We report a 54-year-old male patient who developed an unusual form of generalized drug eruption. He had pain and breathlessness on the left chest wall. He had history of taking several drugs at private clinics under a diagnosis of herpes zoster. Two weeks later he had a generalized skin eruption. Examination showed multiple variable sized, mild pruritic, erythematous macules and papules on the face and upper extremities. Skin lesions take the form of a clinically consistent with disseminated superficial actinic porokeratosis (DSAP). Methylprednisolone 16 mg, astemisole 10 mg, oxatomide 60 mg was prescribed. Topical corticosteroid cream was applied. Within two months, his eruption had cleared almost completely. The pathogenetic mechanisms of this case are unclear, but drug and UV light have been considered.
Case Report ; Drug Eruptions/physiopathology ; Drug Eruptions/etiology* ; Drug Eruptions/drug therapy ; Facial Dermatoses/pathology ; Facial Dermatoses/drug therapy ; Facial Dermatoses/chemically induced* ; Hand Dermatoses/pathology ; Hand Dermatoses/drug therapy ; Hand Dermatoses/chemically induced* ; Herpes Zoster/complications* ; Human ; Male ; Middle Age ; Porokeratosis/pathology ; Porokeratosis/drug therapy ; Porokeratosis/chemically induced*

The investigation was aimed to determine prognostic factors related to postherpetic neuralgia (PHN), and treatment options for preventing PHN. The data showed 34 (17.0%) out of 188 patients with herpes zoster had severe pain after 4 weeks, and 22 (11.7%) after 8 weeks, compared with 109 (58.0%) at presentation. The age (>or=50 yr), surface area involved (>or=9%), and duration of severe pain (>or=4 weeks) might be the main factors that lead to PHN. On the other hand, gender, dermatomal distribution, accompanied systemic conditions, and interval between initial pain and initiation of treatment might not be implicated in PHN. The subjects were orally received antiviral (valacyclovir), tricyclic antidepressant (amitriptyline), and analgesic (ibuprofen) as the standard treatment in the group 1. In addition to the standard medication, lidocaine solution was sub- and/or perilesionally injected in the group 2, while lidocaine plus prilocaine cream was topically applied to the skin lesions in the group 3. The rates of PHN in the 3 treatment groups were not significantly different, suggesting adjuvant anesthetics may not be helpful to reduce the severity of pain.
Acyclovir/administration & dosage/*analogs & derivatives ; Adolescent ; Adult ; Aged ; Amitriptyline/administration & dosage ; Anti-Inflammatory Agents, Non-Steroidal/administration & dosage ; Antidepressive Agents, Tricyclic/administration & dosage ; Antiviral Agents/administration & dosage ; Child ; Drug Therapy, Combination ; Female ; Herpes Zoster/*complications/drug therapy/physiopathology ; Humans ; Ibuprofen/administration & dosage ; Male ; Middle Aged ; Neuralgia/drug therapy/*etiology/physiopathology/prevention & control ; Prognosis ; Time Factors ; Valine/administration & dosage/*analogs & derivatives