Severe exfoliative dermatitis caused by esomeprazole.

摘要

An 82-year-old man with no significant past medical history was admitted to the hospital for a 1-week history of generalized pruritic erythema and exfoliative scaling of the body 2 weeks after oral intake of esomep-razole 40 mg for duodenal ulcer. Examination showed an erythematous cutaneous rash with diffuse itching that began on the arms and spread, 2 days later, to the head and then to the trunk and legs. He also had redness and extreme sloughing of the skin on his hands. There was no pyrexia. He had no known drug allergies. He was a non-smoker and denied any drug abuse or alcohol intake; at the time of the reaction, he was not taking any concomitant therapy. Laboratory values were normal except for a total leucocyte count of 15.0 x 10~3/muL with an eosinophil count of 9% and a creatinine level of 3.1 mg/dL (normal range 0.8-1.2 mg/dL). Skin biopsy showed a chronic inflammatory infiltrate in the dermis, with a prominent eosinophil content; there was - focal spongiosis and hyperkeratosis.