Lateralized exanthem mimicking figurate inflammatory dermatosis of infancy after methimazole therapy

Int J Immunopathol Pharmacol. 2016 Dec;29(4):707-711. doi: 10.1177/0394632016652412. Epub 2016 Jun 7.

Abstract

We reported a case of an 11-year-old girl admitted to our hospital for goiter, tachycardia, sweating, and visible and palpable thyroid. Thyroid function tests revealed a low thyrotropin level (<0.004 mIU/L) and elevated free thyroxine level (3.4 ng/ dL) diagnosed with Graves' disease and treated with methimazole. This anti-thyroid drug is recommended as first-line treatment in children with Graves' disease because it produces minor adverse effects with respect to propylthiouracil. She developed a lateralized exanthem mimicking figurate inflammatory dermatosis of infancy after methimazole therapy. The symptoms resolved after discontinuation of methimazole and treatment with an antihistamine and a corticosteroid. Furthermore, the treatment was changed to propylthiouracil without any adverse effects. According to current literature this is the first case of cutaneous figurate erythema related to methimazole, different from other well-known reactions such as skin eruption or urticaria.

Keywords: Graves’ disease; adverse drug reactions; cutaneous figurate erythema; methimazole.

Publication types

  • Case Reports

MeSH terms

  • Child
  • Exanthema / chemically induced*
  • Female
  • Graves Disease / drug therapy
  • Humans
  • Inflammation / chemically induced*
  • Methimazole / adverse effects*
  • Methimazole / therapeutic use
  • Skin Diseases / chemically induced*
  • Thyroid Gland / drug effects

Substances

  • Methimazole