A case of tripterygium glycosides-associated AGEP-like drug reaction combined with bullous pemphigoid

Dermatol Ther. 2021 Jul;34(4):e15012. doi: 10.1111/dth.15012. Epub 2021 Jun 10.

Abstract

Acute generalized exanthematous pustulosis (AGEP) is a severe cutaneous drug reaction. Bullous pemphigoid (BP) is an acquired autoimmune disease that might be associated with drugs. There is currently no report of tripterygium glycosides (TG)-induced AGEP-like lesions combined with BP. A 66-year-old male with a 20-year history of psoriasis was prescribed oral TG at 1 mg/kg, three times a day, due to aggravated psoriasis. Seven days later, erythemas, and blisters appeared. After another 3 days, there were two types of blisters: (1) numerous small tension blisters with a lot of neutrophils on the top similar to AGEP combined with BP; (2) a BP. After intravenous injection of methylprednisolone and gamma globulin, the lesions were controlled. This patient developed two types of lesions, including one similar to AGEP combined BP (AGEP-like) and a BP. It is a rare drug reaction induced by TG.

Keywords: acute generalized exanthematous pustulosis; drug-related side effects; pemphigoid bullous; tripterygium.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Generalized Exanthematous Pustulosis*
  • Aged
  • Glycosides / adverse effects
  • Humans
  • Male
  • Pemphigoid, Bullous* / chemically induced
  • Pemphigoid, Bullous* / diagnosis
  • Pemphigoid, Bullous* / drug therapy
  • Pharmaceutical Preparations*
  • Tripterygium

Substances

  • Glycosides
  • Pharmaceutical Preparations