Skin manifestations of a case of phenylbutazone-induced serum sickness-like reactions

Serum sickness consists of a systemic reaction resulting from the formation of soluble circulating immunocomplexes after the introduction of a foreign substance into the body. We studied a 38-year-old woman diagnosed with anx iety, depression and right sacroileitis who was treated with phenylbutazone , ranitidine, clomipramine and levomepromazine. After taking this treatment for 1 month. she presented with fever, diarrhea, localized edemas, general ized pruritic papular and erythematous rash and lymphadenopathies. She pres ented the same symptoms after oral intake of metamizole. The diagnosis was confirmed following a single-blind, placebo-controlled provocation test wit h phenylbutazone and a biopsy of the affected skin.