A Case of Erythema Multiforme-Type Drug Eruption due to Pregabalin

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  • IWANAGA Tomomi
    Division of Dermatology, Department of Internal Medicine, Faculty of Medicine, Saga University
  • INOUE Takuya
    Division of Dermatology, Department of Internal Medicine, Faculty of Medicine, Saga University
  • NARISAWA Yutaka
    Division of Dermatology, Department of Internal Medicine, Faculty of Medicine, Saga University

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Other Title
  • プレガバリンによる多形紅斑型薬疹の 1 例
  • 症例 プレガバリンによる多形紅斑型薬疹の1例
  • ショウレイ プレガバリン ニ ヨル タケイコウ ハンガタヤクシン ノ 1レイ

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Abstract

<p>A 70-year-old woman presented with multiple erythemas on her entire body that she had noticed four days previously. She had been prescribed pregabalin and three other drugs for leg paralysis following a surgery for a spinal cord tumor three years previously. On examination, multiple typical target lesions distributed over the trunk and extremities were observed. Microscopic examination revealed vacuolar change in the dermo-epidermal junction and several individual necrotic keratinocytes. A drug-induced lymphocyte stimulation test was performed for each of the four drugs, and the stimulation index value was only positive for pregabalin. The erythema subsided immediately after pregabalin intake was stopped, and oral prednisolone therapy was initiated. Therefore, we diagnosed the patient with erythema multiforme-type drug eruption due to pregabalin. Drug eruption caused by pregabalin is very rare, and to our knowledge, only five cases (not including our case) have been reported thus far. We discuss six cases of pregabalin-induced drug-eruptions, including five previously reported cases and the present case. Of these six cases, severe drug eruption was reported in three cases. Two of these three cases of severe drug eruption involved erythemamultiforme-type drug eruption (one of these cases was the present case), and one case involved drug-induced hypersensitivity syndrome. Furthermore, it should be noted that the two cases of erythema multiforme-type eruption developed between 11 months and 3 years of the first intake of pregabalin. Prescription of pregabalin for postherpetic neuralgia has been increased. Thus, clinicians should pay attention to drug eruption throughout the window of management with pregabalin and not just at the initiation of drug therapy.</p>

Journal

  • Nishi Nihon Hifuka

    Nishi Nihon Hifuka 81 (6), 465-468, 2019-12-01

    Western Division of Japanese Dermatological Association

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