Abstract
A 46-year-old housewife developed erythema accompanied by pustules on the entire body after pregnancy of the first child at the age of 23 years. The erythema improved after delivery of the second child at the age of 36 years, and the condition was maintained by external use of steroids. On September 4, 1993, she was treated with Augmentin® due to fracture of the lower leg. On September 5, a fever (39°C) developed, and erythema appeared on the abdomen and rapidly generalized, accompanied by pustules. She was admitted to our hospital. The white cell count was 40, 000, and the CRP was 5, 230mg/l. Biopsy revealed kogoj spongiform pustules. Oral drugs were discontinued, and a steroid was administered. The eruption improved, and no eruption was induced after orthopedic surgery. DLST was negative. A patch test was strongly positive for Augmentin®. Intracutaneous reactions were strongly positive for Augpenin® and Viccillin® but negative for Ticarpenin®. Pustular psoriasis seemed to have been induced by antibiotics rather than the stress of fracture and was aggravated. However, the differentiation from pustular drug eruption was difficult.
