Reactions 1486, p24-25 - 1 Feb 2014

SParacetamol

Hypersensitivity vasculitis in a child: case reportA 10-year-old boy developed hypersensitivity vasculitis

while receiving paracetamol [acetaminophen].The boy presented with an itching erythematous-purpuric

rash arranged in a reticular form over his entire skin surface,which had persisted for 2 months. Four days before rashonset, he had started paracetamol [dosage and route notstated], after experiencing a flu-like episode with high fever; hehad usually received paracetamol for fevers without anyadverse effects. The rash had worsened, becoming vasculiticand resembling the pattern of livedo reticularis in 1 week. Hisparents noted that his paracetamol administrationscontributed to an increase in rash extension and severity. Hehad a history of atopic dermatitis, cyclically treated withantihistamines and emollient creams. A skin biopsy showeddermal perivascular lymphocyte infiltration and RBCextravasation. His final diagnosis was drug-inducedhypersensitivity leucocytoclastic vasculitis, related toparacetamol administration.

The boy received betamethasone and cetirizine, with slowimprovement of his skin lesions in about 3 weeks. Paracetamolwas subsequently forbidden as an antipyretic.

Author comment: "This report recalls attention to theoccurrence of severe cutaneous manifestations associatedwith paracetamol".Guerriero C, et al. Paracetamol-induced hypersensitivity vasculitis in a 10-year-oldchild. European Review for Medical and Pharmacological Sciences 17: 3405-3406,No. 24, 2013. Available from: URL: http://www.europeanreview.org/ -Italy 803098964

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Reactions 1 Feb 2014 No. 14860114-9954/14/1486-0001/$14.95 Adis © 2014 Springer International Publishing AG. All rights reserved