Cutaneous and ocular toxicology
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Case Reports
Acute generalized exanthematous pustulosis with lymphangitis triggered by a spider bite.
Acute generalized exanthematous pustulosis (AGEP) is a rare, severe cutaneous reaction pattern that, in the majority (>90%) of cases, is related to administration of medication. It can be seen in both genders and in all ages. The cutaneous manifestations of AGEP are usually seen 1-14 days after drug administration. ⋯ Because there was no drug use in her history, we attributed her AGEP lesions to the spider bite. This case is interesting, because the patient also had lymphangitis. Herein, we present the fifth case reported in the literature of AGEP caused by a spider bite.
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Nicolau syndrome is rare cutaneous adverse reaction following injection of various drugs. The disease has been associated with almost all classes of medications, such as nonsteroidal anti-inflammatory drugs, local anesthetics, corticosteroids, antibiotics, vitamin B complexes, antihistamines, and vaccines. ⋯ Subcutaneous injection is an important factor in the pathogenesis of the syndrome. We report a case of Nicolau syndrome resulting from intramuscular injection of diclofenac and discuss some precautions to prevent this complication.