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October 1993

Widespread Erythematous Scaly Plaques in an Adult

Author Affiliations

Tel Aviv (Israel) Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University

Arch Dermatol. 1993;129(10):1333-1334. doi:10.1001/archderm.1993.01680310103020

REPORT OF A CASE  A 58-year-old man was referred to us because of a widespread papulosquamous eruption.His history included mild diabetes for 12 years for which he had been receiving glyburide (15 mg/d) and metformin (850 mg/d). Three years ago, he had a myocardial infarction and began receiving acetylsalicylic acid (325 mg/d) and dipyridamole (75 mg three times daily). Oral quinidine bisulfate in sustained-action tablets had been added to therapy 1 month before admission for the management of premature ventricular contractions.On examination, erythematous scaly plaques were noted on his trunk and extremities (Figure 1). A biopsy specimen of a plaque showed focal parakeratosis and absence of granular cells at these areas, elongation of the rete ridges and the papillae with dilated capillaries within them, and a perivascular infiltrate composed of lymphocytes in the dermis (Figure 2).What is your diagnosis?

DIAGNOSIS:  Psoriasiform eruption induced by quinidine.

CLINICAL COURSE  Since an adverse reaction to quinidine had been suspected, he was instructed to discontinue this therapy. The lesions

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