Acute generalized exanthematous pustulosis due to etodolac in a patient with an iliopsoas muscle abscess.

© 2011 The Authors. doi: 10.2340/00015555-1116 Journal Compilation © 2011 Acta Dermato-Venereologica. ISSN 0001-5555 Acute generalized exanthematous pustulosis (AGEP) is a disease characterized by the rapid onset of numerous small, non-follicular, sterile pustules on an erythematous base associated with oedema, which usually begins in intertriginous areas (1). Fever over 38oC and peripheral blood leukocytosis are often present in these patients. AGEP is usually attributed to systemic drugs, mainly antibiotics. Sidoroff et al. (2) proposed a validation score based on morphological and histological criteria as well as on the disease course. Etodolac, a non-steroidal anti-inflammatory drug (NSAID) with potent cyclo-oxygenase type 2 (COX-2) inhibition, is widely used in the treatment of patients with osteoarthritis due to a more favourable therapeutic index compared with other NSAIDs. We report here a case of AGEP caused by etodolac in a 70-year-old Japanese man, which was confirmed by the lymphocyte transformation test (LTT) in vitro. Although there have been previous reports of AGEP induced by selective COX-2 inhibitors (3–7), to the best of our knowledge, this is the first case of AGEP caused by etodolac.