phenobarbital-induced dress: a lichenoïd picture.

we describe, the first case of phenobarbital-induced dress syndrome presenting as a lichenoïd eruption. a 49-year-old man had received phenobarbital for a cerebral metastasis. twenty-five days later, he developed a purplish skin eruption, odynophagia, oral mucosal erosion and fever. physical examination revealed a cervical lymphadenopathy and facial edema associated to a diffuse violaceous maculo-papular itchy rash. laboratory findings showed a 1200/mm³ eosinophil's cell count. alanine aminotransferase was 169 iu/l. lactate dehydrogenase and creatinine phosphokinase were at 768 and 90 iu/l, respectively. all symptoms resolved completely five weeks after phenobarbital withdrawal. few days later, the patient died because of a cardio-respiratory arrest.