Griseofulvin-induced Drug Toxicoderma in a Child: An Unusual Case

Introduction: Griseofulvin is an antifungal known to be a cause of toxidermias. It is frequently prescribed especially in pediatrics, however it can have serious adverse effects, as we show through an observation.

Observation: We present a first case of drug-induced drug eruption type maculo-papular erythema induced by griseofulvin. This is a 10-year-old girl followed for ringworm of the scalp for 1 month, was placed on griseofulvin for 15 days ago. She was hospitalized for febrile rash made up of erythematous, papular and pruritic lesions. She also had ringworm of the scalp. The clinical examination showed a fever of 39ºC, an altered general condition with submandibular lymphadenopathy. Skin examination revealed maculopapular erythema on the face, trunk and limbs with edema of the upper lip. griseofulvin was stopped and replaced by terbinafine, intravenous antihistamine treatment combined with corticosteroid therapy was initiated. The resolution was rapidly favorable.

Conclusion: Clinicians should be aware of the possibility of an erythema maculopapular-like reaction associated with griseofulvin treatment and consider this possibility when choosing between griseofulvin and newer, more expensive drugs. The molecule of griseofulvin is widely used outside its indications and as the benefit/risk balance then pleads largely against it.