A 61-year-old female patient was admitted to internal medicine department for renal colic. She had no history of psoriasis or any other skin disorder. The patient had a history of long-standing arterial hypertension for 3 years treated with captopril, indapamide, nifedipine, and diabetes mellitus for 3 years treated with glibenclamide, glimepiride, and dyslipidemia treated with simvastatin. She was given oral piroxicam 20 mg/day by her primary care physician for treatment of renal colic.
There were no other medications prior to starting piroxicam. At 4 days after starting oral piroxicam, she developed a generalized itchy eruption consisting of multiple papules that sometimes coalesced to larger and scaly plaques, on a background of widespread erythema with associated multiple 2-3 mm pustules (image attached). Examination The remaining physical examination was normal. Her white blood…
