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Acute generalized exanthematous pustulosis induced by hydroxychloroquine prescribed for COVID-19

2020; Elsevier BV; Volume: 8; Issue: 8 Linguagem: Inglês

10.1016/j.jaip.2020.05.046

2213-2201

J. Delaleu, Benjamin Deniau, Maxime Battistella, Adèle de Masson, Benoît Bensaïd, M. Jachiet, Ingrid Lazaridou, M. Bagot, Jean‐David Bouaziz, Gordon L. Archer, A. Benattia, Anne Bergeron, Louise Bondeelle, Jean‐David Bouaziz, D. Bouda, David Boutboul, Berthon I. Brindel, Emmanuelle Bugnet, S. Caillat Zucman, S. Cassonnet, Karine Celli Lebras, Jacqueline Chabert, Sylvie Chevret, Meredith E. Clement, Claire Davoine, Nathalie De Castro, É. de Kerviler, Constance de Margerie‐Mellon, Constance Delaugerre, François Dépret, B. Denis, Lalia Djaghout, Clarisse Dupin, Dominique Farge, Catherine Fauvaux, E. Feredj, Delphine Feyeux, J.P. Fontaine, Véronique Frémeaux‐Bacchi, Lionel Galicier, Stéphanie Harel, Jegu AL, E. Kozakiewicz, Marc Lebel, Ariane Baye, J. Le Goff, Pierre Le Guen, Nicolas Etienne, Geoffroy Liégeon, Gwenaël Lorillon, I. Madelaine Chambrin, Grégoire Martin de Frémont, Marie Meunier, Jean‐Michel Molina, Florence Morin, Éric Oksenhendler, Régis Peffault de la Tour, Olivier Peyrony, Benoît Plaud, Maud Salmona, Julien Saussereau, Juliette Soret,

COVID-19 Clinical Research Studies

Hydroxychloroquine is now commonly used off-label for the treatment of COVID-19 in combination with drugs, at doses and in populations where it is not typically used.We present a case that highlights that even in short course therapy acute generalized exanthematous pustulosis should be recognized as a potential adverse effect of hydroxychloroquine.Acute generalized exanthematous pustulosis (AGEP) is a rare drug reaction characterized by acute, extensive formation of numerous nonfollicular sterile pustules on a background of edematous erythema. 1Hydroxychloroquine (HCQ) is widely used to treat rheumatic and dermatologic diseases, and is well known to cause AGEP. 1 At the end of 2019, a novel coronavirus was identified as the cause of a cluster of pneumonia cases in Wuhan, city of China.It rapidly spread in China and outside, and on March 12, 2020, the World Health Organization declared a pandemic.HCQ has been reported to inhibit SARS-CoV-2 in vitro, but clinical data evaluating HCQ are limited, and its efficacy against SARS-CoV-2 is unknown.Nevertheless, given the lack of clearly effective interventions, HCQ is being used off-label in combination with drugs, at doses and in populations where it would not be traditionally used.Therefore, vigilance needs to be applied especially if this drug is not being used in clinical trial settings where adverse-event information and monitoring are more meticulous.Herein we report a case of AGEP induced by HCQ prescribed for COVID-19.We also reviewed literature about HCQ-induced AGEP and efficacy of HCQ in COVID-19.On March 23, a 76-year-old patient with a medical history of diabetes mellitus consulted the emergency department for cough and diarrhea since March 17.Chest computerized tomography scan revealed bilateral patchy ground glass opacities consistent with COVID-19 disease.He did not present with any severity criteria and returned home.The day after, clinical symptoms worsened with asthenia, fever, and dyspnea.Thus, on March 24,