A Case Report of Drug-Induced Exfoliative Erythroderma

Case Report

Abstract

Exfoliative erythroderma is a severe cutaneous reaction characterized by widespread erythema and scaling affecting more than 90% of the body surface area. This case report describes a 46-year-old patient who developed generalized itchy, raised scaly lesions and lower limb edema following concurrent administration of itraconazole and prednisone for fungal infection and rheumatoid arthritis, respectively. The patient presented with erythematous, pruritic, and maculopapular lesions, accompanied by generalized pitting edema predominantly affecting the lower extremities. Initial assessment revealed stable vital signs without systemic involvement, while detailed skin examination showed characteristic scaling and erythema. Comprehensive laboratory investigations, including complete blood count, renal and hepatic function tests, were conducted to evaluate the extent of involvement. Discontinuation of both itraconazole and prednisone was implemented as the primary intervention, followed by supportive management with antihistamines and topical corticosteroids. The patient showed significant improvement within weeks of drug discontinuation, with complete resolution of cutaneous manifestations and edema. This case highlights the importance of recognizing drug-induced exfoliative erythroderma as a potential adverse reaction to commonly prescribed medications and emphasizes the need for prompt identification and management to prevent complications