Case Report: Etoricoxib Induced Acute Generalized Exanthematous Pustulosis
Abstract
Acute generalized exanthematous pustulosis (AGEP) is a rapid-onset pustular dermatosis characterized by widespread sterile pustules on erythematous skin, commonly triggered by medications. Etoricoxib, a selective COX-2 inhibitor widely used for inflammatory and pain conditions, is a rare but recognized cause of drug-induced AGEP. A female patient in her forties had prescribed oral etoricoxib 90 mg two times a day for the management of dental pain. After that patient started to develop multiple bilateral symmetrical pustules with erythematous base present over both bilateral upper limb and lower limb. Patient was treated with Inj. Hydrocortisone intravenous stat, Tab. Prednisolone 40 mg orally once a day, Tab. Azithromycin 500 mg once a day, Tab. Levocetirizine 5 mg orally twice a day and Tab. Pantoprazole 40 mg twice a day for 5 days. For pustules over skin patient was treated with fremycetin cream and betamethasone cream. Patient was recovered in seven days. The adverse drug reaction was assessed as certain by the WHO causality scale and probable by the Naranjo scale. Severity was categorized as moderate (Level 3) using the Modified Hartwig and Siegle scale, while preventability assessment indicated that the reaction was definitely preventable.
Keywords: Acute generalized Exanthematous Pustulosis, Etoricoxib
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