risk. Nat Rev Rheumatol. 2016;12:235-42. doi: 10.1038/nrrheum.2015.132.

Shiohara T, Kano Y. Drug reaction with eosinophilia and systemic symptoms (DRESS): incidence, pathogenesis, and management. Expert Opinion on Drug Safety 2017;16(2):139-47. doi: 10.1080/14740338.2017.1270940.

Vanini A, Hutomo M. Manifestasi klinis sindroma DRESS (drug reaction with eosinophilia and systemic symptom). Berkala Ilmu Kes Kulit Kelamin 2010;22(1):40-4.

Anggraini DR, Pasaribu SD. Laporan kasus: pria 60 tahun dengan eritroderma et causa dermatitis seboroik. Maj Kedokt UKI. 2021;37(1):20-5. doi: 10.33541/mk.v37i1.3366.

Maharani S, Setyaningrum T. Profil pasien eritroderma. Berkala Ilmu Kes Kulit Kelamin. 2017;29(1):44-51

Miranti U, Misturiansyah NI, Nuridah AL, Amien MI, Yoga RR. Diagnosis dan tata laksana eritroderma. Cermin Dunia Kedokt. 2024;51(6):311-5. doi: 10.55175/cdk.v51i6.1086.

Khaled A, Sellami A, Fazaa B, Kharfi M, Zeglaoui F, Kamoun MR. Acquired erythroderma in adults: a clinical and prognostic study. J Eur Acad Dermatol Venereol. 2010;24(7):781-8. doi: 10.1111/j.1468-3083.2009.03526.x.

Published

08-09-2025

How to Cite

Emeralda, P. A., & Savitri, D. (2025). Erythroderma Suspected to be Caused by Allopurinol Drug Reaction: Case Report: Case Report. Cermin Dunia Kedokteran, 52(9), 609–614. https://doi.org/10.55175/cdk.v52i9.1513

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