Reactions 1433 - 5 Jan 2013

SCarbamazepine

DRESS with reactivation of human herpesvirus 7:case report

A 62-year-old man developed drug eruption witheosinophilia and systemic syndrome (DRESS) with humanherpesvirus-7 (HHV-7) reactivation while receivingcarbamazepine.

The man was receiving oral carbamazepine [dosage notstated] for pain after surgery for prostate cancer on30 June 2004. On 11 July, he developed fever and systemicdiffuse erythema and was diagnosed with hepatic dysfunction.He was urgently admitted 3 days later with systemic diffuseerythema, eosinophilia, liver dysfunction and facial oedema.Skin biopsy showed small amounts of eosinophils and nucleardust with perivascular lymphocytic infiltration with the upperdermis; DRESS was suspected.

Carbamazepine was discontinued and the man startedreceiving prednisolone; his fever and skin eruption graduallyimproved. Four days after his initial presentation, HHV-7 DNAwas found in peripheral blood. Five days after initialpresentation, high titres of IgG antibodies to HHV-7 wererecorded. HHV-7 DNA became negative 15 days after initialpresentation, following remission of the eruption.

The man subsequently underwent patch testing, which waspositive for carbamazepine after 48 and 72 hours. A drug-induced lymphocyte stimulation test was positive forcarbamazepine.

Author comment: "Our case took carbamazepine p.o. for11 days before the onset of the disease. . . diagnostic criteriafor DRESS are fulfilled and our patient showed solely HHV-7reactivation as far as we examined."Morito H, et al. Drug eruption with eosinophilia and systemic syndrome associatedwith reactivation of human herpesvirus 7, not human herpesvirus 6. Journal ofDermatology 39: 669-70, No. 7, Jul 2012. Available from: URL: http://dx.doi.org/10.1111/j.1346-8138.2011.01365.x - Japan 803081495

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Reactions 5 Jan 2013 No. 14330114-9954/10/1433-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved