Volume 100, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Praziquantel is widely used for treating parasitic infections globally, especially in countries with endemic schistosomiasis. However, severe hypersensitivity to praziquantel has rarely been reported. We report the case of a 30-year-old Japanese man who developed acute generalized exanthematous pustulosis (AGEP), which is a rare and severe cutaneous reaction usually triggered by drugs, after taking praziquantel. During medical examination, eggs of were found in his stool. He took praziquantel 600 mg for 1 day and developed skin rashes and fever the next day. Pruritic generalized maculopapular erythematous eruptions were observed over the entire body. He had elevated white blood cell count, liver enzymes, and C-reactive protein level. We prescribed acetaminophen, fexofenadine hydrochloride, loxoprofen sodium, and topical ointments including difluprednate and hydrocortisone. Over the next 3 days, he developed pinhead-sized, non-follicular pustules on his diffusely erythematous skin. Histological findings of the pustular lesion showed spongiform subcorneal pustules with perivascular inflammatory cells. Approximately 8 days after taking praziquantel, the pustules resolved with desquamation. He became afebrile on day 9 and his laboratory parameters returned to normal levels on day 16. He was diagnosed with AGEP caused by praziquantel. Physicians need to be aware that praziquantel could cause AGEP, although it is generally considered a safe drug.


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  1. Lee JM, Lim HS, Hong ST, , 2011. Hypersensitive reaction to praziquantel in a clonorchiasis patient. Korean J Parasitol 49: 273275. [Google Scholar]
  2. Shen C, Choi MH, Bae YM, Yu G, Wang S, Hong ST, , 2007. A case of anaphylactic reaction to praziquantel treatment. Am J Trop Med Hyg 76: 603605. [Google Scholar]
  3. Kyung SY, Cho YK, Kim YJ, Park JW, Jeong SH, Lee JI, Sung YM, Lee SP, , 2011. A paragonimiasis patient with allergic reaction to praziquantel and resistance to triclabendazole: successful treatment after desensitization to praziquantel. Korean J Parasitol 49: 7377. [Google Scholar]
  4. Huang SW, , 1992. A clinical approach to a patient with praziquantel hypersensitivity. J Allergy Clin Immunol 90: 867. [Google Scholar]
  5. Liu T, , 1984. Allergic manifestation after pyquiton treatment of schistosomiasis [in Chinese]. J Parasitol Parasit Dis 2: 192203. [Google Scholar]
  6. Roujeau JC, 1991. Acute generalized exanthematous pustulosis. Analysis of 63 cases. Arch Dermatol 127: 13331338. [Google Scholar]
  7. Sidoroff A, Halevy S, Bavinck JN, Vaillant L, Roujeau JC, , 2001. Acute generalized exanthematous pustulosis (AGEP)—a clinical reaction pattern. J Cutan Pathol 28: 113119. [Google Scholar]
  8. Ingen-Housz-Oro S, Hotz C, Valeyrie-Allanore L, Sbidian E, Hemery F, Chosidow O, Wolkenstein P, , 2015. Acute generalized exanthematous pustulosis: a retrospective audit of practice between 1994 and 2011 at a single centre. Br J Dermatol 172: 14551457. [Google Scholar]
  9. Choi MJ, Kim HS, Park HJ, Park CJ, Lee JD, Lee JY, Kim HO, Park YM, , 2010. Clinicopathologic manifestations of 36 Korean patients with acute generalized exanthematous pustulosis: a case series and review of the literature. Ann Dermatol 22: 163169. [Google Scholar]
  10. Alniemi DT, Wetter DA, Bridges AG, El-Azhary RA, Davis MD, Camilleri MJ, McEvoy MT, , 2017. Acute generalized exanthematous pustulosis: clinical characteristics, etiologic associations, treatments, and outcomes in a series of 28 patients at Mayo Clinic, 1996–2013. Int J Dermatol 56: 405414. [Google Scholar]
  11. Manzano S, Guggisberg D, Hammann C, Laubscher B, , 2006. Acute generalized exanthematous pustulosis: first case associated with a Chlamydia pneumoniae infection. Arch Pediatr 13: 12301232. [Google Scholar]
  12. Ofuji S, Yamamoto O, , 2007. Acute generalized exanthematous pustulosis associated with a human parvovirus B19 infection. J Dermatol 34: 121123. [Google Scholar]

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  • Received : 18 Oct 2018
  • Accepted : 26 Nov 2018
  • Published online : 21 Jan 2019

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