Case report: Vancomycin induced exfoliative dermatitis

Abstract

Drug rashes, exfoliative dermatitis is a condition of inflammatory skin and causes red rashes with peeling scabs across the body, spreading more than 90% of skin area. The massive peeling skin can cause a patient to lose high amount of water and protein, which can be severe to shock condition. It is believed that the condition is caused by a medication, a former skin condition, or a disease in the body, especially cancer. However, in some cases, there is no known cause. Skin peeling is caused by expansion of cells in the skin and faster skin exfoliation. Drug rashes regularly causes by the allergy to pain relief and antibiotic medicine such as sulfonamides, penicillin, NSAIDs, allopurinol, from taking those medicine for 1 – 14 days (faster or slower). Exfoliative dermatitis from vancomycin less found. The study shows few case reports. In Thailand, there are 42 case reports of exfoliative dermatitis from vancomycin. This case report is about a patient with drug rashes, exfoliative dermatitis, which is caused by an allergy to vancomycin in treating large abscess at right thigh. The patient has been examined by Naranjo Algorithm and found out that this patient got drug rash, exfoliative dermatitis, at a level of probable from taking vancomycin.