Atenolol-Induced Pustular Psoriasis

To the Editor.—  Beta-blocking agents may cause psoriasiform eruptions and worsen existing psoriasis.^1-4 In a recent review of β-blocker-related psoriasiform eruptions 39 of 59 cases occurred in patients with no history of psoriasis.¹ Pustular eruptions are relatively rare with only 1 of 59 cases reviewed by Abel et al¹ and 6 of 16 cases reported by Heng and Heng being of this type.²Recently, Heng and Heng² described the first case of an atenolol-induced pustular psoriasis in a patient with no history of psoriasis. We report two additional cases of atenolol-induced pustular psoriasis.

Report of Cases.—Case 1.—  A 50-year-old Hispanic woman with diabetic renal disease was treated with hemodialysis and atenolol beginning on September 19,1988. She had no history of psoriasis. Her other medications were hydralazine, metolazone, and insulin. On September 27, she noted an eruption on the right medial aspect of the