Acute generalized exanthematous pustulosis is a rare severe pustular cutaneous adverse reaction characterized by a rapid clinical course with typical histological findings. It is accompanied by fever and acute eruption of non-follicular pustules overlying erythrodermic skin. The causative agents are most frequently antibacterial drugs. We present a patient with acute generalized exanthematous pustulosis caused by methylene blue and indigotin dyes.
Acute Generalized Exanthematous Pustulosis/*chemically induced/drug therapy/pathology ; Administration, Oral ; Adrenal Cortex Hormones/therapeutic use ; Aged ; Biopsy ; Coloring Agents/administration & dosage/*adverse effects ; Humans ; Indoles/administration & dosage/*adverse effects ; Intradermal Tests ; Male ; Methylene Blue/administration & dosage/*adverse effects ; Skin/*drug effects/pathology ; Treatment Outcome

Although there are several studies showing the association between cancer and urticaria, the mechanisms by which these events occur are not yet known. In this report, a case of acute urticaria with a diagnosis of thyroid papillary carcinoma is presented. Disappearance of treatment-resistant urticarial lesions after thyroidectomy suggests that this association was not a coincidence. The fact that urticaria which was nonresponsive to treatment disappeared spontaneously as a result of tumorectomy, strongly suggests that this association is not a coincidence. To our knowledge, this is the first report of the coexistence of acute urticaria and thyroid papillary carcinoma. This case provides further support that detailed history taking and a thorough physical examination are of paramount importance.
Carcinoma, Papillary ; Physical Examination ; Thyroid Gland ; Thyroidectomy ; Urticaria

Immune complexes are found in the circulation of 30%-75% of patients with urticarial vasculitis and much evidence supports the role of these immune complexes in the pathogenesis of urticarial vasculitis. Plasmapheresis is effective for removing these immune complexes; however, there are few reports on the use of plasmapheresis in the treatment of urticarial vasculitis. We describe a case of "refractory" urticarial vasculitis in which the symptoms improved after plasmapheresis treatment. We suggest that plasmapheresis be considered as an option in patients with severe or treatment-resistant urticarial vasculitis.
Antigen-Antibody Complex ; Humans ; Plasmapheresis ; Vasculitis