A Patient Undergoing Dialysis Presents With a New-Onset Rash Involving the Whole Body

The Patient Takes Multiple Medications Including Allopurinol

A 60-year-old person who is undergoing dialysis presents with a new onset rash involving the whole body. It is non-blanching, pruritic, and painful. They finished a course of augmentin three days ago. What do you think is the cause?

Emergency medicine physician: “The culprit in this case is allopurinol> thrombocytopenia, petechiae + pruritus + toxic epidermal necrolysis, toxic pustuloderma”

Family medicine physician: “Presumably he’s been taking allopurinol for a long time — why would the pustuloderma suddenly appear now?”

Emergency medicine physician: “Side effects can happen with any medication at any time even if they have been taking it without any problems for 20 years.”

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