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Correspondence | July 2011

Acute Generalized Exanthematous Pustulosis Induced by Methylphenidate: A New Adverse Effect

Lucie M. Heinzerling, MD, PhD, MPH; Werner Pichler, MD; Mark D. Anliker, MD

Arch Dermatol. 2011;147(7):872-873. doi:10.1001/archdermatol.2011.179.

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Methylphenidate hydrochloride (Ritalin; Novartis, Basel, Switzerland or Concerta: Johnson & Johnson, New Brunswick, New Jersey) is considered a safe drug for children with attention-deficit/hyperactivity disorder (ADHD). Generally, adverse effects include insomnia, gastrointestinal symptoms, or cardiovascular effects with rare reports of maculopapular eruption, urticaria, and alopecia.

Correspondence: Dr Heinzerling, Department of Dermatology, University Hospital Erlangen, 90152 Erlangen, Germany (lucie.heinzerling@uk-erlangen.de).

Financial Disclosure: None reported.

Additional Contributions: We thank Heinrich Otremba, MD, for referring his patient to our clinic and for his continued good cooperation, and Michael Mayer, MD, for referring control patients for the LTT.

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Figure 1. Clinical picture of cutaneous manifestation of acute generalized exanthematous pustulosis. Typical lesions are multiple pustules on erythematous skin.

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Figure 2. Biopsy specimen showing intracorneal pustule with granulocytes enclosed (thick arrow). Exocytosis of leukocytes into the epidermis can also be seen (thin arrows) (hematoxylin-eosin, original magnification ×400).

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Heinzerling LM, Pichler W, Anliker MD. Acute Generalized Exanthematous Pustulosis Induced by Methylphenidate: A New Adverse Effect. Arch Dermatol. 2011;147(7):872-873. doi:10.1001/archdermatol.2011.179.

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