Severe erythema multiforme caused by sodium ozagrel

A 78-year-old male patient with cerebral infarction received an IV infusion of ozagrel sodium 40 mg twice daily. On day 2,the patient developed purple rash with itching on his feet and left groin. A review of his medical history revealed that he had similar symptoms after taking ozagrel sodium 2 years ago. Ozagrel sodium was withdrawn and anti-allergic therapy was given. On day 3 of ozagrel sodium withdrawal, purple rash occurred on his hands and right groin. He was given an IV infusion of methylprednisolone 40 mg once daily and oral chlorphenamine 4 mg once daily. His symptoms gradually exacerbated, on day 5, the patient presented with blister on the rash and oral-mucosal erosion. It was diagnosed as erythema multiforme induced by drug. Methylprednisolone administration was changed to a 40 mg IV infusion twice daily. Three days later, his erythema was lighter in color than before and no new rashes occurred. Methylprednisolone was stopped. Two days after methylprednisolone withdrawal, the patient experienced aggravated eruption on left foot with pain and a high temperature of 39℃. Methylprednisolone 40 mg twice daily was administered again. Three days later, the temperature declined to normal. Eight days later, the rash on the feet, hands, and the groin basically subsided, the pain and itching disappeared, the blister became scabby or exfoliated and the oral mucosa erosion healed. Methylprednisolone was switched to oral prednisone and the dose was reduced each week until the drug stopped. Two weeks after prednisone discontinuation, the rashes disappeared completely. Key words: Ozagrel; Erythema multiforme; Aged