Identification of Possible Causative Agents in a Polymedicated Patient Presenting With Toxic Epidermal Necrolysis

Pregabalin-induced delayed cutaneous hypersensitivity reaction occurring after 40 days of use: a case report

Pregabalin is the first-line treatment for neuropathic pain. Cases of cutaneous hypersensitivity reactions caused by pregabalin generally occur within 2 weeks of initiating medication. We report a rare case of a delayed cutaneous hypersensitivity reaction caused by pregabalin, which was confirmed by a drug provocation test. A 72-year-old man with severe herpes zoster neuralgia developed maculopapular drug eruption covering 80% to 90% of his total body surface area after 40 days of combined multidrug analgesia. A drug provocation test for pregabalin was positive. The time interval between initiating medication and the onset of the patient's rash was the longest and he also had the largest area of skin affected compared with patients with a similar condition in previous related reports. Remaining vigilant for possible adverse cutaneous hypersensitivity reactions during treatment is important because of the long-term course of pregabalin treatment for neuropathic pain.

Pregabalin Induced Maculopapular Eruption in an Elderly Male

Pregabalin is used in the treatment of neuropathic pain of various etiologies and as adjuvant in epilepsy. Blockade of the α2δ subunit of L and N type Ca-channels is its main mechanism of neurotropic action. Compared to other antiepileptics like phenytoin, valproate and lamotrigine, and other neuropathic pain medications such as amitriptyline and duloxetine, pregabalin has a relatively favorable safety profile and hence is a drug of choice for many geriatricians. Here we describe a case of maculopapular rash induced by pregabalin in an elderly man which resolved with withdrawal of the offending drug and conservative management. We have also conducted a literature review of similar cases and highlight the clinical patterns and management strategies for pregabalin induced skin rashes.