HYDROXYCHLOROQUINE-PUVA PHOTOINDUCED ACUT E GENERALIZED EXANTHEMATOUSPUSTULOSIS

Introduction. Acute generalized exanthematous pustulosis usually occur s as a typical skin reaction to drugs. We observed a case with a photo distribution induced by hydroxychloroquine and/or PUVA. Case report. A male subject had been treated for actinic pseudolymphoma since 1988. General corticosteroids had been given initially and were followed by PUVA and azathioprine. A new episode with erythema involving the trunk and the proximal portion of the limbs was treated with corticosteroid s and hydroxychloroquine. The symptomatology regressed but pustular er ythema developed in exposed areas two days after a PUVA session on the upper part of the body. The eruption did not involve the zones of the phototests one month earlier. The lesions resolved rapidly after with drawal of hydroxychloroquine and PUVA. Discussion. Photo-induced acute generalized exanthematous pustulosis with a photodistribution has not been reported previously. The imputability of hydroxychloroquine and PUVA, and their association is suggested. The appearance of pustular l esion on exposed areas and the protection resulting from the phototest s would lead to several hypotheses. General corticosteroids were ineff ective in preventing and in treating acute generalized exanthematous p ustulosis.